The Journal of the Egyptian Public Health Association (J Egypt Publ Health Assoc )

Publisher: Egyptian Public Health Association


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Publications in this journal

  • Rania Abd El Hamid Hussein
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    ABSTRACT: Breakfast skipping is prevalent among adolescents and young women, and deprives the body of important nutrients. This study was conducted to assess the correlation between breakfast eating and sociodemographic and lifestyle criteria.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):100-104.
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    ABSTRACT: Persons with continuous complex care frequently require care in multiple settings. During transitions between settings, there is evidence that the quality of care is jeopardized for these patients.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):74-80.
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    ABSTRACT: The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C - Revised is designed to assess the safety of the most common procedures that puncture the skin within health services.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):66-73.
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    ABSTRACT: Out-of-pocket payments are the main sources of healthcare financing in most developing countries. Healthcare services can impose a massive cost burden on households, especially in developing countries. The purpose of this study was to calculate households encountered with catastrophic healthcare expenditures in Ferdows, Iran.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):81-84.
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    ABSTRACT: Many people use bottled water instead of tap water for many reasons such as taste, ease of carrying, and thinking that it is safer than tap water. Irrespective of the reason, bottled water consumption has been steadily growing in the world for the past 30 years. In Egypt, this is still increasing to reach 3.8 l/person/day, despite its high price compared with tap water.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):60-65.
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    ABSTRACT: Over one billion Muslims fast worldwide during the month of Ramadan. Fasting during Ramadan is a radical change in lifestyle for the period of a lunar month, and it might affect the biochemical parameters among diabetic patients.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):47-52.
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    ABSTRACT: Multiple sclerosis (MS) is an inflammatory disorder of the central nervous system. Many diseases are associated with Epstein-Barr virus (EBV) infection, such as infectious mononucleosis and many types of malignancies, and it is thought to be related to some diseases of autoimmune origin, such as rheumatoid arthritis, systemic lupus erythematosis, and others. The present study aimed to assess EBV in patients with MS.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):90-95.
  • Heba S Selim, Mona H Hashish
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    ABSTRACT: For effective control and treatment of swine influenza, rapid and cost-effective diagnosis is important. Although the gold-standard method for the diagnosis of influenza virus is culture isolation, it is not routinely used in outpatient settings because of the cost and the time needed to complete the assay. This has led to the development of an array of rapid influenza diagnostic tests. The aim of this study was to compare between the performance of CerTest Swine Flu card and RT-PCR in the detection of H1N1 infection.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):96-9.
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    ABSTRACT: The hands are known to be the most commonly injured body parts in traumatic occupational injuries. They can be disabling, leading to major adverse social and economic consequences for the worker and for his or her family.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):85-89.
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    ABSTRACT: Poor iron status affects billions of people worldwide. The prevalence of obesity continues to rise in both the developed and developing nations. An association between iron status and obesity has been described in children and adults. The aim of the study was to assess the iron profile and dietary pattern in primary school-aged obese Egyptian children.
    The Journal of the Egyptian Public Health Association 08/2014; 89(2):53-59.
