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GFMER Country Coordinators

Khadija Ahmed Matrook

GFMER Coordinator for Gulf Cooperation Council

Khadija Ahmed Matrook

Khadija Ahmed Matrook, RN, MBCBT, CDE, CHES, MPH, PG Dip.
PHD Scholar (Population health), Royal College of Surgeons in Ireland (RCSI)
Khadijahasan@rcsi.com

Ms. Khadija aims to advocate the highest standards of health promotion and research at both academic and clinical levels nationally and internationally. Given to her diverse background in the science of public health; population health; and nursing, combined with the art of anthropology and behavioral therapy, she is keen to integrating the psychosocial aspects within health care dynamics. She worked in academia, research, health education, and nursing.

Khadija is a Fulbright Scholar, Dilmun scholar, Certified Health Education Specialist through the National Commission for Health Education and Credentialing, (NCHEC), USA, Mindfulness Based Cognitive Behavioral Therapist through Stonebridge Associated Collages (SAC), UK. Khadija graduated with Bachelor Degree in Nursing Sciences from CHS in Bahrain, Masters in Public Health (Major in Health Education, Minor in Anthropology) from USM in USA, Post graduate Diploma in health Profession Education from RCSI. Currently, Khadija is doing her PHD in Population Health in RCSI.

Following completing her Masters degree in the United Sates, Khadija participated in the Evidence-Based, Abstinence Approach to Teen Pregnancy, STD, and HIV Prevention, in the Public School Districts. Her work with Sexual and reproductive education with school teenagers increased in her interest in adolescent health, in particular. Khadija had been selected among 15 top awardees at the GFMER Intensive Training Workshop in Geneva. Khadija accumulated great experience working as GFMER country tutor over the last years. This training experience enhanced her motivation towards education in sexual and reproductive health not only from scientific merit but also from cultural relevance scope.

Awards

  • 2009: Awarded the Bahrain Prime Minister Award of Excellence
  • 2011: Awarded Fulbright Scholarship from the Embassy of the United States
  • 2014: Geneva State chancellery travel grant to attend GFMER Training Workshop
  • 2016: Awarded PhD Scholarship from RCSI.

Publications

  • Hussein WI, Hasan K, Jaradat AA. Effectiveness of mobile phone short message service on diabetes mellitus management; the SMS-DM study. Diabetes Res Clin Pract. 2011 Oct;94(1):e24–26.
  • Matrook KA. Care and cost effectiveness of mobile phone intervention among patients with type 1 and type 2 diabetes mellitus. IDF 2015 Vancouver World Diabetes Congress 30 november-4 December, Canada, pp 445.
  • Matrook KA, Bukhallaf A, Din Abdulla A. Exploration of nurse educator experience with teaching and learning in Bahrain. KHUH/RCSI 2016 International Conference, 16-17 November 2016, Bahrain.

Country Situation

Epidemic of STI at national and international levels

According to the Center for Disease Control and Prevention (CDC), Sexually Transmitted Infections (STIs) or Sexually Transmitted Diseases (STDs) is defined as the acquired and transmitted pathogens through sexual activities that can lead to infections and clinical syndromes (Center for Disease Control and Prevention 2015). STIs are ongoing challenge across the geographical and life spans. STDs including HIV/AIDs are burden over all the countries including Bahrain and other Gulf Cooperation Council (GCC). Its resultant illnesses are socioeconomically hindering the human resource and countries’ infrastructure development.

In 2014, it was estimated that 36.9 million people were living with HIV, with 1.2 million died with AIDS (World Health Organization 2014). Most importantly, 49% of people infected with HIV were unaware about their HIV status which jeopardized the efforts made to control the prevalence of the infection (World Health Organization 2014). In 2010 there was lesser number of people living with HIV compared to 2014. In 2010, 35.3 million people live with HIV/AIDS, and 1.6 million people died from AIDS and its disorders in 2012, although 95 million people were tested for HIV/AIDS worldwide (GHO 2014). Approximately, more than one million people get infected with STIs every day. If STI is not treated it results in long-term physical, psychological, and financial consequences on the infected individual, and on the communities (World Health Organization).The burden of HIV/AIDS varies remarkably from WHO region to another. Sub-Saharan Africa reported the highest HIV rates amongst all regions, as evidence by, being accounted for 71% of people living with HIV worldwide (GHO 2014). The overall HIV prevalence of the Eastern Mediterranean Region was 0.2% in 2014 (Eastern Mediterranean Regional Health System Observatory 2014). Bahrain is part of Eastern Mediterranean region, more particularly one of the GCC. Although the number of reported STIs and HIV/AIDS is not as remarkable as other countries, Bahrain and GCC countries are is not an exception.

