Vol. 19 No. 5 (2025): Sana’a University Journal of Medicine and Health Sciences

Background: Schistosomiasis is a persistent health concern in Yemen, despite the continued mass drug administration campaigns using praziquantel. This survey investigated the epidemiology of schistosomiasis among schoolchildren in previously identified hypoendemic areas, more than ten years after the last national mapping in 2014 was conducted.

Methods: In June to August 2025, we conducted a cross-sectional survey of 348 children aged 5–15 years living in Jabal Ash Sharq, Hubaysh, and Amd districts. Simultaneously, the data on sociodemographic and behavioral characteristics were obtained through a standardized questionnaire. Urine filtration and the Kato-Katz technique were used to diagnose Schistosoma haematobium and S. mansoni, respectively. Statistical analyses, including binary logistic regression, were used to estimate the independent risk factors for schistosomiasis.

The combined prevalence of schistosomiasis was 19.3% (95% CI: 15, 23%), with S. haematobium (12 · 4 %) being more prevalent than S. mansoni (6.9%). All looked-at districts experienced a substantial increase in the infection rate compared to the 2014 baseline. The majority of infections were of light intensity; however, 16.3% and 20.8% of S. haematobium and S. mansoni cases were classified as moderate to heavy, respectively. Multivariable logistic regression analysis identified age ≥ 10 years (AOR = 2.3; CI: 1.17–4.55; P = 0.016) and higher frequency of contact with open water bodies (AOR = 2.2; 95% CI: 1.22–3.90; P = 0.009) as independent risk factors for schistosomiasis. Any clinical manifestation related to S. haematobium infection, including dysuria, gross hematuria, and dipstick hematuria with proteinuria, was significant.

Conclusion: Schistosomiasis has become meso-endemic in previously hypoendemic areas, with S. haematobium infection accounting for most cases among school children. A significant proportion of cases were mild, but a subset of moderate to heavy infections indicated ongoing transmission. This survey highlights the need to administer praziquantel twice a year to all school-aged children (SAC), along with other control measures, such as health education, improved sanitation, safe water supplies, and snail control.

Background: Schistosomiasis remains a significant public health problem in low- and middle-income countries, including Yemen. Although the disease primarily affects the urinary and intestinal systems, involvement of the male genital tract—particularly the testes—is rare and often underrecognized. Testicular schistosomiasis can cause chronic inflammation and granulomatous damage that may lead to male infertility, including secondary infertility.

Case presentation: We report a case of a 30-year-old man with a ten-year history of secondary infertility and progressive deterioration of sperm parameters, culminating in azoospermia. Testicular histopathological examination revealed focal granulomatous inflammation with schistosome ova. Notably, clinical exam, imaging, and repeated stool, urine, and semen analyses showed no bilharzial ova.

Conclusions: This case highlights the importance of considering testicular schistosomiasis in the differential diagnosis of male infertility in endemic areas, even when clinical and laboratory findings are unremarkable. Early recognition and treatment may prevent irreversible testicular damage and preserve fertility.

Background:
Antimicrobial resistance is a critical global threat, particularly in urinary tract infections (UTIs) caused by Escherichia coli. The rise in aminoglycoside-resistant strains complicates treatment. This study investigated the prevalence of aminoglycoside resistance among E. coli isolated from patients with UTI in Sana’a city, Yemen.
Methods:
A cross-sectional study was conducted on 378 patients at Al-Kuwait University Hospital in Sana’a City. Midstream morning urine samples were cultured, and E. coli isolates were identified using standard methods. Antimicrobial susceptibility was assessed using the Kirby-Bauer disk diffusion method according to the CLSI (2019) guidelines.
Aminoglycoside resistance was phenotypically detected.
Results:
Among the 378 samples, 167 E. coli isolates were identified (44.18%), of which 41(24.6%) exhibited resistance to at least one clinically critical aminoglycoside (gentamicin, tobramycin, or amikacin). The risk factors for resistance included catheterization, hospitalization, and older age.

