Somali National University

Health Information Systems (HIS) are vital for the collection, storage, analysis, and dissemination of health data to support effective decision-making and resource management at all levels of healthcare. However, despite their importance, many healthcare professionals do not effectively use routine health information, leading to missed opportunities for data-driven decisions and weakened health system performance. This study aimed to assess the utilization of routine health information and its determinants among healthcare professionals in public health facilities in the Banadir Region, Somalia. A facility-based cross-sectional study was conducted from March to June 2024 across 32 public health facilities in the Banadir Region, Somalia. A total of 405 healthcare professionals were selected using a two-stage cluster sampling technique. Data were collected using self-administered questionnaires and observational checklists developed based on the PRISM framework. The questionnaire included items assessing factors influencing RHIS use, such as the availability of training, standardization of indicators, level of supervision, and attitudes toward data utilization. Data were entered and cleaned in Excel and analyzed using SPSS version 27. Bivariable and multivariable binary logistic regression analyses were performed, with variables showing p < 0.05 in the multivariate analysis considered statistically significant. In this study, 68.1% of healthcare professionals demonstrated good RHIS utilization (95% CI: 63.5%–72.6%). Multivariable analysis showed that professionals working in hospitals were less likely to utilize health information than those in health centers (AOR = 0.273, 95% CI: 0.144–0.519). Lack of HIS training (AOR = 0.061, 95% CI: 0.030–0.125), non-standardized indicators (AOR = 0.188, 95% CI: 0.047–0.745), and lack of supervision (AOR = 0.195, 95% CI: 0.098–0.386) were associated with lower utilization. Additionally, untrained professionals in data analysis were less likely to use health information effectively (AOR = 0.165, 95% CI: 0.029–0.926). Health professionals with a positive attitude toward data utilization were 2.8 times more likely to use health data (AOR = 2.861, 95% CI: 1.155–7.090). The study found that 68.1% of healthcare professionals demonstrated good RHIS utilization. Key barriers included inadequate training, insufficient supervision, non-standardized indicators, and limited data analysis skills. Strengthening in-service training, improving supervision and feedback mechanisms, enhancing access to digital tools, and standardizing indicators are recommended to improve RHIS utilization and foster evidence-based decision-making in the Banadir Region.

This study explored residents’ awareness, behaviors, and key factors affecting sustainable waste management in Mogadishu, Somalia. Guided by the Theory of Planned Behavior, it examined how awareness of waste management principles influences household waste handling practices and identified factors that facilitate or hinder this process. A descriptive quantitative research design was used, employing structured questionnaires administered to residents. Data were analyzed with descriptive statistics and non-parametric tests in SPSS version 27. The results showed moderate awareness of health and environmental risks associated with improper waste disposal, along with a limited understanding of environmentally safe disposal methods and waste categorization. Significant differences were found across education levels in awareness of safe disposal methods (χ² (4) = 17.295, p = 0.002) and knowledge of recyclable waste (χ² (4) = 16.877, p = 0.002). Additionally, familiarity with local waste management rules (ρ = 0.394, p &amp;lt; 0.01) and regular waste separation routines (ρ = 0.469, p &amp;lt; 0.01) showed strong positive correlations with actual waste management behaviors. Although many residents reported practicing proper waste disposal, consistent implementation remained difficult, revealing a persistent gap between knowledge and action. Access to reliable waste collection services, community support, and educational programs emerged as crucial enablers of sustainable waste management. Overall, the study emphasizes the need for combined educational, institutional, and infrastructural strategies to enhance sustainable waste management and advance Sustainable Development Goals 3, 11, and 12.

