This community process evaluation highlights key enabling factors that facilitated the implementation of a community peer education program for youth HIV prevention in four poor and vulnerable areas of Aden, Yemen. It also explains the implementation process and provides a deeper understanding of the impact evaluation outcomes, which revealed improved HIV knowledge and risk perception and decreased stigma and risky behavior. This process evaluation was based on qualitative methodologies, where five focus group discussions and 15 in-depth interviews were conducted among 52 participants: community peer educators, community focal points, targeted young people, and local councils. The results revealed that contributing factors to implementing the peer education program had been community participation, mobilization of targeted communities, and capacity building of all those included in the intervention. Existing community-based organizations like the Social Service Centre played a key role in building trust with the targeted communities and linking HIV peer education intervention to other existing community services. This process evaluation could provide lessons learned for replicating similar youth peer education programs in conservative communities.

Background: The incidence of breast cancer is rapidly increasing in Yemen with recent indications of constituting one-third of female cancers. The main problem in Yemen remains very late presentation of breast cancer, most of which should have been easily recognisable. Since stage of disease at diagnosis is the most important prognostic variable, early diagnosis is an important option to be considered for control of breast cancer in low resourced settings like Yemen. In the present study, we aimed at describing breast cancer knowledge, perceptions and breast self-examination (BSE) practices among a sample of Yemeni women. Materials and Methods: This cross-sectional study covered 400 women attending four reproductive health centres in Aden, Yemen through face-to-face interview using a structured questionnaire during April -July 2014. We collected data on sociodemographic characteristics, knowledge about breast cancer, and screening practices as well as respondents' perceptions based on the five sub scales of the Health Belief Model (HBM): perceived susceptibility; perceived severity; perceived barriers; perceived benefits; and self-efficacy. The response format was a fivepoint Likert scale. Statistical Package for Social Sciences (SPSS 20) was used for statistical analysis. Statistical significance was set at p<0.05. Logistic regression analysis was conducted with BSE as a dependent variable. Results: The mean age of women was 26.5 (S.D=5.6) years. The majority (89.0%) had never ever performed any screening. Two-thirds of respondents had poor knowledge. Perceived BSE benefits and self-efficacy and lower BSE barriers perception were significant independent predictors of BSE practice. Conclusions: Poor knowledge and inadequate BSE practices are prevailing in Yemen. The need for implementing culturally sensitive targeted education measures is mandatory in the effort to improve early detection and reduce the burden of breast cancer.

BackgroundThis article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen. The intervention was developed after a survey among the same population in 2005, which revealed a high level of stigma towards people living with HIV (PLWH) and a low level of HIV knowledge.MethodsIn a quasi-experimental design students who received the peer education intervention (78.6%) were compared with students who did not receive the intervention (21.4%). No systematic procedure was applied in selecting students for the intervention condition. Data were collected using a self-administered questionnaire from a sample of 2510 students from all 27 high-schools in Aden governorate. To increase internal validity, students were also compared with a cohort control sample surveyed in 2005, which was a random sample of 2274 students from the same schools.ResultsSixty eight percent of students targeted by peer education had good knowledge scores, compared with 43.3% of students not targeted by peer education (χ2 = (df = 1) = 111.15, p < .01). Multi-level regression analysis revealed that, although there was a significant difference among schools, the intervention effect of peer education at the individual level was significant; students who received peer education had a statistically higher knowledge score(9.24 out of 12.0) compared with those not targeted (7.89 out of 12.0), OR = 2.11, 95% CI = 1.04-4.27, p < .05). Compared with the 2005 cohort control sample, students targeted by peer education had better knowledge on the modes of transmission and prevention and fewer misconceptions; and knowledge on the use of condoms increased from 49.4% to 67.8%. In addition, students who received the peer education interventions suggested significantly more actions to provide care and support for PLWH. Also, the levels of stigma and discrimination were much higher among the 2005 cohort control group, compared with those who received the peer education intervention.ConclusionThe school-based peer education intervention has succeeded in improving levels of knowledge on modes of transmission and prevention, and in decreasing levels of stigma and discrimination in a culturally conservative setting.

Background In Yemen; initial surveillance of COVID-19 focused primarily on patients with symptoms or severe disease and The full spectrum of the disease are not clear. To the best of our knowledge, this is the first seroprevalence study done in Yemen. Methods It is a one-time cross-sectional investigation among 2000 participants from all age groups from four districts in Aden at southern Yemen. A multi-stage sampling method used. Data collected by using a well-structured questionnaire and blood sample were collected. Healgen COVID-19 IgG/IgM Rapid diagnostic Test (RDT) Cassette was used in all participants. All positive RDTs and 14% of the negative RDTs underwent ELISA test (WANTAI SARS-CoV-2 Ab Elisa Kit) Results A 549 out of 2001 participants were RDT positive and proved by ELISA giving the prevalence of COVID-19 infection to 27•4% and specifically the prevalence of IgG was 25%. The prevalence of asymptomatic COVID-19 infection in all the study group was 7•9%. The highest prevalence was observed in Al-Mansurah district (33•4%). Regarding socio-demographic factors females, housewives and history of contact a COVID-19 patients have significant higher prevalence rates (32%, 31% and 39% respectively). Conclusion high prevalence of SARS-CoV-2 antibodies was reported. Household contacts are the main factors for transmission.

Reporting adverse drug reactions (ADRs) is considered the essence of pharmacovigilance practice.Physician and nurse are among health care providers who extensively take part in reporting.However, underreporting is a malpractice worldwide. This study aimed to determine physicians and nurses' knowledge and perception toward pharmacovigilance in general, and consumer's related pharmacovigilance. Method: A cross-sectional study was conducted in Al-Gamhouria Teaching Hospital at Aden, Yemen. The study conducted from September to October 2014.Target populations were physicians and nurses. A 40-item self administered questionnaire was administered among participants. Descriptive and Chi square analysis were used to analyse to express the results. Results: 130 health care professionals were participating in the study with a mean age of 42.9 (SD7.93) years and a mean experience period of 20.3 (SD 9.73). Females comprised 63.1% of the participants and majority of them are nurses (68.5%). Although, Physicians and nurses showed varied statistically significant differences in knowledge toward pharmacovigilance. However, nurses showed a positive attitude and perception. Meanwhile, regarding consumer pharmacovigilance, again nurses showed positive attitude compared to physicians but physicians were more positive with the consumer reporting. Both physicians and nurses were highly scored for the importance of pharmacovigilance in Yemen as well as to be part of health education curriculum. Conclusion: A relatively good level of pharmacovigilance knowledge has been encountered among physicians and nurses. Nurses had had optimistic attitude and higher perception toward pharmacovigilance compared to physicians who more valued consumer reporting.