The Journal of the Egyptian Public Health Association最新文献

Background: Children with disabilities face heightened violence risks, particularly in resource-limited settings. Despite global evidence, data on violence against children with disabilities in rural Upper Egypt remain scarce. This study aimed to determine the prevalence, types, and family-related risk factors of violence against children with disabilities in this region.

Methods: A community-based cross-sectional study was conducted (December 2023-March 2024) in two rural Upper Egypt villages. Using a multistage random sampling, 213 young adults (aged 18-24 years) with disabilities were included. Data were collected using validated structured interviews (ISPCAN tool) and focus group discussions.

Results: The sample comprised 54% males and 46% females. Around 50% primarily had intellectual, and 33.8% had physical disabilities. Emotional violence was nearly universal (93.1 in males, 100% in females), followed by physical (73.6-78.6%) and sexual violence (21.1-26.4%). Females experienced higher violence rates (50% vs. 9.6% males, p < 0.001). Parental drug abuse (22.6% males vs. 10.2% females, p = 0.02) and low socioeconomic status (59.1% vs. 43.9%, p = 0.03) were significant risk factors. Intellectual disabilities correlated with elevated sexual violence Perpetrators included parents (35.4-41.8%) and unrelated individuals (44.3-60%).

Conclusions: Systemic violence against children with disabilities in rural Upper Egypt was pervasive, driven by poverty, low parental education, and gender disparities. Interventions must address familial and community-level factors, including economic support, parental education, and stricter enforcement of child protection laws.

Background: Obesity and overweight represent significant global public health concerns. School-age adolescents are particularly at risk of experiencing obesity and overweight due to a sedentary lifestyle, electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Evidence on low physical activity levels is available in Pakistan; however, a comparative analysis of PA levels between rural and urban adolescents is lacking. The study aimed to compare physical activity levels among school-age adolescents in rural and urban areas of Swat, KPK, Pakistan. The study also aimed to explore how gender, age, grade, and school type influenced the PA levels of adolescents.

Methods: A cross-sectional analytical study was carried out with a sample size of 287 school-age adolescents (aged 10 to 14 years) selected from eight governmental and private middle schools in rural and urban areas of district Swat, KPK, Pakistan. The data about physical activity was collected using a researcher-administered questionnaire adapted from the Physical Activity Questionnaire for Older Children (PAQ-C).

Results: The mean PA score for rural adolescents was 3.65 ± 0.38 out of a total score of 5, whereas the mean PA score for urban adolescents was 2.22 ± 0.47 with a significant difference (p < 0.001). In addition, a significant difference between private and government school-age adolescents' PA levels was found (p < 0.001). However, there was no significant difference in PA levels in terms of gender and school grade. Further, a very low negative correlation was found (r = - 0.1) between school-age and PA scores.

Conclusion: The place of residence has an impact on the PA level of adolescents. The study found a significant difference in the mean PA levels of school-age adolescents in rural and urban areas. Future research is recommended to identify the factors contributing to disparities in PA among adolescents residing in urban areas.

Background: Dysmenorrhea, or painful menstruation, is a common condition among women of reproductive age, significantly hindering their ability to work and participate in social, family, and sports activities. In Egypt, there is limited data on the frequency of dysmenorrhea among working women and its impact on their productivity. Therefore, this study aimed to investigate the prevalence of dysmenorrhea among working women, its determinants, and its effect on their work productivity and activity impairment.

Methods: A cross-sectional study was conducted on 548 working women aged 20 to 45 years. Data were collected using an interview-based questionnaire that included sociodemographic, occupational, and clinical information, menstrual history, job stress assessment using the workplace stress scale, and work productivity evaluation with the work productivity and activity impairment questionnaire.

Results: The dysmenorrhea rate was 66.1%, with 64.7% of those affected reporting moderate to severe pain. Key independent predictors of dysmenorrhea include young age (≤ 32 years), working overtime or extra jobs, experiencing workplace stress, having an early menarche (< 12 years), and having a family history of dysmenorrhea. Dysmenorrheic working women reported an absenteeism rate of 39.5%, a presenteeism rate of 96.1%, an overall work impairment rate of 96.4%, and a daily activity impairment rate of 94.2%. All of these rates were significantly higher in dysmenorrheic working women compared to those without the condition. Notably, the significant differences between the two groups increased with the severity of menstrual pain.

Conclusion: Dysmenorrhea is a prevalent issue among working women in Egypt, adversely affecting their performance at work and in daily activities. Therefore, providing workplace rest areas equipped with pain relief options, implementing flexible work schedules or menstrual leave, and encouraging dysmenorrheic working women to seek medical care for severe pain that impairs their work or daily activities are highly recommended.

