Libyan Journal of Public Health Practices

Environmental Lifestyle and Genetic Factors Associated with Cancer Patients in Eastern Libya: A Cross-Sectional Study

Twfeik Elbagrmi — 2026-06-14

Cancer is a growing public health problem in Libya, particularly in Benghazi. Multiple risk factors, including environmental, lifestyle, and dietary factors, contribute to the problem, along with stress. Despite the increasing incidence of cancer, research on the subject remains limited. This cross-sectional study aimed to identify factors associated with cancer among 200 cancer patients (130 women and 70 men) in Benghazi. The study was conducted from February to June 2025 at the Benghazi National Cancer Center, and consecutive patients were recruited. Data were collected through interviews with patients using a structured 35-item questionnaire. Descriptive statistics and the chi-square test were used to analyze the data. Ethical approval was obtained, and data were kept confidential. Most participants were female (65%), aged 41 years or older (60%), and 70% lived in urban areas. The proportion of smokers was 45%, whereas 70% of nonsmokers reported exposure to secondhand smoke. 30% live near industrial areas, 55% eat meat regularly, and only 35% eat fruits and vegetables daily. 25% reported a family history of cancer. The most common cancers were breast cancer (40%) followed by lung cancer (30%), with low levels of awareness. Only 20% of participants were aware of the link between smoking and cancer, and just 15% of women underwent early screening. These findings highlight the diversity of cancers and emphasise the need for smoking cessation, environmental monitoring, improved early screening, and culturally appropriate health education. However, the cross-sectional design among patients limits causal inference.

Antimicrobial Resistant Profile And ESBL Production in Enterobacteriaceae Isolated from Fresh Vegetables Sold in Markets in Benghazi City, Libya

Asrra A Ali — 2026-06-14

Fresh vegetables are widely consumed because of their high nutritional value, however, they may serve as vehicles for the transmission of pathogenic and antimicrobial-resistant bacteria. This study aimed to isolate and identify members of the Enterobacteriaceae from fresh vegetables sold in markets in Benghazi, Libya, and to determine their antimicrobial resistance profiles as well as the presence of Extended-Spectrum Beta-Lactamase (ESBL)-producing isolates. A total of 31 raw vegetable samples were collected from six different markets in April 2025. Samples were processed conventionally, with antimicrobial susceptibility determined via CLSI-compliant Kirby-Bauer disc diffusion on Mueller-Hinton agar. Phenotypic detection of ESBL production was performed using the synergy test with a β-lactam antibiotics. Microbial growth was detected in 26 out of 31 samples (83.9%). The most predominant are E.coli (22.58%), followed by Shigella spp. (19.35%), Proteus spp., Klebsiella spp. (16.13%), Salmonella spp. (12.90%), Enterobacter spp. (6.45%), and Serratia spp. (6.45%) each. Antimicrobial susceptibility testing revealed high sensitivity to imipenem, amikacin, and meropenem (100%), followed by gentamicin (96.8%) and ciprofloxacin (93.5%). In contrast, high resistance was observed to amoxicillin/clavulanic acid (87%), while moderate resistance was detected to ampicillin (38.7%) and cefotaxime and ceftriaxone (32.3%). ESBL production was confirmed in 6 isolates (19.3%).This study found that commonly consumed vegetables are contaminated with antibiotic-resistant bacteria. The notable presence of multidrug-resistant bacteria on vegetables requires immediate, effective contamination control strategies from local health authorities.

Postgraduate Dental Students' Perceptions of Evidence-Based Dentistry at the University of Benghazi

Eman K. M. Mansur — 2026-06-14

This cross-sectional study investigated perceptions, attitudes, self-reported knowledge, evidence-seeking behavior, and confidence related to Evidence-Based Dentistry (EBD) among postgraduate dental students at the Faculty of Dentistry, University of Benghazi. All 159 enrolled postgraduate students were invited to participate during October-November 2022, and 112 completed the questionnaire, giving a response rate of 70.4%. Data was collected using a self-administered questionnaire consisting of socio-demographic and educational items and the validated Knowledge, Attitudes, Access, and Confidence Evaluation (KACE) instrument. The KACE instrument comprised 35 items across four domains: knowledge, attitudes, behavior in accessing evidence, and confidence in critical appraisal. Participants showed low EBD knowledge (mean 2.7 +/- 2.2 out of 10), moderately positive attitudes (mean 5.4 +/- 2.6 out of 10), moderate evidence-seeking behavior (mean 10.7 +/- 4.0 out of 18), and fair confidence in critical appraisal (mean 6.4 +/- 3.7 out of 12). The knowledge domain showed a floor effect (21.4%), indicating limited understanding of core EBD concepts or possible item difficulty. Significant differences were observed for knowledge by postgraduate specialty (P = 0.009), attitude by prior research/statistics training (P = 0.002) and current academic level (P = 0.021), and behavior by prior research/statistics training (P = 0.049). These findings indicate a gap between awareness of EBD and its effective implementation. Integrating structured, competency-based EBD education within undergraduate and postgraduate curricula is needed to strengthen evidence-based clinical practice and improve oral health care quality in Libya.

