The Journal of the Egyptian Public Health Association最新文献

Background: Cognitive decline is one of the aging health problems that strongly affects daily functioning and quality of life of older adults and threatens their independence. The aim of this study was to assess the prevalence and pattern of cognitive impairment (CI) among community-dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment.

Methods: A cross-sectional study involved 470 community-dwelling elderly aged 60 years or older living in Kafr El-Sheikh Governorate, Egypt. Subjects were recruited from home visits, geriatric clubs, and outpatient clinics. The Montreal Cognitive Assessment tools (MoCA & MoCA-B) were used to assess the prevalence of cognitive impairment, Hachinski ischemic score (HIS) to investigate the type of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) tool to assess the pattern of specific cognitive domain affection, and an Egyptian socioeconomic status (SES) scale to classify the SES of the study participants.

Results: The prevalence of cognitive impairment was 50.2% distributed as 37.7% for mild cognitive impairment (MCI) and 12.5% for dementia. The most common type of cognitive impairment was the degenerative type (47.9%). Pattern of specific domain affection among cognitively impaired subjects ranged from 94% for visuospatial function to 12.7% for abstraction. Cognitive impairment was significantly higher with increasing age, female sex, marital status (single or widow), low education, higher number of comorbidities, and positive family history of cognitive impairment (p < 0.001). Also, cognitive impairment was concentrated mainly among participants with low socioeconomic score (p < 0.001).

Conclusion: In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Patients with mild CI were more than those with dementia, and the most common type of CI was the degenerative type. Increasing educational level of low SES population and improving their access to healthcare services are highly recommended to improve the inequity of cognitive impairment.

Background: The escalating emergence of the COVID-19 pandemic interrupted human life due to the ever-increasing morbidity, containment measures, and the associated emotional distress. This study examined the influence of COVID-19-related measures on the lifestyle behaviors of adults living in the Kingdom of Saudi Arabia (KSA).

Methods: The study recruited 638 participants through convenience sampling in Jeddah and Taif cities, Saudi Arabia. Demographic characteristics and COVID-19-related information were collected through an anonymous self-reported electronic questionnaire. Lifestyle behaviors were assessed before and during the quarantine using the Healthy Dietary Habits Index (HDHI)-A and the International Physical Activity Questionnaire (IPAQ-SF).

Results: The study revealed significant changes in the dietary pattern: a reduction in fish intake and increased consumption of French fries and candies. Vegetables and fruit intake increased significantly. Sedentary time > 6 h per day increased from 36.7% pre to 60.8% during the pandemic. Healthy dietary index score and physical activity MET-minutes/week values were respectively 3.5% and 37.9% significantly higher before compared to the full quarantine period.

Conclusion: The pandemic detrimentally influenced eating habits and physical activity levels that led to weight gain, and hence higher vulnerability to COVID-19 infection and negative outcomes. This analysis provides public health agencies with data to tailor nutrition interventions that mitigate the observed adverse lifestyle behaviors.

Background: Exposure to dust in textile mills adversely affects workers' health. We collected epidemiological data on textile workers suffering from respiratory diseases and assessed work absence associated with illnesses in Faisalabad, Pakistan.

Methods: We recruited 206 workers using multistage sampling from 11 spinning mills in Faisalabad, Pakistan. The data were collected using 2-week health diaries and face-to-face interviews. The data pertains to socio-demographics, occupational exposures, the state of the workers' health, and other attributes. A theoretical framework of the health production function was used to estimate the relationship between cotton dust exposure and respiratory illnesses. We also estimated functional limitations (e.g., work absence) associated with dust exposure. STATA 12 was used to calculate descriptive statistics, an ordered probit for byssinosis, a probit model for chronic cough, and three complementary log-log models for blood phlegm, bronchitis, and asthma to measure dose-response functions. A Tobit model was used to measure the sickness absence function.

Results: We found that cotton dust exposure causes a significant health burden to workers, such as cough (35%), bronchitis (17%), and different grades of byssinosis symptoms (22%). The regression analysis showed that smoking cigarettes and working in dusty sections were the main determinants of respiratory diseases. Dusty work sections also cause illness-related work absences. However, the probability of work absence decreases with the increased use of face masks.

Conclusion: The study's findings imply the significance of promoting occupational safety and health culture through training and awareness among workers or implementing the use of safety gadgets. Promulgating appropriate dust standards in textile mills is also a need of the hour.

Background: According to Islam's teachings, women are religiously exempt from fasting during pregnancy if a woman is concerned about her health or that of the fetus. This study assesses the intentions of pregnant women to fast during Ramadan and evaluates the contribution of items derived from the theory of planned behavior (TPB) in predicting these intentions.