Introduction and importance: Ectopic testis is a rare congenital condition where the testicles are located outside the normal scrotal area. Only about 1% of ectopic testes are found in the perineal region. Case presentation: A 21-year-old male from Debre Tabor, Ethiopia, presented with a right-sided perineal swelling since childhood and associated pain in the same area for 6 months prior to presentation. Physical examination was unremarkable, except for the genitourinary examination, which revealed an underdeveloped right scrotum with no palpable testis. A 3 cm × 4 cm soft, non-tender, mobile mass was palpated in the right perineal area. The left scrotal testis was normal. Diagnostic perineal ultrasound showed an atrophied ectopic right testicle in the perineal area, with a normal left scrotal testis. Consequently, a right orchiectomy with left-sided testicular fixation was performed. The surgery was uneventful. Clinical discussion: Perineal ectopic testis is a rare congenital anomaly. Testicular development and descent is a complex, multi-stage process influenced by mechanical and hormonal factors. Cryptorchidism refers to the testis descending outside the scrotum, but remaining within the normal pathway. In contrast, descent outside the normal pathway is defined as ectopic testis. Ectopic testes can be found in various locations, the superficial inguinal pouch being the most common and rarely in perineal area. Surgical management depends on the condition of the ectopic testis. Conclusion: Perineal ectopic testis, though rare, should remain in the differential diagnosis for any perineal mass. Early diagnosis and prompt management are paramount to prevent potential complications such as testicular atrophy.

Background:Myocardial bridging (MB) is a congenital coronary artery anomaly in which a segment of an epicardial coronary artery, most commonly the left anterior descending (LAD) artery, courses intramyocardially, and undergoes systolic compression. Although historically regarded as a benign anatomical variant, myocardial bridging has increasingly been recognized as a potential cause of myocardial ischemia, exertional chest pain, and other cardiac symptoms, particularly in patients without obstructive coronary artery disease. Awareness of this condition is important, as its diagnosis and management differ from those of atherosclerotic coronary disease.Case presentation:We report 2 cases of symptomatic myocardial bridging involving the mid-segment of the LAD artery. The first case involved a 35-year-old male with a 2-month history of exertional chest pain and no cardiovascular risk factors. Initial evaluation, including electrocardiography, cardiac biomarkers, and transthoracic echocardiography, was unremarkable. Coronary angiography demonstrated a myocardial bridge in the mid-LAD with systolic compression and normal diastolic filling, without evidence of obstructive coronary artery disease. The patient was treated with diltiazem, resulting in complete symptom resolution at 1-month follow-up. The second case involved a 48-year-old male with a history of smoking and well-controlled hypertension who presented with exertional chest pain radiating to the left arm, accompanied by palpitations. Laboratory investigations, electrocardiography, and echocardiography were normal. Coronary angiography again revealed myocardial bridging of the mid-LAD without obstructive lesions. Treatment with diltiazem led to complete symptom resolution, and the patient remained clinically stable at 2-month follow-up.Discussion:These cases highlight the clinical significance of myocardial bridging as a cause of angina-like symptoms in patients with non-obstructive coronary arteries. The pathophysiology is multifactorial and includes dynamic systolic compression, delayed diastolic relaxation, endothelial dysfunction, and increased susceptibility to ischemia during tachycardia. Medical therapy aimed at reducing heart rate and myocardial contractility, particularly with non-dihydropyridine calcium channel blockers, remains the cornerstone of management.Conclusion:Myocardial bridging should be considered in the differential diagnosis of chest pain in patients with normal coronary arteries. Early recognition and appropriate medical therapy can result in effective symptom control and may prevent unnecessary invasive interventions.