The Impact of the Novel E‑J Biomechanical Footwear System on Lower Limb Biomechanics in Recreational Female Athletes at High Risk of Non‑Contact ACL Injury: A Feasibility Study

Ihab El-Zein — 2026-06-14

Anterior Crucial Ligament injury is one of the most severe knee injuries that happens to young athletes who participate in sporting activities that require cutting, pivoting, and sudden deceleration. Prevention programs have proven to lower limb neuromuscular control, which would reflect on dynamic knee stability and functional performance. However, most of those programs have low compliance rates because they require a time commitment and a considerable level of intensity and complexity. The study aims to evaluate the feasibility of performing the intervention on healthy recreational female athletes with the E-J system and to review the current prototype design of the device, according to the user perspective, and finally, to observe any alterations in postural stability. The study was conducted in three phases. Of 15 potential participants, 10 female participants were recruited after being 2D video assessed at the screening phase, as they showed an FPPA exceeding 8.5 degrees while performing a single-leg squat. Participants were assessed using the Y balance test in the pre-intervention phase and after 4 weeks in the post-intervention phase. Compliance rate, Y-balance test outcomes of each limb length, reach for the right and left lower limbs in three directions each (Anterior, Posteromedial, Posterolateral). Results showed a significant (p-value < 0.05) increase in limb length of reach, along with a compliance rate of 89%. The outcomes suggest that performing an intervention with the E-J system is safe and feasible. In addition, the E-J system demonstrated that it may have potential for improving lower limb postural stability.

Use of Social Media as a Source of Nutritional Information Among Health Science Students at Benghazi University

Mariam Aljarrari — 2026-06-14

Social media is challenging as an information-sharing community because there is no formal review process before the information is published. University students rank among the most engaged users of social media and have demonstrated difficulty in assessing credible information on the internet. The study aims to explore the use of social media as a source of nutritional information among health science students at Benghazi University, Libya. A Descriptive, cross-sectional study was conducted between January and May 2024. The study sample consisted of 434 health science students (377 females and 57 males). Data were collected using an online, self-administered questionnaire via Google Forms. A chi-square test was utilized to analyze the relationship between demographic characteristics and the use of social media for sourcing nutrition information. Results indicated that 81.6% of students utilized nutrition information, with 25.8% actively following a specific diet. Participants primarily searched for general nutrition tips and disease-specific dietary information. Approximately half of the respondents (50.5%) considered social media platforms to be their most reliable source of nutrition information. Statistical analysis revealed a significant correlation between gender and several factors, including social media usage, preferred content types, qualifications of followed pages, and the perceived accuracy and helpfulness of the information. Additionally, the students' specific faculty was significantly associated with their use of social media for nutrition information and their perception of page credibility. This study has shown that social media is the most common source of nutritional information among students. This study indicates that Facebook is the preferred social media platform among a majority of students.

The Role of Nursing in Enhancing Care for Patients with Cardiovascular Diseases

Khadija M.A. Abu Sitta — 2026-06-14

Cardiovascular diseases are among the leading causes of morbidity and mortality worldwide and represent a major public health challenge. Nurses play a crucial role in providing health education and comprehensive care to cardiac patients, which may contribute to improving patient outcomes and satisfaction. This study aimed to evaluate the role of nursing in health education and improving the quality of care provided to cardiac patients. The results showed that the most represented age group was 30-45 years, with males outnumbering females. A significant proportion of participants also held university degrees, and most had been living with the disease for one to five years. Regarding nursing health education, the results showed a good-to-high level, with an overall average of 3.9, indicating the effectiveness of the nursing role in enhancing patients' knowledge of the disease, its risk factors, and prevention. The results also showed that the nursing role in providing comprehensive care was strong, with an overall average of 3.76, particularly in psychological support. Regarding patient satisfaction, the level was relatively high, with a satisfaction rate of 65% and an overall average score of 3.8. The results also revealed a statistically significant positive correlation between health education and patient satisfaction (r = 0.62). The study further demonstrated statistically significant differences in health literacy levels attributable to educational attainment. It can be concluded that nursing health education plays a pivotal role in improving health literacy and increasing patient satisfaction.

Assessment of Vaccine Handlers' Knowledge and Cold Chain Management in Primary Health Care Facilities in Tripoli, Libya

Mohmmed A. Elgiurnazi — 2026-06-14

Vaccination is one of the most effective public health interventions for preventing infectious diseases. In Libya, particularly in Tripoli, challenges related to infrastructure, training, and supervision may affect the effectiveness of vaccine storage and handling practices. The Knowledge, Attitudes, and Practices (KAP) assessment framework provides a structured approach to evaluating provider-level performance in immunization services, yet limited evidence exists from primary health care facilities in Tripoli. A descriptive cross-sectional study was conducted in August 2024 across 65 primary health care vaccination sites in six municipalities of Tripoli, Libya. Using a total population sampling approach, all 65 vaccination providers were assessed. Data were collected using structured questionnaires and observational checklists adapted from WHO Effective Vaccine Management (EVM) guidelines. Standardized categorical scoring thresholds were applied to evaluate provider knowledge, attitude, and practice, alongside overall facility performance. Most facilities possessed functional cold chains with adequate refrigeration (96.9%) and temperature monitoring (98.5%), though operational gaps remained in guideline availability and emergency alarms. While providers overwhelmingly demonstrated positive attitudes (98.5%), good practices (96.9%), and moderate-to-good overall knowledge (93.8%), specific deficiencies were identified regarding mild illness contraindications, vaccine distinctions, batch number recording, and post-vaccination observation times. The study concluded that despite functional cold chains and experienced staff, operational gaps in training, documentation, and emergency preparedness threaten vaccine quality in Tripoli. Addressing these through continuous training, supportive supervision, and enhanced monitoring is essential for safe immunization.