Introduction: Despite the efforts and support of the World Health Organization and other international organizations to reduce the incidence of the disease, tetanus is still an acute condition with serious consequences, including death. The purpose of this study was to assess the tetanus patients we have been monitoring over the past two years in Somalia, a country with a protracted civil conflict, extreme poverty, and restricted access to hospital, social security, and public health facilities. Methods: This study includes tetanus patients who were admitted to the Recep Tayyip Erdoğan Training and Research Hospital in Mogadishu, Somalia, Turkey between January 1, 2022, and November 1, 2023. Hospitalization, diagnosis, treatment, complications, death, and test results were all looked at in addition to the patients’ sociodemographic details. Results: The average age of the 196 patients was 10 years, with males making up 67.9% of the total (min-max: 7 days-71 years). Acute injury was the cause of 53.1% of tetanus cases, with the legs being the most frequently injured body area (28.8%). A mean duration of stay of 11 days was observed for 82.1% of the patients who were monitored in the hospital (min-max: 1– 38 days). The total fatality rate was 14.3%, and 85.7% of patients had never had a tetanus vaccination. The group with severe tetanus had higher rates of intensive care admission (p< 0.001), generalized/neonatal tetanus (p< 0.001), high non-vaccination rate (p:0.011), antibiotic usage (p< 0.001), and a positive blood culture (p< 0.001). Almost all of the complications (p< 0.001) and all of the deaths (p< 0.001) were in the severe group. Conclusion: In sub-Saharan Africa, immunization rates are regrettably still insufficient despite the tetanus vaccine’s low cost and great effectiveness. Public education and encouragement on anti-vaccination must continue alongside the enhancement of vaccination programs. Otherwise, low- and middle-income countries will still be plagued by this illness, which has been overlooked in high-income nations.

Introduction: Historically, antimicrobials have been used to treat microbial illnesses in humans and animals. But throughout this time, antibiotics that had been successful against particular microorganisms started to lose their effectiveness due to rising inappropriate use brought on by ignorance, negligent attitudes, and improper methods. Our goal in conducting this study was to ascertain the knowledge, attitudes, and practices of doctors with relation to the use of antibiotics in light of the growing global and Sub-Saharan African problem of antimicrobial resistance. Methods: In a tertiary hospital in Mogadishu, Somalia, a cross-sectional survey study was carried out to assess experts’ and research assistants’ knowledge, attitudes, behavior, awareness, and practices regarding the use of antibiotics and antibiotic resistance. A questionnaire consisting of 2 sections and 22 questions was applied to the participants on a voluntary basis. Results: Among the 202 doctors that participated in the study, 49 (24.3%) were specialists, and 153 (75.7%) were assistants. Prescriptions for one to ten antibiotic boxes per week on average were reported by 146 respondents (72.3%). Of the physicians, just 27 (13.4%) did not require assistance when prescribing an antibiotic. The most often accessed sources of support were experts in infectious diseases (43.1%) and national/international antimicrobial guidelines (32.2%). The top three factors contributing to antibiotic resistance in Somalia include misuse of antibiotics (61.4%), unnecessary prescriptions written by doctors (44.6%), and an absence of infectious disease specialists in most institutions (44.1%). Conclusion: As an alarming level of antimicrobial resistance has been observed globally in recent years, the results of our survey will help educate our doctors by gauging their perceptions, attitudes, and knowledge about rational antibiotic use in Sub-Saharan Africa. This will provide better patient outcomes.

Background: Hepatitis E virus is a re-emerging pathogen with an increase in human cases that can lead to chronic infection in immunosuppressed patients. Turkey is located between Asia and Europe, 2 regions with distinct epidemiological and clinical features of hepatitis E virus infection. This multicenter cross-sectional study aimed to investigate the prevalence of hepatitis E virus infection in liver and kidney transplant recipients in Turkey and to determine the role of possible transmission factors. Methods: A total of 485 plasma samples of solid organ recipients were collected from 7 transplantation centers in Turkey. Samples were tested for anti-hepatitis E virus immunoglobin M, immunoglobin G, and hepatitis E virus ribonucleic acid. Water- and food-related risk factors were evaluated by a questionnaire. Results: Samples of 300 kidney and 185 liver recipients were collected. Hepatitis E virus ribonucleic acid was tested in 472 samples and none were positive. Anti-hepatitis E virus immunoglobin G and immunoglobin M were detected in 84 (17.3%) and 3 (0.6%) patients, respectively. Seropositivity was associated with older age, male gender, being a liver recipient, and being infected with hepatitis B virus and/or hepatitis C virus. None of the patients under the age of 30 were seropositive. Hepatitis E virus immunoglobin G prevalence was higher in the Central East and Southeast Anatolia. Eating raw meat was the only independent variable associated with hepatitis E virus seropositivity. Conclusion: This is the first prevalence study of hepatitis E virus infection in solid organ recipients in Turkey. Anti-hepatitis E virus immunoglobin G prevalence was 17.3% which was higher than the previously reported rate in blood donors. Seropositivity was significantly higher in liver recipients. Despite the high antibody prevalence, none of the patients were viremic.

