In the Gaza strip, diarrhea is one of main reasons for children visiting primary healthcare centers. Hence, we investigate predictors of the diarrheal illness and health care-seeking behavior among different age groups. This community-based cross-sectional survey was conducted from August 2017 to June 2018 among 1857 households. A pretested structured questionnaire included information about socio-demographic, sanitation, hygiene, source of water, diarrheal illness, and seeking healthcare in households was administered to head of household. To achieve representativeness for the five Gaza’s governorates, a cluster random sampling was applied. Of the 1857 household’s heads, 421 (22.7%) reported an episode of diarrhea during the 48 h preceding the interview resulting an overall prevalence rate of 3.8 per 100 individuals. The prevalence of diarrhea was statistical significant greater in males (5.4/100) compared to females (1.3/100) in all age groups (p < 0.05). Socio-demographic, economic, water, sanitation, and hygiene factors were predictors of the diarrheal illness and seeking of non-professional healthcare for diarrhea illness treatment among. A transition behavior from professional to non-professional and vice versa in seeking healthcare in each diarrheal episode was found. We recommend improving the status of water, sanitation, and hygiene in the Gaza strip’s households to reduce diarrhea among the population of Gaza strip. Community sensitization about the importance of seeking care at primary health centers because treatment of children is available for free or in low costs.

Objectives: Several factors have changed interactions between people, animals, plants, and the environment – renewing the relevance of the One Health surveillance system in the fight against zoonotic diseases such as COVID-19. Therefore, this study aimed to explore barriers to implementing an integrated One Health surveillance system in Palestine. Methods: This qualitative study was conducted from April 2020 until August 2020. Data were collected using semi-structured interview guides. Seven key stakeholders were interviewed during data collection. A thematic analysis was performed. Results: Four overarching themes emerged explaining barriers to integrated implementation of the One Health surveillance system. They are lack of policy coherence, limited financial resources, poor governance and leadership, and lack of One Health training programmes. Conclusion: Improved understanding of the transmission and effective control (including One Health approach) of zoonotic disease and better governance and leadership are critical in the diseases that threaten public health, such as the COVID-19.

Objective: Evidence shows that anemic individuals are at a higher risk of hearing loss. However, there is no systematic review and meta-analysis study. Thus, we aimed to meta-analyze the existing evidence on the association of iron deficiency anemia (IDA) with sensorineural hearing loss (SNHL). We searched PubMed, MEDLINE, Embase, Scopus, and Google Scholar from inception through October 30, 2017, for studies done on the association of the IDA with SNHL. Pooled odds ratio (OR) was calculated by random effect meta-analysis method. Heterogeneity was assessed by I² metrics. Result: Four studies, covering a total of 344,080 adults and children, were included. The odds of SNHL was higher by 55% in individuals with IDA, compared with individuals without IDA (OR = 1.55, 95% CI 1.17–2.06; P = 0.03). The age-specific ORs were 1.36 (95% CI 1.15–1.61; P = 0.27) and 3.67 (95% CI 1.72–7.84) for adults and children, respectively. IDA may be a contributing factor to hearing loss. Further studies are warranted, including whether IDA treatment reduces the risk of hearing loss. Meanwhile, hearing loss screening in anemic individuals, or vice versa, may represent an important consideration. PROSPERO registration CRD42017082108

Background: This study aims to assess the prevalence and associated factors of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) among children in this region during a period of conflict.Methods: A cross-sectional study was conducted with a sample of 1,200 children under 5 years old, selected through stratified random sampling from three governorates in the Gaza Strip. Data were collected using structured interviews and physical examinations, including Mid-Upper Arm Circumference (MUAC) measurements to determine nutritional status based on established cut-off points. Statistical analyses were performed using IBM-SPSS, version 26.Results: Among the 1,200 children screened, 605 (50.8%) were males and 595 (49.2%) were females. The age distribution of the children screened showed that 48.4% (n = 581) fall within the range of 6 months to <24 months category and 51.6% (n = 619) fall within the range of 24–60 months. Overall, 58.3% of children live in schools, 26.6% live in houses, and 15.1% reside in tents. The overall prevalence of malnutrition across all regions was 16.6%, including 6.7% with SAM and 9.7% with MAM. The prevalence of SAM is highest in North Gaza and South Gaza (both at 6.8%) and slightly lower in the Middle Zone (6.5%). For MAM, the highest prevalence is in South Gaza (11.5%), with Middle Zone showing the lowest rate (7.3%). Logistic regression analysis indicated that children living in houses had a higher likelihood of SAM (OR = 2.36; 95% CI = 1.39–3.99) and MAM (OR = 1.44; 95% CI = 1.13–1.84), and children living in schools had a higher likelihood of SAM (OR = 2.79; 95% CI = 1.35–5.74) and MAM (OR = 2.08; 95% CI = 1.14–3.80) compared to those in tents. Notably, children residing in North Gaza were significantly more likely to experience SAM (OR = 13.2; 95% CI = 6.23–27.95) and MAM (OR = 10.51; 95% CI = 5.74–19.3) compared to those in South Gaza.Conclusion: The study highlights a high prevalence of malnutrition among children under five in the Gaza Strip, particularly among those living in houses, shelters and in the North Gaza governorate. These findings underscore the urgent need for targeted nutritional interventions and support for affected families in conflict zones.

The Gaza Strip has been enduring a severe humanitarian crisis due to prolonged conflict, blockade, and systemic instability, resulting in the collapse of its healthcare system. To explore the impact of healthcare collapse on the spread of infectious diseases in Gaza, focusing on the challenges faced by healthcare workers, the barriers to disease management, and the coping mechanisms employed by the community. In this qualitative research, semi-structured interviews and focus group discussions with healthcare professionals, humanitarian workers, and community members in the Gaza Strip were utilized. In total, 30 interviews were conducted with healthcare professionals and humanitarian workers, and 6 focus group discussions (FGDs) with community members were held in three different locations across the Gaza Strip. Each interview lasted approximately 45–60 min, and FGDs ranged from 60 to 90 min. All interviews and discussions were audio-recorded with participants’ consent. The semi-structured interview guide used in this study was specifically developed by the research team to address the study’s objectives. The guide was informed by a review of relevant literature and expert input to ensure comprehensiveness. An English-language version of the interview guide has been provided as a Supplementary File 1. Descriptive themes of participant experiences to identify key challenges and patterns related to the collapse of the healthcare system and its impact on infectious disease spread. The study found that the collapse of healthcare infrastructure in Gaza could have exacerbated the spread of infectious diseases, as it created conditions that may have increased the risk of transmission. Key challenges included severe shortages of medical supplies and equipment, overcrowded healthcare facilities, and inadequate sanitation and hygiene conditions. These issues were compounded by the psychological stress and burnout experienced by healthcare workers. The lack of effective disease surveillance and delayed international aid further impeded the response to infectious disease outbreaks. Participants reported a reliance on traditional remedies and community networks due to a loss of confidence in the formal healthcare system. The findings underscore the urgent need for comprehensive international support to rebuild Gaza’s healthcare infrastructure and improve disease management. Addressing the shortages of medical supplies, enhancing disease surveillance, and providing psychological support for healthcare workers are critical steps in mitigating the spread of infectious diseases. The study highlights the broader implications of healthcare system collapse in conflict zones and calls for coordinated global efforts to address the underlying issues contributing to public health crises in such settings.