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    ABSTRACT: Deficiencies of protein, energy, and micronutrients are highly prevalent in developing countries and have major effects on pregnancy outcome. Low dietary intake is the most common reason for zinc deficiency. The present research is part of a larger double-blind randomized-controlled trial to evaluate the effect of zinc supplementation on the pregnancy outcome. The aim of the present study was to assess the zinc status and dietary intake of zinc and other macronutrients and micronutrients among pregnant women in Alexandria, Egypt. Participants were pregnant women attending two antenatal care centers that serve low-income and middle-income pregnant populations. A total of 1055 healthy pregnant women aged 20-45 years were assessed for eligibility. Of these, only 675 had serum zinc level below the median for the gestational age. They were assigned randomly to one of three parallel groups. Zinc supplements were provided from 16 weeks until delivery. A subsample of 100 women was assessed for their dietary intake. A questionnaire interview was used to collect basic socioeconomic and data on current pregnancy and labor. Dietary data were collected using the 24-h recall method and a food frequency questionnaire. The nutritive value of the daily diet was computed using the Egyptian food composition tables. The blood hemoglobin level, serum zinc level, and fasting blood sugar were determined. Zinc deficiency was detected among 53.5% of the sample. Dietary intake of zinc was low, representing 59.4, 59.4, and 62% of the recommended dietary allowance (RDA) for the zinc group, zinc plus multivitamins, and the placebo group, respectively. The iron intake was below 50% of the RDA. Protein intake was less than 70% of the RDA. The mean intakes of fat were 191.97, 211.8, and 196.3 g/day for the three groups. The mean energy intake represented 51.1, 53.5, and 49.8% of the RDA. Except for carbohydrate intake, the dietary intake of all macronutrients and micronutrients was low. The lowest intake was of iron (below 50% of the RDA). Zinc and protein intake represented less than 70% of the RDA. The overall energy intake was around 50% of the RDA. Nutritional health education should be used as a preventive approach to allow the large sector of the low-income population to maximize the use of the limited resources in the best way. In women at high risk of zinc deficiency, zinc supplementation should be added to the routine supplements.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):35-41.
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    ABSTRACT: Smoking addiction is influenced by cultural and environmental factors and personality traits. We assessed the associations between neuroticism and depression and smoking behavior and motives among Egyptian adult men in rural Qalyubia Governorate. Using a cross-sectional design, we administered questionnaires to randomly selected 201, 278, and 120 adult men aged 18 years or above who were never, current, and former smokers, respectively. We used Center for Epidemiologic Studies Short Depression (CES-D) scale, Eysenck Personality Inventory (EPI), Fagerström Test for Nicotine Dependence (FTND), and Wisconsin Inventory of Smoking Dependence Motives scales to assess the associations between neuroticism, depression, and smoking risk. The mean CES-D and EPI scores were significantly higher among current smokers as compared with never smokers (P=0.02 and 0.006, respectively). The greatest risk for ever smoking was observed among those with both neuroticism and depression [adjusted odds ratio (95% confidence interval) were 1.98 (1.23-3.19); 2.56 (1.34-4.88); and 1.82 (1.10-3.03) for ever, former, and current smokers, respectively]. Both CES-D and EPI scores were associated with a variety of smoking motives and with the level of severity or intensity of nicotine dependence on FTND. Neuroticism and depression were associated with smoking behavior and motives among Egyptians, and thus attention should be given to individual needs in designing and implementing smoking cessation interventions.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):16-21.
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    ABSTRACT: Healthcare-associated infection is a prominent problem among patients in pediatric intensive care units (PICU) as it could result in significant morbidity, prolonged hospitalization, and increase in medical care costs. The role of nurses is extremely important in preventing hazards and sequela of healthcare-associated infections. The aim of this study was to assess the effect of a health education program regarding infection-control measures on nurses' knowledge and attitude in PICUs at Cairo University hospitals. This was a pre-post test interventional study in which a convenient sample of 125 nurses was taken from the nursing staff in different PICUs at Cairo University hospitals. The study took place in three phases. In the first phase, the nursing staff's knowledge, attitude and practice concerning infection-control measures were tested using a self-administered pretested questionnaire and an observation checklist. The second phase included health education sessions in the form of powerpoint and video presentations; and in the third phase the nurses' knowledge and attitude on infection-control measures were reassessed. A significantly higher level of knowledge was revealed in the postintervention phase as compared with the preintervention phase with regards to the types of nosocomial infections (94.4 vs. 76.8%, P<0.001), the at-risk groups for acquiring infection (95.2 vs. 86.4%, P=0.035) and the measures applied to control nosocomial infections (89.6 vs. 68%, P<0.001). Nurses in the postintervention phase had significantly more knowledge about the types of hand washing (99.2 vs. 91.2%, P=0.006). A significantly higher percent of nurses in the postintervention phase knew the importance of avoiding recapping syringes (72.8 vs. 34.4%, P<0.001) and believed that infection-control measures could protect them completely from acquiring infection (79.2 vs. 65.6%, P=0.033). Statistically significant higher total knowledge and attitude scores were revealed in the postintervention phase as compared with the preintervention one (P<0.001). The percentage practice score of observed units was the highest among nurses in the neonatal intensive care unit at the Japanese Hospital (88%), whereas it was the lowest in the emergency pediatric unit (65%). There is scope for improvement in knowledge and attitude after educational program was offered to the nursing staff. Educational training programs should be multidisciplinary interventions in the era of quality control to help healthcare workers realize the importance of basic infection-control measures in reducing pediatric morbidity and mortality and improving the quality of care.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):22-8.
