Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Household Headship and Women’s Health: An Exploratory Study from Egypt193090810.21608/ejcm.2019.30908ENJournal Article20190430Background: Despite of the efforts done to achieve women’s empowerment as one of the 17<br />Sustainable Development Goals, women still suffer from unequal access to education besides<br />several illnesses contributing to chronic diseases development. Women Headed Families<br />(WHF) are a major concern nowadays as it can be considered as a risk factor for many<br />morbidities and social problems. Therefore, this study was conducted to draw attention to the<br />uprising vulnerability trend of WHF. Objectives: to compare the socio-demographic<br />characteristics and pattern of morbidities between females heading families and those who do<br />not. Method: A cross-sectional study was conducted at Met-Rahena Village in Egypt. A<br />purposive sample of 886 females were interviewed. The questionnaire included questions<br />about education, work status, and several morbidities. Data was analyzed using SPSS 20.0.<br />The Chi-square or Fisher Exact tests were used to analyze the association between variables.<br />Results: The mean age of the females heading a family was (47.3) years, which was<br />significantly higher than the mean age of females not heading a family (36.1) years. The<br />studied types of morbidities appeared to be represented higher in the group of females<br />heading a family than in the other group, namely; hypertension, diabetes mellitus, GIT<br />diseases, ophthalmological problems and musculoskeletal disorders (p <0.05). Conclusion<br />and Recommendation: As the health status of women heading families is not desirable, so<br />there is a great need for effective interventions directed to this vulnerable group to improve<br />their quality of life.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Disclosure of HIV Positive Status: A Challenge Facing HIV Control, Alexandria, Egypt10163091010.21608/ejcm.2019.30910ENJournal Article20190430Background: Egypt is reported to have a growing HIV epidemic especially among injecting<br />drug users and men who have sex with men. There is no published research studying<br />disclosure among those living with HIV in Egypt. The study aimed to estimate disclosure<br />rate, motives, barriers, consequences, and association with sexual behavior. Methods: Eighty<br />(80) people living with HIV -16 years old and above- were selected using a systematic<br />random technique from those regularly attending Alexandria National AIDS program center<br />for treatment supply. A designed semi-structured interview questionnaire was used to collect<br />data. Results: Self disclosure rate was 78.8%. Socially unaccepted behaviors associated with<br />HIV transmission are significantly associated with non disclosure. Seeking support was the<br />main motive. Sister and mother were first to disclose to (79.3%). Anger and rejection was<br />significantly associated with disclosure of HIV transmission through socially unaccepted<br />behaviors. Denial of disease was the parents’ reaction in 4.8%. Female sex workers and men<br />having sex with men were regretting disclosure to their sexual partners in most occasions and<br />usually have unprotected sex. Conclusion: Culture, traditions, and religious beliefs play an<br />important role in disclosure motives and consequences in Egypt. Public awareness regarding<br />disease nature and high risk behaviors, and encouraging screening among high risk behavior<br />groups should be integrated in the control program. Disclosure of HIV status and having<br />protected sex should be discussed with all HIV diagnosed cases irrespective of their marital<br />status.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Working Environment Effects on Peak Expiratory Flow Rate among Traditional Egyptian Bakers17263091110.21608/ejcm.2019.30911ENJournal Article20190430Background: Bakers face various common health problems at their work which may be<br />aggravated when combined with improper awareness of ways of protection. Objective: The<br />current study aimed at determining the most common symptoms encountered by bakers and to<br />compare the peak expiratory flow rates of bakers with a control group. Method: The study<br />included 71 bakers and 120 controls. The participants filled an interview questionnaire<br />containing socio-demographic data as age, marital status, education, occupational background<br />and questions about history of common diseases, body mass index was calculated, and peak<br />expiratory flow rates were measured. Results: The mean expiratory flow rate of bakers was<br />significantly lower than that of the control group. None of the workers reported receiving<br />training to raise their