Handicapping conditions among children under six years in family medicine centers in Alexandria. Part I: screening and detection

Early identification of children with developmental delays is important in the primary health care [PHC] setting. The PHC practitioner's office is mostly the place where the majority of children younger than 5 years of age are seen and is ideal for developmental and behavioral screening by the use of age-appropriate developmental checklists to record milestones during preventive care visits as a part of developmental surveillance. The aim of the present study was to screen children under 6 years in 5 family medicine [FM] facilities in Alexandria, Egypt for the early detection of some handicapping conditions [visual, hearing, speech, and orthopedic] and to review the family files of the screened children to assess the number of suspicious cases missed by the family physicians. Data were collected using a pre-designed screening sheet for the early detection of the above mentioned handicapping conditions among 550 children attending the study FM facilities and by family file review of the screened children. Screening of children under 6 years old had yielded the following results: orthopedic abnormalities represented 14.2%, followed by visual abnormalities [9.3%], speech abnormalities [8.9%], hearing abnormalities [6.2%], and mental retardation [2%]. Risk factors found to affect the occurrence of the study handicapping conditions were found to be mostly positive family history, consanguinity between parents, maternal age at the time of pregnancy, and complications during pregnancy; labour; and in the post natal period. Recording was incomplete as only 11.6% of the screened children had both complete files including growth and development charts. Poor performance of the family physicians in the study facilities was evident regarding detection and referral of handicapped cases in children as only 75 handicapped cases [46.3%] could be detected by the family physicians in the study facilities out of the 162 handicapped cases detected by the researcher. Family physicians in the study facilities referred only 57.3% of the detected. Therefore, screening for risk factors of handicap should be performed by the family physicians during routine daily activity as well as during the well baby clinic schedules. This is best achieved by proper development and application of guidelines and protocols for screening, follow up, and management of handicapping conditions including proper recording and referral

Handicapping conditions among children under six years in family medicine centers in Alexandria. Part II: assessment of resources

Handicap means the disadvantage or restriction of activity caused by disability. It is the practical consequence of disability and impairment. It is estimated that 5% of the world's children population suffer from severe handicaps and an additional 10-15%, may need special attention to overcome less severe handicaps. The aim of the present study was to assess the quality of human and non-human resources necessary for the prevention and control of handicapping conditions among children under 6 years in 5 family medicine [FM] facilities in Alexandria, Egypt. Data were collected using 2 different questionnaires: a checklist was designed to assess the availability of resources required for the early detection of visual, hearing, speech, and orthopedic causes of handicap among children under six in the study family medicine facilities. A self-administered questionnaire was designed to assess the knowledge, attitude, and practice [KAP] of 34 family physicians working in the study FM facilities about the early detection of the previously mentioned handicapping conditions in children. The percentage of registered to the total population was highest at Gohn FM unit [68.8%] and lowest at El-Seiouf FM center [24.6%]. Most of the equipment required for handicap screening was available in the study FM facilities. Child health records, daily registration records, and well baby clinic records were available, but no specific records or reports for handicapping conditions in children were present. About half of the physicians [47%] had no postgraduate studies at all, only 23.5% and 3% of the family physicians were trained about detection of mental retardation, and genetic causes of handicap, respectively and 14.7% did not attend any training course at all. The majority of family physicians had fair knowledge [76.5%], positive attitude [61.8%], and partial practice [70.6%]. The difference in KAP levels between the different study facilities was statistically insignificant. There was a statistically significant direct proportionate relation between the knowledge of the physicians and their practice; i.e., the higher is the knowledge the better is the practice. Therefore, handicap prevention and control should be properly integrated within PHC [Family medicine] services with continuous, proper training of all health team members

Quality assessment of primary health care services provided for diabetes mellitus control in Alexandria

The present study was conducted aiming at: assessment of the quality of primary health care [PHC] services provided for the control of diabetes mellitus [DM] in Alexandria; and opportunistic screening of high risk individuals attending PHC facilities for DM. Accordingly, the availability of human and non-human resources for DM control in two r h and two urban PHC centers in Alexandria [one of them was sewing a desert area] was assessed by a pre-designed checklist 920 adult PHC attendants were screened for risk factors of DM. Individuals having more than one of the following risk factors: age above 50 years, overweight [body mass index >27 kg/m2], family history of DM in first degree relatives, history of hypertension, hypertension [systolic blood pressure >140 mm Hg and /or diastolic blood pressure >90 mm Hg], history of hyperlipidemia and history of gestational diabetes or birth of a large sized baby in females- were subjected to random capillary blood glucose [RCBG] testing. Cases were considered likely diabetic if RCBG was >200 mg/dl. The performance of all PHC physicians examining and managing 560 diabetic patients was observed over a period of two months. One fourth of the diabetic cases were checked for the level of glycaemic control by fasting capillary blood glucose testing

role of primary health care in patient education for diabetes control

The aim of the present work was to study the role of primary health care [PHC] in patient education for diabetes control in Alexandria. Accordingly, the knowledge and perception concerning diabetes and its management of all PHC physicians [88] and nurses [104] working in 2 rural health centers and 2 randomly chosen urban health centers of Alexandria Governorate were assessed by a pre-designed self-administered questionnaire. All diabetic patients [560] over 20 years of age attending the study health facilities over a period of 2 months were assessed for their knowledge and attitude concerning diabetes and self-management and asked about their degree of satisfaction with the provided PHC services by a pre-designed interview questionnaire. It may be concluded that there is a serious gap in the provision of basic education services to the majority of diabetic patients attending PHC facilities in Alexandria