Background: Dysmenorrhea is a highly prevalent gynecological problem that may compromise the girls' quality of life. Disabled girls might experience menstruation both differently and more negatively compared to non-disabled girls. The current study aimed to investigate the prevalence of dysmenorrhea and its associated symptoms amongst disabled girls.

Methods: A cross-sectional study was conducted among 93 adolescent girls with disabilities. An interviewer questionnaire was used to inquire about personal characteristics, menstrual history, knowledge and attitudes of dysmenorrhea, symptoms that coincide with menstruation, and methods used by girls to manage their menstrual pain. WaLIDD scale was used to assess pain intensity during menstruation.

Results: About 97% of the studied disabled girls suffered from moderate or severe degrees of menstrual pain. Using methods to mitigate the pain was reported by 72%. Herbal drinks and analgesics were the most frequently used methods. School absenteeism because of dysmenorrhea was reported by 36%. Most of the girls (87.1%) had a poor knowledge level. The most frequent disabling/severe symptoms that coincide with dysmenorrhea were general aches, dizziness, and fatigue. Increased perception of symptoms coinciding with menstruation was a significant predictor for severe dysmenorrhea (AOR = 3.279, 95%CI = 1.028:1.088).

Conclusion and recommendations: Most disabled girls suffer from moderate to severe dysmenorrhea. Increased symptoms associated with menstruation positively affect severe dysmenorrhea perception. Girls with disabilities need better access to menstrual health education. Tailored reproductive health programs should be provided for blind and deaf girls for assurance and proper practice to manage symptoms associated with menstruation, especially pain, to mitigate their disabling impact.

Background: Same-day elective surgery cancellations disrupt healthcare efficiency by wasting resources and increasing costs due to repeated preparations and extended hospital stays. Beyond the financial toll, delays in necessary procedures can worsen health conditions, heighten patient anxiety, and prolong recovery times. These cancellations also place emotional and logistical burdens on patients and families, further amplifying their impact. This study aimed to determine the prevalence of same-day elective surgery cancellations at the El-Demerdash University Hospital in Egypt, identify the underlying causes-including hospital-related, patient-related, and staff-related factors-and explore the perceptions of operating room (OR) staff regarding these causes.

Methods: A mixed-methods approach was used, combining quantitative and qualitative components. The quantitative component was a cross-sectional study including the prospective collection and analysis of 993 elective surgeries performed in 21 ORs at El-Demerdash University Hospital. The qualitative component involved 25 OR staff members and comprised two focus-group discussions with OR nurses, as well as 15 in-depth interviews with surgeons, anesthesiologists, and OR secretaries.

Results: The cancellation rate for same-day elective surgeries was 12.59%. Key reasons for cancellation included unavailable OR time (24.03%), lack of ICU beds (21.71%), changes in the patient's medical condition (14.73%), prolonged previous surgeries (10.85%), and equipment issues (7.75%). The qualitative analysis revealed that most OR staff expected a cancellation rate of 10-20%, identifying ICU bed unavailability and changes in patient condition as the primary contributing factors.

Conclusion: Same-day elective surgery cancellations at El-Demerdash University Hospital are lower than the rates reported in most developing countries but remain higher than the international efficiency benchmark. The leading causes are primarily avoidable and hospital related. To improve OR utilization, strategic management interventions targeting the key causes are recommended. These include optimizing the OR booking system, improving department communication, and ensuring proper preoperative patient preparation and education and better resource allocation.

Background: In economics, the word "willingness to pay" refers to the highest amount that an individual would be willing to pay, give up, or exchange to obtain goods or services or to avoid something undesirable. It can be applied in healthcare as a way to evaluate the worth of improving the quality of health services. This study aims to assess patients' willingness to pay (WTP) for healthcare quality improvement among hospitalized patients in two hospitals in Egypt.

Methods: Four-hundred and twenty-six patients were asked to provide a rating for different quality attributes. Patients were presented with a hypothetical scenario and asked about their WTP for a monthly insurance premium to benefit from improving each quality attribute. WTP was elicited using the payment card (PC) response format.

Results: Fifty-two percent of studied patients were not willing to pay to improve healthcare quality attributes. Fifty percent of those who were willing to pay were certain to pay. The most commonly stated reasons for unwillingness to pay were "being governmental responsibility" and "household cannot afford" (43% and 36.8%, respectively). Patients were willing to pay the highest amount of money to improve the quality attributes "competence," followed by "outcome" and "doctor-patient relationship" (491.03, 465, and 423 LE, respectively). For all quality attributes, except for waiting time and availability of supplies and equipment, the amount of money the patients were willing to pay increased significantly as the perceived quality of that attribute reduced. Advancing age had a significant negative association with WTP (p = 0.002). Also, advancement in education was associated with significantly higher WTP (p < 0.001). Those with health expenditures ranging from 2000 to < 6000 LE per month were 3.38 times more willing to pay than those with health expenditures ranging from 200 to 1000 LE (p < 0.001).