awareness on the types of occupational disorders and methods of<br />prevention. As regard respiratory symptoms, a significant difference was detected between<br />groups regarding chest tightness (P=0.009) and sweating (p=0.03). Multiple logistic<br />regression was done to identify factors associated with abnormal PEFR among bakers. After<br />adjustment of relevant factors (age, BMI, job duration, working hours and workplace<br />characteristics), it was found that exposure to heat in workplace was the independent factor<br />affecting PEFR. Conclusion: The study concluded that bakery workers had various health<br />problems related to the nature of their work and the work environment needed application of<br />safety standards.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Geospatial Analysis of Breast Cancer in Alexandria: Application of a Novel Public Health Tool27363091310.21608/ejcm.2019.30913ENJournal Article20190430Background: Geographic information system is a toolbox that can depict geography of<br />80% of health problems (epidemiology and outcome) and geography of healthcare<br />systems (screening, prevention, treatment/care services delivery), that can predict future<br />cases levels and trends and show areas with significant clustering of cases to target with<br />prevention and control. Objective: The objectives of the present study were to portray the<br />geographical distribution of breast cancer cases in Alexandria, identify the breast cancer<br />cluster areas in Alexandria, and to calculate the predicted number of breast cancer cases<br />until year 2020. Method: Breast cancer cases clinically and pathologically diagnosed and<br />confirmed in Alexandria University Hospital, Medical Research Institute and Ayadi<br />Almostakbal in Alexandria, over 10 years, between January 1, 2005 and December 31,<br />2014 and diagnosed and managed in the three enrolled data warehouse were obtained. A<br />digitalized map of Alexandria was used. The data of breast cancer prevalence was overlaid<br />and spatial analysis of prevalence by district and locality was generated using GIS<br />software. Results: Cancer breast cases through 2005-2014 in Alexandria were 6806 cases<br />of which 4534 cases were geocodable. Four Clusters of districts were found, and the<br />characteristics of each cluster was portrayed and mapped. Projection and prediction of<br />cancer breast revealed 704 cases in Alexandria in year 2020 with a consistent increase in<br />cases. Conclusion: Montaza district was the most significant cluster area.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Overweight and Obesity among Female Students in Sohag University and Factors Associated with their Occurrence37463091410.21608/ejcm.2019.30914ENJournal Article20190430Background: Obesity is a medical disorder in which extra body fat is stored to the degree<br />which may have a harmful effect on the health. People are generally measured obese when<br />their body mass index (BMI) is ≥ 30 kg/m2, with the range from 25–29.9 kg/m2 is<br />considered as overweight. However, some countries, especially in the East Asian area may<br />use lower values to define both overweight and obesity. Objective: This study aimed at<br />determining the proportion suffering from overweight and obesity among a sample of<br />female students in Sohag university, and identifying factors associated with their<br />occurrence. Method: A cross sectional study was carried out in faculties of medicine,<br />nursing and education in Sohag university and included a sample of 600 female students<br />aged 17-25 years in the selected faculties. The data was collected through personal<br />interviews with the participating students using a questionnaire containing questions about<br />sociodemographic variables, dietary habits, physical activity, perceptions of body weight<br />and beliefs of obesity and the record of self-reported and actual anthropometric body<br />measurements. Results: More than one third of participants (37.3%) were overweight and<br />1.2% were obese. Lack of physical activity, consumption of soft drinks and marital status<br />were significantly related to obesity. The participants preferred dairy products and fatty<br />foods over vegetables and fruits. In addition, “lack of time” was the most frequently<br />mentioned barrier to eating a healthy diet and being engaged in regular exercise.<br />Conclusion: Overweight and obesity were detected in 38.5% of the participants. Life style<br />modification is important to improve healthy habits earlier in lifeEgyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Physical Inactivity Prevalence and Determinants among Assiut University Students, Egypt47573091510.21608/ejcm.2019.30915ENJournal Article20190430Background: Physical inactivity (PI) became an alarming epidemic. University students<br />are considered an interesting group for studying the prevalence and determinants of PI.