An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

Awareness of occupational health hazards among street sweepers and garbage collectors at Beni-Suef city, Egypt; a cross-sectional study

Street sweepers and garbage collectors play an important role in maintaining health and hygiene in the communities. However, they usually work at risky environments that expose them to various morbid conditions. In this study, we aimed at evaluating awareness and attitudes of Egyptian street sweepers and garbage collectors regarding the occupational risks they are exposed to and its preventive measures. Therefore, in a descriptive study, 70 randomly-selected street sweepers and garbage collectors from Beni-Suef city, Egypt were randomly selected and approached through direct interviews with a semi-tailored questionnaire. Our results indicated that street sweepers and garbage collectors were aware of occupational health hazards and diseases, to which they are exposed and may encounter at work. Nevertheless, during the past 12 months, 41.4% of them experienced a job-related health problem. They sweep streets and collect garbage directly unprotected hands and without using any personal protective equipment. Additionally, their attitudes towards taking preventive measures while working did not match their knowledge about their job-related health hazards. We conclude that street sweepers and garbage collectors should be treated as a vulnerable group that requires pre-placement and in-service orientations, health education, vaccinations, medical check-ups, with close monitoring of their attitudes and practice

Molecular analysis of transitional cell carcinoma of the upper urinary tract using CDNA microarray

To date, molecular evidence studies for transitional cell carcinoma [TCC], using the microarray technology, are focusing on TCC of the urinary bladder and no studies have been performed on TCC of the upper urinary tract [UUT]. This study was conducted to monitor the gene expression profiles between transitional cell carcinoma of the upper urinary tract [TCC-UUT] and normal urothelium of UUT. cDNA microarrays were prepared by spotting PCR products of 14.551 human genes onto specially treated glass slides to analyze gene expression among 9 eases of TCC-UUT and 8 cases of normal urothelium in order to study the molecular basis of TCC-UUT development. Quantitative real time polymerase chain reaction [QRT-PCR] was performed for selected genes to validate the results of mieroarray hybridization. After supervised analysis of the microarray data, there was at least a 2.5-fold difference in the expression between TCC-UUT and normal urothelium in 55 genes. Significant up-regulation of 27 genes was associated with cases of TCC-UUT, including matrix degradation-related genes, as well as genes related to growth factors, immunology, cell-cycling and angiogenesis. Conversely, significant down-regulation of 28 genes was associated with eases of TCC-UUT including genes involved in epithelial cell dedifferentiation and keratinization, as well as genes related to cell adhesion and apoptosis. Such gene profiling studies can identify new molecular markers for early diagnosis and disease follow-up, it also allows the classification of tumors into subclasses assisting in disease diagnosis and prognosis, as well as in treatment selection

Hepatitis c virus among different social classes at El-Minia governorate; intra familial spread and psychosocial effects

The aim of the study was to evaluate the intra- familial spread of hepatitis C virus among different social classes and the psychosocial effects in patients with hepatitis C. Fifty patients with chronic hepatitis C were studied. They were classified into A, B and C classes according to their social levels based on the educational degrees, the jobs and the monthly income. All patients answered a questionnaire, which was specifically designed to evaluate the psychosocial effects of HCV infection. This questionnaire included the post infection mode of dealing with the family contacts, friends and colleagues, feelings, behavioral changes, personality changes, and psychosomatic disorders. On the other hand, the family contacts of the patients were subjected to anti HCV antibodies to evaluate the intra-familial spread and positive cases were subjected to HCV RNA [PCR] to reflect the existing viremia. The results showed that there was a significant increased incidence of HCV among the lower social classes. The intra-familial spread of HCV was evaluated among the family members of the 50 patients of the study. The overall positive anti HCV ratio was 8.42 [16/190] and all such positive familial contacts were tested for PCR to reflect the existing viremia. The total number of the positive spouses was 12 cases [24.5%] [five husbands and seven wives] of the total cases. The incidence of the positivity of spouses was significantly increased with the duration of marriage. The total number of sons was 75 of whom three were positive for HCV antibodies by ELISA, one of them showed a negative PCR. On the other hand, the total number of daughters was 66 of whom only one was infected with no significant difference between sons and daughters. Also, there were negative psychosocial effects on the patients reflected by the prevalent psychosomatic disorders