Domestic supplies and community self-help in Sidi Ghazzi area, Nile Delta: a strategy for schistosomiasis control Part I Water supplies and the prevalence of schistosomiasis

With the aim of studying the relationship of domestic water supplies to the prevalence of schistosomiasis in Sidi-Ghazy, a demography and tap availability survey was made on the area. A schistosomiasis survey was made on a 5% sample from twelve villages representing the different water supplies. Results when interpreted revealed that water provision was poor in coverage, beside maintenance. Also, schistosomiasis, which was of high prevalence rates in the area, was not related to the mere presence or absence of a public water tap in the village though domestic exposure seemed to play an important role in its occurrence. It is concluded that more intense study of population water interaction relative to schistosomiasis is necessary; especially with the consideration of such a long term control program as that involving community self help with an adequate community water supply. The latter is though to generate enthusiasm in the population for the increased conveniences associated, besides playing a role in the control of many water borne diseases besides schistosomiasis

Domestic water supplies and community self-help in Sidi-Ghazzi area, Nile area: a strategy for schistosomiasis control

An attempt was made at assessing the incidence of schistosomiasis and the acceptability of domestic water in Sidi-Ghazy. Urine and stool samples were collected from individuals of three villages [with different water sources] that had been proved free the previous year and examined. Also samples of water were collected from different tap and well water sources available in the area and analyzed for the physical features, including pH, color, odor, turbidity, hardness, chlorides, taste and conductivity. Results showed that the overall incidence of schistosomiasis mansoni was higher than hematobium in the three studied villages with little difference between them. Meanwhile differences appeared between the villages in rates by age and sex indicating the role of domestic water interaction. Domestic water was proved to be insufficiently available in half the followed up taps. At the same time water available in the rest proved only partially Acceptable, while water was quite unacceptable. It is concluded that this could be the reason for the community's in difference towards tap and well water use, and therefore improvement of the domestic water availability and acceptability would probably affect the rates of schistosomiasis

Domestic water supplies and community self-help in Sidi Ghazzi area Nile delta A strategy for schistosomiasis control: part III, the acceptability of community participation

With the aim of assessing the acceptance of the concept of community participation by the community, 128 village leaders in Sidi-Ghazy were subjected to a questionnaire survey and a schistosomiasis infection investigation. Results revealed that while sufficient knowledge of the relationship between schistosomiasis and water contact was generally poor, it appeared particularly so in the older age groups. At the same time the more the knowledge the lower was the infection rate. The acceptance of community participation in schistosomiasis infection rate was lower the more the acceptance of community participation in water supplies and maintenance. Conclusively it appears that acceptance of C.P. While currently inadequate could be raised with the up lifting of the standard of knowledge about disease transmission and water contact hazards. Meanwhile, it seems of prime importance that links between the community and governmental sectors involved be strong in order to raise community confidence and self-help

Assessment of health service delivery in a rural unit of Beheira province, ARE

Health service delivery in a rural unit of Behaira province was assessed. A questionnaire schedule was constructed to interrogate for basic information, quality of medical care, quality of endemic disease control, physician's home visiting, referral system, community disease control including immunization and isolation, health education, school health care, mother and child care and family planning, dental care and causes of reduced benefit from the unit services

epidemiology of ABO and Rh blood groups in NAY village

A house to house survey of the A B O and Rh blood groups was performed in "Nay" village in Qualiubia governorate and a pedigree analysis was done for each family. Results revealed that the prevalence of the different blood groups does not follow the Hazdy Weinberg formula. This might be due to different social, psychological and biological factors which interfere with the randomity of mating of human beings. Group O, having the highest prevalence in this study as well as in other communities which have a high risk of infection with microorganisms might suggest its value in adaptation to such an environment through the Anti-A and Anbi-B antibodies in the blood. The absence of these antibodies in the blood of those having A B groups might explain the very low prevalence of that blood group. The role of Rh genotype might differ since more holders of Rh antibodies exist among Europeans, The fact that females were more among blood group O holders besides the high prevalence of group O shown in the present study, might indicate the presence of a sex selecting factor. The female sex which has a better resistance to environmental stresses and pregnancy stresses, is that sex mostly of group O. Foetal blood passing transplacentally to the mother could be fatal to her and it is the group O mothers that are capable of getting rid of it and surviving