<br />Interventions for promotion of healthy lifestyle, including physical activity in this group is<br />a way of ensuring a good physical and mental health not only as young adults but also<br />later in life. Objectives: This study was conducted to estimate the prevalence of physical<br />inactivity and its determinants among Assiut university students. Method: A multistage<br />stratified cluster sampling was used to conduct a cross-sectional study among a<br />representative sample of Assiut University student (850 students). A self-administered<br />Global Physical Activity Questionnaire (GPAQ) was used to collect the data. Results:<br />Total respondents were 805 (95%). The mean age was 20.2±1.8 years old. Males represent<br />53.4% and the sample includes 56.5% of theoretical faculties students, 29.0% of practical<br />faculties and 14.5% of medical faculties. The prevalence of physical inactivity was 14.3%<br />(9.3% among males and 20.0% among females). The odds of physical inactivity are nearly<br />3 times more in females (CI= 1.707 – 4.719, p < 0.001). Also, the chance of physical<br />inactivity increased by 2.4 times among student of medical faculties (CI= 1.330 – 4.251, p<br />= 0.003) and nearly two times among students of practical faculties (CI= 1.170 – 3.129, p<br />= 0.019). Conclusion: Most of Assiut University students either moderately or highly<br />active and only 14.3% were physically inactive. Predictors of physical inactivity among<br />Assiut University students are being a female and student of medical or practical faculty.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Antiretroviral Therapy in Egypt: Are There Any Barriers to Medication Adherence?58653091610.21608/ejcm.2019.30916ENJournal Article20190430Background: Egypt provides free antiretroviral therapy (ART) to some 5000 Egyptian<br />People Living with HIV/AIDS (PLWHA) across a number of distribution points. Objective:<br />This study aimed mainly at identifying potential facilitators and barriers to ART. Method:<br />Focus groups discussions (FGDs) were conducted with 33 PLWHA representing most of<br />Egyptian geographical areas. Discussions were designed to cover socio-demographic<br />characteristics of participants, routine investigations, monitoring & follow up measures,<br />problems associated with drug intake, PLWHA needs, stigma, and relevant future concerns.<br />Results: Participants confirmed availability of drugs without interruptions almost all months,<br />yet, for the majority (63.7%) of participants, investigations were done during the process of<br />tracing their clinical complaints that were behind first HIV testing, while treatment was<br />initiated without prior relevant investigations for (36.4%) of participants. The majority<br />(75.75%) of participants did not receive adequate counseling before starting their treatment.<br />Almost two thirds (63.6%) of participants initiated drugs at late stage of the disease. All<br />participants (100.0%) expressed their needs for a well-trained person at each center. The<br />treatment had troublesome side effects in the form of drowsiness and loss of concentration<br />among (72.72%) of participants. All (100%) of participants mentioned different stigmatizing<br />practices against them at treatment facilities. Conclusion: Lack of accurate information about<br />HIV and ART, inadequate Monitoring and follow up measures, drug side effects and<br />stigmatizing practices against Egyptian PLWHA represent the most common barriers to ARV<br />therapy.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Perception of Importance of Premarital Counseling among Medical Students of Tanta University, Egypt66753091710.21608/ejcm.2019.30917ENJournal Article20190430Background: In Egypt utilization of pre-marriage counseling and testing (PMC) is still<br />limited. Objective: To identify knowledge and attitude of medical students towards PMC.<br />Method: A cross sectional study at Tanta Faculty of Medicine on 379 students using a<br />predesigned questionnaire. Results: The majority admit that PMC can detect hereditary<br />diseases (79.4%) and sexually transmitted infections (73.8%). Among participants, 76.2%<br />were willing to use free PMC and 18.8% expressed awareness of premarital investigations.<br />Only 49.7% knew about places providing PMC. Concerning level of information, 27.6% of<br />participants did not have enough information about PMC. The main sources of information<br />were mass media (31.8%) and internet (30.0%). The main reason for not utilizing PMC was<br />not to interfere with “Allah will”. More males (12.5%) think that PMC may delay marriage as<br />compared to 5.1% for females. Students with consanguineous parents showed significantly<br />higher level of knowledge than those whose parents were not related. Conclusion: Students<br />had good perception of the importance of PMC but they did not knew the places and<br />investigations of PMC.