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    ABSTRACT: Childhood attention deficit hyperactivity disorder (ADHD) is a chronic disorder that carries an immense amount of suffering for its victims, their families, and communities. The efficacy of behavioral parent training in the treatment of ADHD has been supported in several studies. To evaluate the efficacy of a predesigned culturally sensitive psychosocial intervention program for parents of ADHD children in Alexandria, Egypt. A pretest-post-test intervention study was carried out at the Child Mental Health Clinic for School Students affiliated to the Health Insurance Organization, Alexandria. The intervention aimed at improving parents' knowledge of ADHD, building their skills in effective parenting, stress management and problem-solving, as well as providing social support. All the participants (50 parents) were assigned to groups, each of five to eight parents. They received a total of eight sessions on a weekly basis. The program was evaluated immediately after completion and 2 months later using the Arabic Version of Conners' Rating Scale to identify ADHD and to assess its severity, Home Situations Questionnaire, Parenting Scale, the Arabic Version of Depression Anxiety Stress Scales (DASS), and parental ADHD-related knowledge questionnaire were used. There was a statistically significant decrease in the mean total scores recorded by parents on Conners' Rating Scale (P<0.001), Home Situations Questionnaire (P<0.05), Parenting Scale (P<0.001), and DASS (P<0.001) immediately after program completion and 2 months later compared with that reported before program initiation. The total scores of participants on the ADHD-related knowledge questionnaire increased significantly after attending the program (P<0.001). Provision of a psychosocial intervention program for parents of ADHD children proved to be effective in reducing perceived severity of the symptoms and problem situations, as well as improving parents' knowledge, discipline practices, and psychological well-being.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):9-15.
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    ABSTRACT: The adequacy and timing of complementary feeding of the breastfed child are critical for optimal child growth and development.Considerable efforts have been made to improve complementary feeding in the first 2 years of life. One of them was the WHO complementary feeding counseling course (CFC). To evaluate the effectiveness of the WHO CFC on knowledge and counseling abilities of primary healthcare physicians; on caretaker's knowledge and adherence to physicians' recommendations and their feeding practices; and on children's growth. A single-blinded randomized-controlled study was carried out in 40 primary healthcare centers divided into matched pairs according to their location, either in rural or urban areas, and training of the selected physicians on integrated management of childhood illness. One center from each pair was selected randomly for its physician to receive CFC training in nutrition counseling and the matched center was selected as a control. Forty primary healthcare center physicians and 480 mother-child (6-18 months) pairs were included in the study. The mother-child pairs recruited were visited at home within 2 weeks, 90, and 180 days after the initial consultation with trained health workers. Special questionnaires were used to collect information on healthcare providers' knowledge of nutrition counseling and practice (counseling skills); maternal knowledge of basic nutrition-counseling recommendations, maternal compliance with the recommended feeding practice; child dietary intake; and gains in weight and length. CFC-trained physicians were more likely to engage in nutrition counseling and to deliver more appropriate advice. This was reflected in improvements in maternal recall of complementary feeding messages, which were higher in the intervention group compared with the control group. Six months after the consultation, children in the intervention group had significantly greater weight gains compared with the control group (0.96 vs. 0.78 kg; P=0.038). Children in the intervention group, who were 12-18 months of age at the time of recruitment, had significantly less faltering in length gain compared with the control group (height/age Z-score; 0.23 vs. 0.04; P=0.004). Nutrition counseling training improved counseling abilities of primary healthcare physicians and led to improvements in mothers' knowledge and practices of complementary feeding. In turn, this led to improved growth of children. We recommend wide and regular utilization of the CFC course to improve the knowledge and skills of health workers who provide counseling to mothers for complementary feeding.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):1-8.