In line with the WHO standards, childhood infectious diseases such as measles have been eradicated in Bahrain. Nonetheless, viral infections such as gonococcal infections and syphilis have slightly increased. On the other hand, non-communicable diseases such as cardiovascular diseases, diabetes, chronic respiratory infections, cancer, and injures are the leading causes of death (World Health Organization 2015). With regards to STIs in Bahrain, gonorrhea reported the highest incidence of 73 cases per 100,000 in 2002. The second highest reported STD for the same year was syphilis (36 cases), followed by non-gonococcal urethritis (18 cases), then bacterial vaginosis (14 cases) (MOH 2003). The incidence rate per 100,000 population of notifiable communicable diseases of other and unspecified predominantly STD had increased from 349 in 2008 to 472 per 100,000 population in 2009, then decreased by more than half to reach 155 by 2010, and continued to also reduce by half to reach 78 per 100.000 population ((MOH) 2012). The AIDS incidence rate had increased from 144 in 2008 to 261 in 2009, then moderately decreased to 214 in 2010, and continued to decrease to reach 123 per 100,000 populations in 2011. Following this, the incidence rate increased to reach 147 per 100,000 population in 2012 ((MOH) 2012).

Health system response

Country strategies and current action plan

Bahrain is located in the World Health Organization (WHO) Eastern Mediterranean Region. The past country strategy in terms of health system is summed up in: providing comprehensive health care services for all citizens of Bahrain, with 100% coverage and accessibility (WHO 2014). The current National Health Strategy (2015-2018) will provide health insurance for nationals and expatriate at both private and public sectors (Word Health Organization 2017). The health indicators reflect that health status is classified as advanced, as per the WHO. Public Health Directorate (PHD) under the Ministry of Health (MOH) plays a significant role in controlling and eradicating the spread of communicable disease, such as STDs, through the Disease Control section, Communicable Disease Unit in particular. HIV/AIDS surveillance is part of the National Communicable Disease Surveillance (Bahrain 2014).

Case reporting

Public Health Directorate (PHD) within the Ministry of Health (MOH) is the responsible department for the disease control section, including Communicable Disease Unit, Non Communicable Disease Unit, Immunization Unit, etc. Vital Statistics Unit under the PHD is the responsible department for the communicable diseases’ notification, for instance, STDs (Bahrain 2014). AIDS case reporting is carried out at institutional level from all the hospitals in Bahrain, and then data are aggregated at the MOH level.

STI Surveillance

Bahrain is part of the Gulf Cooperation Council (GCC), where services and activities are integrated and complemented collaboratively among the gulf countries (Bahrain, Oman, Qatar, United Arab Emirates, Kuwait) in line with the WHO standards towards achieving the Millennium Development Goals (MDG) (Bahrain 2014). In a sub-regional meeting held in Muscat in 2003, one of the meeting objectives was to “assess STD burden and develop operational plans for STD surveillance” (MOH 2003). Based on the WHO Strategic Agenda 2012 -2016, it is highly recommended to consider the preparedness for HIV/AIDS surveillance system. Strengthening surveillance can be achieved through appropriately adopting and sustaining the national program of communicable diseases control. In Bahrain, diseases are classified in line with the WHO diseases classification system as per the as per the ICD 10. This can monitor the incidence and prevalence of STDs and analyze the HIV/AIDS situation in Bahrain. Ideologically, this classification system provides standard diagnostic tool for epidemiological statistics, accurate reform of public health policy requirements. For instance, B20–B24 is the incidence rate for AIDS; A63-A64 is the incidence rate for other and unspecified predominantly sexually transmitted diseases not elsewhere classified ((MOH) 2012).

From the Perspective of the MDG 6: 6A: reserve of HIV/AIDS spread by 2015, 6B: providing universal access treatment for all who need, WHO is working collaboratively with all the countries on increasing HIV prevention, supporting HIV prevention campaigns, improving HIV/AIDS monitoring and evaluation, empowering countries in delivering quality HIV/AIDS testing, counselling, education, and treatment, and ensuring safe blood supplies (WHO 2014). Having the MDG as standards can tackle HIV/AIDS incidence, reserve the prevalence of HIV/AIDS cases, and decrease the socioeconomic burden of disease.

Conclusion

Bahrain has started early and became a pioneer among GCC in establishing the National Committee for AIDS Prevention in 1989. Bahrain’s PHD as member of GCC ensures efficient collaboration between its stakeholders and key informants towards achieving strategic agenda. Despite all the efforts spent to reduce the epidemic of HIV infections, STIs remain a global health issues, and Bahrain plus other GCC are not an exception in the trend.

Up to the authors’ knowledge, research studies about STIs and HIV/AIDS in Bahrain is limited. Information about STI can be found mostly from MOH public reports and statistics. Some scattered information can also be found in newspapers’ and social media.

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