Determinants of unintended pregnancy and its impact on the health of women in some governorates of Upper Egypt

Worldwide, more than half of all unintended pregnancies end in abortion, indicating the preference for increasingly smaller families. The present work aimed to assess the determinants of unintended pregnancy and its impact on women's health in El Fayoum and Benisuef governorates. A community-based cross-sectional household survey was conducted among 827 married women of reproductive age. The study was conducted in two governorates, El Fayoum and Benisuef, for a period of 6 months. The current study revealed that 15.9% of women who participated in the study had an unmet need for family planning, with subsequent unintended pregnancy. Higher age of women and her age at the time of marriage, illiteracy, short interpregnancy spacing, exceeding the desired number of children, negative attitude of husbands toward the use of family planning methods, and absence of discussion between partners on the use of means to postpone pregnancy increased the number of unintended pregnancies. Also, women with unintended pregnancy were at a higher risk of experiencing health problems during her pregnancy. Despite the efforts taken by family planners, the problem of unintended pregnancy continues to increase in Egypt, with its adverse effect on pregnancy and maternal outcomes. Therefore, the strategy for maternal mortality reduction in Egypt should focus on addressing the unmet needs of high-parity, uneducated, nonworking women

Knowledge and behavior towards viral hepatitis among Egyptian children, their mothers and pediatricians

Aim of the work was to assess the knowledge and behavior towards viral hepatitis among children, their mothers and pediatricians. It also aimed to determine the risk factors affecting the children's knowledge towards viral hepatitis and to evaluate the effect of the interventional health education program on their knowledge. This study is an interventional cross- sectional study carried out on a sample of 513 children aged 10 to 18 years, their mothers and 89 pediatricians, recruited from health insurance out-patient clinics. A questionnaire was constructed to collect demographic data [age, sex, and socioeconomic status], level of education of child as well as his parents. For the assessment of knowledge towards viral hepatitis, the questionnaire included 26 questions about the types, causative organisms, mode of transmission, symptoms, complications and prevention. It also included questions concerned with the children's behavior towards viral hepatitis as sharing spoons, razors and toothbrushes. The questionnaire was fulfilled by the study researchers through a direct interview with the studied groups. By the end of each day, a health education lecture covering the information included in the questionnaire was held for both, the children and their mothers. the questionnaire was fulfilled once more by the children to evaluate the effect of intervention program of health education. Those who reported <50% of the score were considered to have bad knowledge, 50%-75% fair knowledge and >75% were considered to have a good level of knowledge. The majority of the studied children [70%] and their mothers [100%] were found to have a bad level of knowledge while only 13% of children had a good level of knowledge towards viral hepatitis. As regards the pediatricians, 93.1% had a good level of knowledge while only 2.3% had a bad level. The mean level of knowledge was upgraded significantly among children from 7.8 +/- 7.4 before health education to 12.1 +/- 6.1 for the post test. The level of knowledge was significantly higher among those within the age group 16-18 years and those in secondary schools in the pre and post-tests [p=0.000]. Logistic regression analysis revealed that the younger age of children was the most significant predictor for bad knowledge. As regards the behavior, nearly 3% and 5.6% of the studied children share toothbrushes and shaving razors while none of the pediatricians did. The percentage of vaccinated pediatricians against HAV and HBV vaccination was 15.7% and 64.7% respectively. There was a low level of knowledge towards viral hepatitis especially among children and their mothers. Health education program led to upgrading of their knowledge. More efforts have to be carried out on wide scales in order to raise the level of children's knowledge and consequently their behavior towards viral hepatitis for the prevention of this serious disease.

Malnutrition and underlying factors among primary school children in Giza Governorate, Egypt

To assess the prevalence of nutritional deficiency diseases and their underlying factors and to assess nutritional knowledge and behavior of urban and rural primary school children. The study is a cross sectional and analytic study conducted upon 1000 primary school children within the age range 10-13 years from five Governmental Primary Schools in Giza governorate. Three questionnaires were fulfilled including demographic data, past history of illnesses and nutritional knowledge and behavior. Full clinical examination and measurements of weight and height were done to assess height for age [HA] and body mass index [BMI]. Hemoglobin levels in blood and stool analysis were performed for all studied children. In rural areas 64.7% of children had errors of refractions, 93.6% had pallor, 42.7% had gingivitis and 11.2% had grade 1 goiter which were significantly higher than children in urban areas [44.5%, 80.6%, 31.3% and 8.6% respectively] while xerosis and flat nails were insignificantly higher. A high proportion of children were underweight and significantly higher in urban than rural areas [76.9% and 69.4% respectively]. High percentages of parasitic infections were found which were significantly higher in urban than rural areas [5 1.7% and 46.2% respectively]. About one third of children [32.7%] in urban areas suffered from anemia compared to 19.7% in rural areas and more than 50% of them had severe anemia [18.3% and 10.3% respectively]. The majority of faulty feeding habits were significantly higher in rural than urban children. Total nutritional knowledge score was 97.4% in urban and 99.2% in rural areas with insignificant statistical difference between regions. As for the total nutritional behavior, about 3/4 of children in both regions had fair score with significant urban-rural statistical difference [74.8% and 71.1% respectively]. The rural community in Giza Governorate showed a significantly higher prevalence of clinical signs indicative of malnutrition and faulty feeding habits than urban regions while the urban community showed a significantly higher prevalence of underweight, anemia, parasitic infestations and dental carries than rural areas. Both regions had poor total nutritional knowledge scores and fair total nutritional behavior scores. The most significant variables influencing the nutritional knowledge were socioeconomic standard [SES], age and urban residence while for nutritional behavior these factors were age, urban residence, SES and nutritional knowledge. The study recommends that primary school children in rural as well as urban areas should be considered as a priority in the nutrition promotion and education programs with a special address to micronutrient supplementation and fortification and de-worming