Somalia's recurring hunger crises are often viewed as emergencies that can be addressed by emergency food aid. In reality, chronic food insecurity now stems from structural fault lines-poverty, conflict, displacement, climate volatility, weak land tenure, under-resourced ministries, and fractured markets-that short-term food aid cannot repair. Today, 4.3 million Somalis face acute food insecurity, and more than 700,000 children are acutely malnourished, even though the country boasts a 3333-km coastline, fertile river valleys and a rich tradition of pastoralism and farming. Cycles of drought have decimated herds, forced pastoralists into urban slums, and eroded coping mechanisms, while conflict blocks access to productive land and drives up dependence on imports for over 80% of staple foods. Climate change is tightening this vise through erratic rains, scorching heat, and flash floods. To achieve sustainable food security, Somalia must shift from emergency relief to long-term investments in resilient and inclusive food systems. That means channelling at least five percent of public expenditure into irrigation, water harvesting, and extension services; securing land rights to spur on-farm investment; scaling early-warning and climate-smart technologies; and rebuilding rural infrastructure, cold chains, and digital marketplaces so smallholders can reach consumers. Nutrition gains hinge on diversifying production of fruits, vegetables, legumes, and animal proteins, linked to community health and education programs. A national Food Systems Coordination Council should align humanitarian and development actors with regional frameworks, while public-private partnerships unlock finance for Somali agribusiness innovations. Ending hunger is not only a humanitarian obligation; it is a prerequisite for stability, growth, and social justice. With political will, integrated governance, and sustained investment, Somalia can move beyond food aid, harness its land and heritage, and lay the foundation for a resilient, self-reliant future.

Diphtheria remains a life-threatening infectious disease in low- and middle-income countries, particularly where immunization coverage is incomplete. Severe complications such as myocarditis and acute kidney injury significantly increase mortality. Reporting rare and complex presentations is essential to improve early recognition and management. We report the case of a 6-year-old girl who presented to the emergency department with five days of aphonia, odynophagia, progressive dysphagia, fever, confusion, and oliguria. On examination, she had cervical lymphadenopathy, pharyngeal pseudomembranes, and signs of systemic toxicity. Laboratory investigations demonstrated acute kidney injury with metabolic acidosis. Echocardiography revealed myocarditis with reduced ventricular function. The patient had incomplete vaccination against diphtheria. She was treated with diphtheria antitoxin, antibiotics, and supportive critical care. Despite aggressive management, the case illustrates the severe systemic complications of toxic diphtheria. Diphtheria is transmitted primarily via respiratory droplets and direct contact with infected lesions. Children in settings with poor vaccine coverage are particularly vulnerable to severe disease. Myocarditis and renal failure are toxin-mediated complications and are the leading causes of death. This case highlights the importance of early diagnosis, laboratory confirmation, and immediate administration of antitoxin. This case underscores the ongoing threat of diphtheria in under-immunized populations. Prompt recognition and treatment are essential to prevent fatal complications. Strengthening routine immunization programs remains the most effective strategy to reduce diphtheria-related morbidity and mortality.

Post-infectious bronchiolitis obliterans (PIBO) is a rare but severe chronic airway disease in children. It usually follows a severe viral lower respiratory tract infection in early life. Persistent inflammation and fibrotic remodeling of the small airways lead to narrowing, air trapping, and progressive loss of lung function. In recent years, reports from countries with high childhood infection burdens, particularly in Asia and Western countries, have drawn more attention to this condition. However, PIBO often remains under-recognized because its symptoms resemble asthma or other chronic lung diseases. This review summarizes available evidence on the epidemiology, risk factors, pathogenesis, clinical features, diagnosis, and management of PIBO in children. Literature was reviewed from published pediatric studies and case series across different regions. Several studies highlight hypoxemia and prolonged mechanical ventilation as strong predictors of disease. Recurrent viral infections, bacterial co-infections, and environmental exposures appear to increase vulnerability. The pathogenesis involves epithelial injury with neutrophildriven in ammation and fibrosis, eventually producing fixed airway obstruction. Clinically, affected children present with a chronic cough, wheeze, tachypnea, and persistent hypoxemia that do not respond to bronchodilators. High-resolution computed tomography (HRCT) is considered the most reliable imaging tool, frequently showing mosaic attenuation, bronchiectasis or air trapping. Lung function testing usually confirms irreversible obstruction. Management remains largely supportive. Systemic corticosteroids, azithromycin, and some immunomodulatory approaches have been tried with variable outcomes. What is clear is that earlier recognition and intervention can help slow progression. More collaborative research is still needed before consistent pediatric guidelines can be developed. The Journal of Ad-din Women's Medical College; Vol. 13 (2), July 2025; p 47-50