Conclusion: WTP for quality improvement among study participants was low, being the lowest among the elderly and lower-educated individuals. Community financing should not be a method for funding quality improvements except for a few quality attributes such as doctor-patient communication and increased doctor competence. This should be coupled with clear exemption criteria for those unable to pay.

Climate change has emerged as a global environmental issue exacerbated by human activities. Specifically, greenhouse gas emissions and land-use changes have contributed to rising global surface temperatures and shifting weather patterns. These changes disrupt environmental and ecosystem balance, directly impacting human health. Worldwide, 3.6 billion people live in regions vulnerable to climate change, and it is projected that between 2030 and 2050, an additional 250,000 deaths annually will occur due to climate change-induced malnutrition, malaria, and diarrheal diseases. The health impacts of climate change vary between genders depending on biological, geographical, and socioeconomic factors, with women experiencing more severe negative effects. Reproductive health is significantly affected by rising temperatures, air pollution, extreme weather events, and changing meteorological conditions. Adverse reproductive outcomes (e.g., low birth weight, preterm birth, and congenital anomalies) are more frequently observed in women. Furthermore, climate change exacerbates hot flashes, increases the risk of cardiovascular diseases, and intensifies mental health disorders in postmenopausal women. Climate change has emerged as a global environmental issue exacerbated by human activities. Specifically, greenhouse gas emissions and land-use changes have contributed to rising global surface temperatures and shifting weather patterns. These changes disrupt environmental and ecosystem balance, directly impacting human health. Worldwide, 3.6 billion people live in regions vulnerable to climate change, and it is projected that between 2030 and 2050, an additional 250,000 deaths annually will occur due to climate change-induced malnutrition, malaria, and diarrheal diseases. The health impacts of climate change vary between genders depending on biological, geographical, and socioeconomic factors, with women experiencing more severe negative effects. Reproductive health is significantly affected by rising temperatures, air pollution, extreme weather events, and changing meteorological conditions. Adverse reproductive outcomes (e.g., low birth weight, preterm birth, and congenital anomalies) are more frequently observed in women. Furthermore, climate change exacerbates hot flashes, increases the risk of cardiovascular diseases, and intensifies mental health disorders in postmenopausal women. However, current literature remains limited in addressing the specific effects of climate change on women's health in low- and middle-income countries, as well as its influence during the menopausal period. Further research is needed to explore the intersection of climate change and socioeconomic disparities, particularly in vulnerable populations. Large-scale longitudinal studies focusing on region-specific risks and health outcomes are essential to develop targeted interventions and policies.

Background: Telemedicine is a key factor in increasing patient accessibility, satisfaction with treatment, and quality of care, effectively utilizing physicians' time, and improving communication among medical experts. Despite global interest in telemedicine, there is limited research exploring users' perspectives on telemedicine within the context of Egyptian university hospitals. This study aims to examine physicians' and employees' levels of knowledge, attitudes, and practices toward telemedicine.

Methods: A cross-sectional study was conducted at Tanta University's medical campus from November 2023 to March 2024. One-thousand employees and physicians were surveyed. A self-administered questionnaire was used to collect the data. It consists of four sections: sociodemographic data, knowledge about telemedicine, attitude, and practice of telemedicine.

Results: Half of physicians used telemedicine, and 38.2% of the employees have used e-health services. Applications of telemedicine included patients' investigations communicated through the Internet (76.4%), patients' management with drugs (71.4%), direct medical consultation between patient and physician (65.4%), second opinion consulting (57.6%), sharing experiences and new trends in medicine and surgery with other specialists in other countries (54%), and follow-up of patients through the electronic technologies (53%). About three-quarters of physicians and employees had a positive attitude toward telemedicine. The advantages reported include being easy to use (63%), reducing travel costs for patients (68.6%), and its importance during pandemics, e.g., COVID-19 (59.8%). However, our results indicated potential barriers when using telemedicine, including the need for training; elderly patients find difficulty dealing with technology, poor infrastructure, technical issues, difficulty for patients to express their feelings and communicate with physicians, and a lack of body language.

Conclusion: A considerable percentage of participants were already using telemedicine services, and they were satisfied with the telemedicine system. Though most participants had favorable attitudes toward telemedicine, potential barriers were reported, such as training for physicians and patients, difficulty dealing with technology, poor infrastructure, and technical issues. These findings underscore the need to develop and implement a regulatory framework that supports telemedicine adoption, including data protection, patient confidentiality, and reimbursement standards.