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    ABSTRACT: Rice (Oryza sativa L.) is one of the leading food crops of the world, the staple food of over half the world's population. The bran, which is an important byproduct obtained during rice milling, constitutes about 1/10 of the weight of the rice grain. Rice bran is the outer brown layer including the rice germ that is removed during the milling process of brown grain. This milling byproduct is reported to be high in natural vitamins and minerals, particularly vitamin E. The present study was conducted to determine the chemical composition of bran and bran oil of 13 different rice varieties commonly produced in Egypt, to study the utilization of rice bran in bread production, and to assess the quality and acceptance of the rice bran edible oil produced. Rice bran was produced from 13 Egyptian varieties of recently harvested rice as well as from paddy rice stored for 1 year. The extracted bran was immediately stabilized then subjected to chemical analysis (such as moisture content, protein, fat, carbohydrates, fiber, and ash) as well as trace and heavy metals determination (P, K, Na, Ca, Fe, Zn, Cu, and Mg). Bread was produced by adding Giza172 rice bran at three different concentrations to wheat flour then subjected to chemical analysis, caloric content, and organoleptic examination. Bran oil was extracted from the different varieties of rice bran (recently harvested and stored) then subjected to chemical and organoleptic examinations as well as vitamin E and oryzanol determination. The percentage of rice bran of newly harvested Egyptian rice was 11.68% and was 10.97% in stored rice. The analysis showed mean values of 5.91 and 5.53% for moisture, 14.60 and 14.40% for crude protein, 14.83 and 15.20% for fat, 44.77 and 45.40% for carbohydrates, 6.55 and 7.06% for crude fiber, and 8.87 and 8.50% for ash for newly harvested and stored rice bran, respectively. Bread containing 15% rice bran showed the highest score percentages for organoleptic quality compared with the control (100% wheat flour). Rice bran oil showed higher scores of taste, smell, appearance, and texture than corn oil and sunflower oil. Rice bran contains high nutritional components as well as phytochemicals such as vitamin E (i.e. tocopherols and tocotrienols) and the γ-oryzanol fraction that have positive effects on human health. Storage of paddy rice before milling resulted in significant effect on all studied rice bran characters and rice bran oil characters under the present investigation except crude protein and carbohydrates characters. Substitution of wheat flour with rice bran by 15% in bread production to fortify the bread with vitamin E and to reduce the amount of imported flour is recommended.
    The Journal of the Egyptian Public Health Association 04/2014; 89(1):29-34.
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    ABSTRACT: Thyroid dysfunction is a known complication of transfusion-dependent β-thalassemia. However, information on its frequency and risk factors among Egyptian Children is still unclear. We aimed to determine the frequency of functional thyroid abnormalities among young patients with β-thalassemia and compare the thyroid function status among patients with β-thalassemia major (TM) and β-thalassemia intermedia (TI). This was a cross-sectional study that included 52 β-thalassemia children [27 boys and 25 girls; 34 (65.4%) with TM and 18 (34.6%) with TI]. Their mean age was 16.0±1.91 (range: 12-18) years. Thyroid function and iron load status were assessed by measurement of free tetraiodothyronine, free triiodothyronine, thyroid stimulating hormone (TSH), and serum ferritin concentrations. Serum TSH of the studied cases ranged from 0.28 to 25 μIU/ml with a mean of 4.5±4.8 μIU/ml. None of the studied cases had overt primary hypothyroidism and the frequency of subclinical hypothyroidism was 19.2%. No risk factors for thyroid dysfunction could be identified among our cases. The thyroid profile was comparable in TM and TI patients (P>0.05) and the frequency of subclinical hypothyroidism among TM cases was 20.6% and it was comparable to the 16.7% found among TI patients (P>0.05). No correlations were found between TSH, serum ferritin, chelation therapy, and frequency of blood transfusion. Both TM and TI patients are at risk for subclinical thyroid failure regardless of their iron overload status. Early evaluation of thyroid function in β-thalassemia children and thyroid replacement therapy for subclinical hypothyroidism should be introduced in the treatment protocols.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):148-52.