Conclusion:
The high prevalence of aminoglycoside-resistant E. coli strains in Yemen underscores the need for enhanced molecular surveillance and antimicrobial stewardship.

Background: Acute coronary syndrome (ACS) poses a significant burden in low- and middle-income countries like Yemen, where delays in care and limited resources elevate the risk of adverse outcomes. Identifying the predictors of in-hospital major adverse cardiovascular events (MACEs) is essential for improving management strategies.

Objective: To assess and compare the predictors of in-hospital MACEs among Yemeni patients diagnosed with ACS, with a specific focus on gender-based differences.

Methods: An observational, retrospective study included 1,743 Yemeni patients aged ≥18 years, admitted with ACS to six tertiary hospitals in Sana’a City between January 2020 and December 2023. The primary outcome was in-hospital MACEs including cardiac death, recurrent MI, or revascularization.

Results: MACEs occurred in 12.7% of patients, with a higher occurrence in females (16.5%) and STEMI cases (15.1%). The predictors included older age, STEMI, elevated blood sugar, WBC count, creatinine, low SBP, DBP, and HDL-c. Gender-specific predictors varied, with males showing associations with delayed presentation and prior PCI, and females showing associations with age, STEMI, and increased waist circumference.

Conclusion: Key predictors of MACEs were age, STEMI, elevated creatinine, and waist circumference, with notable gender-based differences suggesting the need for tailored interventions.

Background: Penetrating neck trauma (PNT), involving the aerodigestive system, is a life-threatening condition. Effective management is crucial, particularly in resource-limited conflict zones.

Objective: To evaluate the management and outcomes of PNT at a military hospital in Sana’a, Yemen.

Methods: We retrospectively reviewed the records of 50 patients who underwent PNT (January 2018 and March 2023). This analysis included 30 patients with confirmed aerodigestive tract injuries.

Results: All patients were male (90% aged 20–30 years). Gunshot wounds (67%) predominated, with 77% presenting within 24 h; all were Zone II injuries. The most common signs were dyspnea (50%) and dysphagia (59%). Surgical exploration was indicated in 50% of patients. Single-structure injuries (77%) primarily involved the pharynx (53%) or larynx (43%). Pharyngeal injuries were often managed conservatively (63%), and all patients with esophageal injuries required surgical repair. Postoperative infections occurred in 13% (airway) and 17% (digestive) of cases. The overall survival rate was 96.7%, with 66.7% of patients surviving without morbidity, 30% surviving with morbidity, and 3.3% mortality.

Conclusion: Despite significant infection rates, high survival rates are achievable in this resource-limited conflict setting. Context-specific protocols that prioritize rapid pre-hospital care, multidisciplinary management, and robust infection control are vital.

Background: Depression, anxiety, and stress among medical students are significant health issues because of their impact on the challenging journey in medicine.

Objective: To assess the degree of relief in depression, anxiety, and stress symptoms attributed to the graduation of final-year medical students from the Faculty of Medicine and Health Science, Sana’a University, Yemen, in 2023.

Methodology: A comparative cross-sectional design was employed. There were 408 volunteers, with a response rate of 99.8%. All groups were contacted electronically via patch telegram groups. There were 212 final-year respondents and 197 interns in total. The data were collected via electronic questionnaires using google doc that included socio-demographic characteristics and a validated self-administered DASS-21 questionnaire to assess depression, anxiety and stress. The collected data were analyzed using SPSS version 26. An Ethical Clearance Certificate, according to the Helsinki Declaration, was obtained from the Faculty of Medicine, Sana’a University.
Results: Final-year medical students had incidence rates of 74.1% depression, 66% anxiety and 62.7% stress. However, 63.96% of internship graduates were depressed, 56.9% anxious, and 45% stressed. Improvements were significant in depression (p=0.032) and stress symptoms (p<0.0001), whereas anxiety was not significantly associated (p=0.067).

Conclusion: The rates of depression, anxiety and stress symptoms were high in both cohorts. The improvement attributed to graduation was significant for depression and stress.