Methods: A cross-sectional survey was carried out in Arabic on a convenience sample of 181 pregnant women in Lebanon using a mixture of in-person (46), telephone (31), and online recruitment (104) techniques from February to April 2020. An Exploratory Bayes Tree Analysis was done to examine which TPB items appeared to separate the intention to fast in the best possible way. Then, an ordinal regression was completed followed by a latent class analysis to examine specific classes of participants that could be determined based on the regression results.

Results: Overall, 58% of participants had the intention to fast all days of Ramadan, 22% had the intention to fast some days and 20% did not intend to fast for any duration. A model was run with perceptions of physical ability, Islam guidance, husband's opinion importance, mother's opinion beliefs, and impact on general health as predictors (R² = 0.74). A four-cluster model was chosen as the most parsimonious one in interpretation, where classes one and two included the groups of women who intended to fast month-long with differences in predictors. Class three represented the group of women who did not have the intention to fast and the final class represented the group of women who had the intention to fast some days of the month. The women's belief in their physical ability to fast and the opinion of the pregnant women's mothers were very important in deciding the participants' intention to fast.

Conclusions: Items derived from TPB constructs helped in producing a model predicting women's intention to fast during Ramadan. Educational messages and interventions related to fasting while pregnant may be delivered by individuals with legitimacy among pregnant women such as those viewed by the target population as powerful motherly figures in their communities.

Background and purpose: Diabetes mellitus (DM) is a leading cause of death worldwide. Stigma is a sign of social disgrace occurring within public relations, and it is linked with many health conditions including diabetes. Stigma could worsen the disease course, reduce treatment adherence, and affect the quality of life of diabetic patients. The objective of this study was to assess the magnitude of diabetic stigma among patients with type 2 DM.

Methods: In this analytic cross-sectional study, data collection was performed from June 1, 2022, until November 1, 2022, et al.-Najaf City, Iraq. A consecutive sample of 429 patients with type 2 DM was interviewed using the Arabic version of the type 2 Diabetes Stigma Assessment Scale (DSAS-2), which is a validated tool. The total diabetic stigma score, treated differently score, self-stigma score, and blame and judgment score were estimated.

Results: The mean age of the sample was 56.6 years, and males represented 61.8% of them. The total diabetic stigma score mean was 51.72. The question regarding people's judgment of food choices showed the highest rate (53%) among patients. Problematic stigma appeared in 24.71% of DM patients. Lower educational level, being divorced or widow, age above 50 years, being unemployed or housewife, and lower income showed significantly higher diabetic stigma scores.

Conclusion: One-quarter of type 2 DM patients showed problematic stigma. The mean diabetic stigma score was significantly higher among patients with lower education, divorced or widow status, older age, unemployment or housewife category, and low-income status.

Background: Provider bias is a main barrier that extensively violates the right of free family planning method choice. Egypt is one of the countries that shows skewness in its method mix. Provider bias and insufficiency of alternative methods are identified as potential factors underlying this phenomenon which contributes to high unmet needs and discontinuation rates. Provider bias may be influenced by cultural beliefs and societal trends and is usually overlooked as a possible cause of this skewed method mix. This study aims to explore the presence of provider bias in rural Upper Egypt and its potential causes, a community with conservative cultural beliefs and least contraceptive prevalence rates.

Methods: This is a qualitative study using the "simulated client's approach." The study was conducted in 16 villages in Assiut and Sohag governorates in Egypt. The simulated clients visited 30 clinics, 15 in each governorate, including primary healthcare units and private clinics. Three scenarios were used to explore the physicians-imposed restrictions for contraceptive use with different clients' eligibility criteria. Data was analyzed using the grounded theory methodology.

Results: Recommending a contraceptive method for the mystery clients was not based on informed choice. Most providers had method or client bias. Copper IUD was the most favorable contraceptive method recommended by providers, with negative attitude towards using hormonal contraception. Nulliparous and young clients were discouraged to use contraception before proving fertility or offered temporary methods as emergency contraception or condoms. Providers have shown misconceptions related to infertility-associated complications of contraceptive use, especially for the young and nulliparous women.

Conclusion: In this study, providers had a clear bias towards recommending IUD rather than all other contraceptive methods, which was hindered in some cases by the lack of insertion skills. Interventions to reduce provider bias should go beyond technical training. Moreover, training on reproductive rights should be a main component of routine training. Providers should regularly receive research results and be oriented toward recent medical eligibility criteria of contraceptive methods use. Moreover, the sociocultural beliefs of providers that may affect their practice should be explored and addressed.