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Twenty Month Surveillance Infections in Intensive Care Unit of Zagazig University hospitals76843091810.21608/ejcm.2019.30918ENJournal Article20190430Objective: To report types and rates of healthcare-associated infections (HAIs) as well as<br />pathogen distribution from HAI surveillance system of Zagazig University Hospitals.<br />Method: Active prospective surveillance was conducted from March 2016 through<br />November 2017 in intensive care hospitals (ICUs) in Zagazig university hospitals. Definitions<br />were adapted from the CDC’s National Healthcare Safety Network. Data collection was<br />performed by trained healthcare workers in the participating ICUs, and data was recorded on<br />clinical symptoms, radiological and laboratory investigations. A convenience sample of<br />clinical isolates was tested for quality control at a central reference laboratory. Results:<br />Fifteen (15) ICUs from 7 hospitals collected 106,028 patient-days of surveillance data. Of 290<br />HAIs identified, 56.6% % were bloodstream infections followed by urinary tract infection<br />32.4%. The highest rate of device-associated infections was reported for central lineassociated<br />Blood stream infection (3.39 CLABSIs/1,000 central line-days) followed by<br />ventilator-associated pneumonia (1.13 VAP/1,000 ventilator-days). Out of 280 isolates of<br />ICU acquired organisms, Klebsiella was the most common isolated organism (38.2%)<br />followed by staphylococcus and E. Coli (11.4 % and 10.4%). The most common obstacles<br />identified were work overload and lack of cooperation of ICU staff. High levels of<br />satisfaction of surveillance team for surveillance program training course, data collection<br />tools (logbooks and smart devices, and overall usefulness of the program in reducing HAIs)<br />were reported. Conclusions: HAIs have great threat to patient safety in Zagazig University<br />ICUs. Continuation of surveillance activities and implementation of preventive bundles<br />should become a priority for the Infection control team.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Maternal Knowledge and Practice Regarding Children’s Nutrition and Impact on Growth of their Children in Sixth of October City, Cairo.85943091910.21608/ejcm.2019.30919ENJournal Article20190430Background: Malnutrition has been responsible for 60% of the 10.9 million annual deaths<br />and 50 to 70% of the burden of diarrheal disease and respiratory tract infections among<br />under-five year’s old children. It is also a major cause of disability preventing children from<br />reaching their full developmental potential. In the context of nutrition and food consumption;<br />knowledge is generally defined as the understanding of the health benefits of different foods<br />and nutrients. This awareness of healthy nutrition is then translated to feeding practice.<br />Objectives: To assess mothers’ feeding knowledge and practice of their 6 to 60 months old<br />children in 6th of October City and to evaluate the influence of this knowledge on their<br />children’s nutritional status. Method: A cross-sectional study was conducted among<br />mothers-children pairs randomly selected from two family health centers in 6th of October<br />city using an interview questionnaire, 24 hr. dietary recall, and anthropometric<br />measurements. Results: Interviewed participants were 252; mean mothers’ age was 27.9 ± 6<br />years, 81% were housewives, and 61% had higher than 2ry school education. Early initiation<br />of breastfeeding (BF) was reported by 28.9% of mothers, 51.2% practiced exclusive BF for<br />4-6 months, 25.4% gave formula milk during 1st 6 month of life, 16.4% continued breast<br />feeding up to 2 years. Stunting, wasting & overweight among children were 20.2%, 6% and<br />9.9% respectively. Mother`s age, education, nutritional knowledge and practice scores, and<br />family socioeconomic status significantly affected child`s Height for age Z-score (HAZ) and<br />Weight for Height Z-score (WHZ). Conclusion: This study demonstrated that mothers had<br />good knowledge and practice regarding most aspects of BF and weaning yet they showed<br />poor practice of early initiation and continuation of BF, introduction of meat and whole eggs,<br />child`s consumption of fruits , vegetables, and eggs.Egyptian Community Medicine AssociationThe Egyptian Journal of Community Medicine1110-186537220190401Obituary of Professor Dr. Gabr Metwally El-Sayed95953092010.21608/ejcm.2019.30920ENJournal Article20190430