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    ABSTRACT: Combating poverty and illiteracy represents the cornerstone for promoting health among Egyptian children; yet, drop out from the elementary education is a major problem facing stakeholders in Egyptian governorates. To tackle this problem, many projects were implemented such as reading and writing classes, and Girls Education Initiatives (GEIs). The aim of the study was to construct a clinical and laboratory database for students attending the Girls Education Initiative schools in Upper Egypt. This cross-sectional study was carried out by involving schoolchildren in three Egyptian Governorates implementing the Girls Education Initiative (GEI) project in 197 schools in these governorates. For each student, a questionnaire investigated the possible predictors for intestinal parasitic infections, a stool sample was examined using the Kato-Katz technique, the hemoglobin concentration was measured, and anthropometric assessments measuring weight and height were carried out. Out of 2695 students, 898 (33.3%) students were infected by parasites; 92% of these students were infected by Enterobius vermicularis worms. The mean weight of the girls was 29.4±10.6 kg and that of the boys was 29.1±8.6 kg. The mean height of the girls was 132.5±16.9 cm and that of the boys was 132.9±16.3 cm. BMI was 16.6±6.8 and 16.7±9.5 for girls and boys, respectively. The mean hemoglobin levels were 10.6±1.37 and 10.7±1.4 mg for girls and boys, respectively. More than two-thirds of the studied group had poor hygiene habits, such as contact with canal water, not washing their hands before and after eating food, not washing their hands after bathroom visits, and not washing vegetables and fruits. The students studied had chronic nutritional deficiencies, mainly anemia. Poor hygiene habits, poor household sanitation, and lack of parents' education in rural areas were predictors for intestinal infections. It is recommended that health education campaigns be conducted to increase students' and mothers' awareness and encourage proper sanitation and hygiene habits at home and in their environment.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):153-9.
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    ABSTRACT: Evidence-based medical practice has gained worldwide attention and is an emerging must-know topic for today's physicians. Yet, it continues to puzzle physicians either in its understanding or in its practice, and gaps continue to exist between research-based evidence and clinical practice. This study aimed to evaluate the self perceived EBM competency of the clinicians and staff of Zagazig University Hospital. A cross-sectional study was carried out on a sample of 184 clinicians during the period of March-July 2012 at five randomly chosen special medicine departments (tropical medicine, rheumatology, neurology, dermatology, and hematology-oncology) using a self-administered, specifically tailored questionnaire. Sampled clinicians were dichotomized according to their self-reported frequency of evidence-based practice into evidence-based medicine (EBM) nonusers (62.5%) and EBM users (37.5%). There was no significant difference between users and nonusers in total mean scores (21.37±1.86 vs. 21.34±2.2, P=0.119). Users had significantly higher mean score for self-perceived EBM competency compared with nonusers (P=0.000), although both users and nonusers had unsatisfactory mean score for EBM competency (38.33±2.87 vs. 32.96±3.026, respectively) (median, 39 vs. 33, respectively). Users of EBM had a significantly higher score in competencies related to the use of a bibliographic database, understanding of methodological terminology, confidence in their skills in EBM steps, and consequently in cumulative EBM competency (P=0.000). Our findings support some important facts: first, there is discrepancy between clinicians' perceptions and their competency, as they considered themselves practicing EBM although they were not; second, strategies to promote a change in clinical practice are more likely to be successful if they are based on an analysis of problems. All findings in this study highlighted the importance of training in EBM.
    The Journal of the Egyptian Public Health Association 12/2013; 88(3):121-9.

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