Background: According to National Institute for Health and Care Excellence (NICE), UK, common audiovestibular symptoms of COVID-19 include dizziness, tinnitus, and otalgia. The pathogenesis of otologic disorders ranges from direct damage to the inner ear structures to immune-mediated damage. Since the start of the pandemic, the prevalence of audiovestibular symptoms linked to COVID-19 has not been thoroughly investigated in Egypt. Our objective is to study and analyze the prevalence of the audiovestibular symptoms in the Egyptian population with history of COVID-19 infection.

Methods: A cross-sectional study was conducted among Egyptian adults on the presence and nature of the audiovestibular manifestations in COVID-19 patients. An online questionnaire was used. The questionnaire was developed using Google Form. It was disseminated to the target population through social platforms from October 2021 till February 2022.

Results: Data from 245 respondents were collected through online assessment of a convenient sample. The following de novo audiovestibular symptoms were experienced by the participants: Vertigo 20.8%, hearing loss 13.9%, tinnitus 12.7% and ear fullness 11.4%. No correlation was found between the investigations done (D-Dimer, CT chest) and the audiovestibular symptoms.

Conclusion: Audiovestibular symptoms are fairly common among COVID-19 patients, with higher prevalence, particularly of vertigo, in our study sample compared to the literature. It is recommended that patients with audiovestibular symptoms undergo early testing so that prompt interventions can be taken.

Background: Coronavirus disease (COVID-19) caused the death of millions of people and affected the lives of hundreds of millions worldwide. The WHO recommendations aimed mainly to reduce transmission, minimize infection, and get people vaccinated. Nevertheless, opinions and attitudes about the disease varied. In this study, we evaluated personal attitudes and practices of a cohort of an educated Syrian population, after several waves of infection with COVID-19 and the release of different types of vaccines.

Methods: A cross-sectional internet-based survey was launched in January 2022.The survey queried the participants' personal experience, attitudes, practices towards COVID-19, and vaccination.

Results: The study included 408 individuals. The respondents were mainly females (72.6%), 20-29 years old (39.2%), and college graduates (59.3%). A large proportion (89.7%) reported having been infected at least once during the pandemic; a significant association was found with age (p = 0.001). Nearly half of the respondents got vaccinated; the majority were > 40 years old. Opinions differed regarding the effectiveness and safety of the vaccines; only a small percentage of the participants (17.4%) thought all vaccines were effective and safe. Remarkably, the level of education did not significantly dominate the participants' attitudes or practices towards the COVID-19 pandemic. Approximately half of the respondents (44.9%) stated their lives were affected by the pandemic and over the third were worried (38%). A significant association was detected with gender in favour of females. Most of the participants have taken at least one precautionary measure to limit the infection.

Conclusion: The level of education did not significantly dominate the participants' attitudes or practices towards the COVID-19 pandemic. Female respondents were more cautious, concerned and committed to taking precautionary measures regardless of their education level. However, their unwillingness to receive the vaccine raises significant concerns. Efforts should be made to emphasize the importance of immunization, the safety and effectiveness of vaccines, and encourage vaccination among individuals.

Background: Bakery products are important food snacks consumed by people of all ages and economic groups. The growth of unwanted microorganisms that deteriorate products such as bacteria, moulds, and fungi in these foodstuffs may offer risks to consumers' health and generate considerable economic losses. This work aimed to assess the microbiological quality of some packed and unpacked bread products in Alexandria, Egypt.

Methods: This cross-sectional comparative study involved 168 local and branded bakery products that were collected randomly from 2 districts in Alexandria. Hygienic practices such as covering of the bread and wearing gloves during handling were observed and recorded. All bread samples were tested to determine the total plate count (TPC), presence/absence of Staphylococcus aureus (S. aureus), total yeasts and moulds in CFU/g and total coliform count (TC) in MPN/g.

Results: The mean of the total yeasts and moulds and TC in the packed bread was lower than that of the unpacked bread (3.40 × 10³ CFU/g and 3.25 MPN/g versus 6.37 × 10³ CFU/g and 31.61 MPN/g, respectively). However, the mean of TPC in the packed bread was higher than that of the unpacked bread (1.39 × 10⁶ versus 2.07 × 10⁵ CFU/g, respectively). The mean TPC, total yeasts and moulds and TC was higher in the studied flatbread than Fino bread and toast (3.4 × 10⁶, 1.14 × 10⁴ CFU/g and 24.6 MPN/g, respectively). The presence of S. aureus was higher in flat, unpacked bread, bread displayed outside the shop and handled without gloves.

Conclusion: Bread produced by local bakeries showed lower standards in packaging and microbial quality. Better manufacturing, packaging, storage, and handling initiatives should be introduced to avoid related food safety concerns in the future. The formal authorities should define and clarify standards and rules on bread safety.