International Journal of Infectious Diseases
March 2016 Volume 44, p1-74
http://www.ijidonline.com/current

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Editorial
HIV in the MENA Region: Cultural and Political Challenges
Seif Al-Abri, Jacques E. Mokhbat
p64–65
Published online: February 9 2016
Preview
Over the last few years, our knowledge of the HIV epidemic and its drivers in the Middle East and North Africa (MENA) region have improved markedly, thanks to many recently conducted studies.1 While the annual number of new HIV infections in sub-Saharan Africa has declined by 33% since 2005, new HIV infections in the MENA region have increased by 31% since 2001, the greatest increase in all regions in the world. There are growing HIV epidemics in key populations (KPs) including people who inject drugs, men who have sex with men, and to a lesser extent, female sex workers.

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Reviews
Rapid Spread of Zika Virus in The Americas – Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games
Eskild Petersen, Mary E. Wilson, Sok Touch, Brian McCloskey, Peter Mwaba, Matthew Bates, Osman Dar, Frank Mattes, Mike Kidd, Giuseppe Ippolito, Esam I. Azhar, Alimuddin Zumla
p11–15
Published online: February 4 2016
Highlights
:: We discuss the global spread of the Zika virus (ZIKV) since its first discovery in 1947 in Uganda to the current outbreak in the Americas which has been declared a ‘Global emergency’ by the World Health Organization.
:: We highlight that ZIKV and other arboviruses may pose a threat to the attendees of the 2016 Rio De Janeiro Olympic and Paralympic games and to residents of Brazil.
:: We review clinical features and highlight the need for more accurate and rapid screening tests for ZIKV
:: We discuss the recent possible linkage of microcephaly in babies exposed to ZIKV in utero, and highlight knowledge gaps in the epidemiology and pathogenesis of ZIKV.
:: We review the public health implications of the current ZIKV outbreak and highlight the need for enhanced preparedness and proactive surveillance for all infectious diseases before, during and after the 2016 Olympic games.
:: We stress that there is no specific treatment available or preventive vaccines and that that the emergence of ZIKV soon after the Ebola outbreak, is yet another wake up call for the urgent need for a coordinated global response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events
Summary
Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a ‘Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events.

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Reviews
HIV/AIDS: trends in the Middle East and North Africa region
Deniz Gökengin, Fardad Doroudi, Johnny Tohme, Ben Collins, Navid Madani
p66–73
Published in issue: March 2016
Highlights
:: New HIV infections have been on the rise in the Middle East and North Africa (MENA) region in recent years.
:: There is substantial heterogeneity in HIV epidemic dynamics across MENA, and different risk contexts are present throughout the region.
:: Overall, the major route of infection in the MENA region seems to be sexual transmission, but a range of challenges limit interventions to determine the actual sexual trends.
:: Despite unfavorable conditions, many countries in the region have put significant efforts into scaling up their response to this growing epidemic.
Summary
Objectives
To give an overview of the HIV epidemic in the Middle East and North Africa (MENA) region.
Methods
Articles on the MENA region were reviewed.
Results
The MENA region comprises a geographically defined group of countries including both high-income, well-developed nations and low- and middle-income countries. While the annual number of new HIV infections in Sub-Saharan Africa has declined by 33% since 2005, new HIV infections in the MENA region have increased by 31% since 2001, which is the highest increase among all regions in the world. Moreover, the number of AIDS-related deaths in 2013 was estimated to be 15 000, representing a 66% increase since 2005. However, the current prevalence of 0.1% is still among the lowest rates globally. There is substantial heterogeneity in HIV epidemic dynamics across MENA, and different risk contexts are present throughout the region. Despite unfavorable conditions, many countries in the region have put significant effort into scaling up their response to this growing epidemic, while in others the response to HIV is proving slower due to denial, stigma, and reluctance to address sensitive issues.
Conclusions
The HIV epidemic in the MENA region is still at a controllable level, and this opportunity should not be missed.