Introduction. COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods. Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan–Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results. A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383–8.625; ), procalcitonin levels (HR 3.083; 95% CI 1.158–8.206; ), and lower oxygen saturation (HR 4.121; 95% CI 2.018–8.414; ) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216–6.487; ), lower platelet count (HR 2.269; 95% CI 1.012–5.085; ), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201–4.651; ) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions. IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes.

Mass casualty incidents, such as explosions and gunshot wounds (GSWs), pose significant public health challenges. This study analyzes the clinico-epidemiological profile and outcomes of patients with explosive injuries and GSWs in Somalia. A retrospective analysis was conducted on 225 patients admitted to the Emergency Department of a tertiary hospital in Somalia between January and December 2021. Data collected included injury type, anatomical distribution, demographics, hospital admissions, and outcomes. Of the 225 explosion and GSW injuries, explosive injuries accounted for 58 %, while GSWs made up 42 %. The majority of patients were male (85.3 %), with 89.5 % in the GSW group and 82.3 % in the explosion group. More than half(58.7 %) of the patients were aged 18 to 30 years, with 59.2 % in the explosion group and 57.9 % in the GSW group. Anatomical analysis revealed that head injuries were most common(21 %), particularly in explosion cases, as well as higher rates of head (26.2 %), maxillofacial(7.7 %), and lower-limb injuries (12.3 %) compared to GSW patients. Some 21.7 % of patients were discharged from ED, 19 % admitted to ICU and an inpatient death rate of 12.9 %, including three patients (1.3 %) who died in the Emergency Department, all from the explosion injury group. The rising incidence of traumatic injuries necessitates a multifaceted approach, including enhanced emergency response systems and public health initiatives. This data serves as a call to action for healthcare providers and policymakers to prioritize the management and prevention of explosion and gunshot-related injuries in Somalia.

Background/Objectives: Türkiye is located at the intersection of major international migration routes and plays a critical role in global migrant health. The growing immigrant and refugee population has introduced new challenges to healthcare systems (HCSs), particularly in emergency departments (EDs). This study aims to address a gap in the literature by evaluating the reasons foreign nationals present to the ED, their diagnostic distribution, and access to healthcare services in relation to sociodemographic characteristics. Methods: This retrospective study included foreign nationals who presented to the Emergency Department of Balikesir University Hospital between January 2020 and June 2025. Sociodemographic and clinical data were obtained from the hospital information management system. Data analysis was performed using IBM SPSS Statistics 27.0. Descriptive statistics were used to summarize demographic and clinical characteristics, including gender, nationality, admission period, diagnosis groups, laboratory testing, consultations, and patient outcomes. Results: A total of 6366 foreign nationals were included. Of these, 66.4% were female and 33.6% were male, with a mean age of 31.9 years for females and 26.8 years for males. Syrians constituted the largest group (50%). ED visits occurred most frequently in spring (30.1%) and peaked in 2024. The majority of patients (99.3%) were managed as outpatients. The most common diagnoses were internal medicine-related conditions (36.1%) and genitourinary emergencies (32.2%). Consultations were most frequently requested from the obstetrics and gynecology department (21.2%). Overall, 92.9% of patients were discharged from the ED. Conclusions: The findings suggest that foreign nationals often use emergency services as an alternative to primary healthcare. Low rates of laboratory and imaging utilization indicate that most ED visits were for non-urgent and uncomplicated conditions. Factors such as language barriers, communication difficulties, prolonged observation times, and limited social support may contribute to this pattern. This study provides comprehensive local data on the emergency care utilization of foreign nationals in Türkiye and offers valuable insights for healthcare planning and policy development.