Zain Aldeen Saleh

Cystic echinococcosis (CE) is a preventable zoonotic disease endemic in low- and middle-income countries, including Jordan, driven by livestock farming and environmental contamination. Children are vulnerable due to early exposure and prolonged incubation. Although environmental and socioeconomic determinants have been implicated, few pediatric studies integrate environmental, socioeconomic, and perinatal factors within one framework. This study evaluated integrated risk factors for pediatric hydatid cyst disease using a case–control design. A retrospective hospital-based case–control study was conducted at two tertiary referral centers in Jordan (2019–24). Thirty surgically and histopathologically confirmed pediatric CE cases were frequency-matched to 30 controls by sex and predefined age categories; controls were admitted for noninfectious conditions. Demographic, socioeconomic, environmental, and perinatal variables were extracted from standardized electronic medical records. Multivariable logistic regression was performed to determine independent predictors. In univariable analyses, exploratory associations were observed for paternal occupation (P = .004), paternal education (P = .041), maternal education (P = .017), higher birth order (median 3.5 vs 2.0; P = .038), larger household size (median 5.5 vs 4.0; P = .002), rural residence (60.0% vs 16.6%; P < .001), and infant feeding type (P = .022). After adjustment for household size and maternal education, rural residence remained the only independent predictor (adjusted OR = 6.04; 95% CI: 1.54–23.63; P = .010). Pediatric CE was independently associated with rural residence—serving as a broad contextual marker of community-level vulnerability rather than direct causality—whereas perinatal and domestic hygiene factors were not. These findings highlight high-risk settings to guide targeted, community-level prevention.

Background: Achieving breast symmetry is an important aesthetic goal following reconstruction post-mastectomy; however, little is known about women’s awareness, attitudes, and barriers regarding Contralateral Breast Symmetry Procedures (CBSP) in Jordan. Objectives: To assess awareness, perceptions, and barriers toward contralateral breast symmetry procedures among breast cancer survivors who underwent reconstruction at King Hussein Cancer Center. Methods: A cross-sectional study was conducted from July to Oct 2025 at KHCC, among 314 women diagnosed with breast cancer who had post-breast reconstruction. Data were collected using a structured Arabic questionnaire, which was developed based on existing literature, validated by an expert panel, and piloted on 10 women for clarity and reliability. The final tool demonstrated acceptable internal-consistency (Cronbach’s α = 0.712). The questionnaire captured sociodemographic and clinical data and detailed knowledge, attitudes, and barriers related to CBSP. Descriptive statistics summarized the data. Results: Participants’ mean age was 45.8 years; the majority were married (83.8%) and held university degrees (65.6%). Most reconstructions used silicone implants (94.6%). Only 6.4% had undergone CBSP, primarily delayed breast augmentation or mastopexy, with 75% reporting satisfaction. Awareness of CBSP was limited (37.9%), and less than one-third had discussed CBSP options with their surgeon or knew about insurance coverage. While 82.5% valued symmetry for body image, 31.5% viewed it as unnecessary after cancer recovery. Main barriers included satisfaction with current appearance (48.1%), fear of additional surgery (32.2%), financial constraints (37.3%), and lack of physician counseling (27.1%). Trust in medical team recommendations was high (89.2%). Conclusions: Contralateral breast symmetry procedures are under-recognized and infrequently pursued, primarily due to limited awareness, financial concerns, and insufficient counseling. Focused education and enhanced surgeon–patient communication are essential to support women’s aesthetic and psychological needs after reconstruction in Jordan.