model for southern mediterranean research institute self-assessment: a SWOT analysis-based approach to promote capacity building at theodor bilharz research institute in Cairo [Egypt]

THEBERA is a project funded by the European Union [EU], as an ERA-WIDE FP7 project, aiming to strengthen the Theodor Bilharz Research Institute [TBRI] capacities. A SWOT [strength/weakness/opportunities/threats] analysis of human, structural and organisational existing resources was performed in light of an extensive analysis of liver disease research and clinical management in Egypt, for a full understanding of TBRI needs. Strength and weakness features were identified and analysed, so were actions to be implemented and targets to be accomplished, to develop a business plan gathering the required critical mass [political, scientific, industrial, social] to select investment priorities, to sacrifice non-strategic areas of research, to promote national and international connections and industrial innovations, to update diagnostics and research device technologies and clinical management processes at European levels, to implement fundraising activities, to organise and properly assess training activities for young researchers, physicians, nurses, and technicians. Research institute self assessment is a priority need for sustainable capacity building and for future build-up of a competent health care research institute. Sustainable capacity building strategies must be designed on needs assessment, involving salient requirements: clear strategy, leverage of administrative capacities, industrial support and connections, systematised training programmes and enhancement of mobility of health care staff implemented within ill-defined boundaries and continuously re-evaluated with multiple feedback loops in order to build a complex, adaptable and reliable system based on value

Epidemiologic approach for early detection and control of renal and urinary tract diseases in rural populations

The dipstick testing, microscopic examination of urine and urine cytology were performed for inhabitants from two rural villages [El Shobak El Sharki, V.I and El Katta, V.2] in Giza G. The proliferating cell nuclear antigen [PCNA] and Schistosoma haematobium antigen were done by immuno-histochemical stain to confirm diagnosis. Also, they were subjected to medical questionnaire, clinical examination, ultra-sonography of kidneys and urinary tract. The results showed that V.2 had higher percentage of haematuria, proteinuria, glucosuria and lower urinary tract infection than V.I. Crystaluria was higher in V.I. Sensitivity of dipstick testing compared to microscopic examination was 26.6%, and specificity was 78.7%. Lower urinary tract infection cytologically detected was 44.2% sensitivity and 62.5% specificity compared to pyuria detected by microscopic examination of urine. Among those suffering variable urinary abnormalities, schistosome antigen was not detected in any fixed urine samples in comparison to corresponding confirmed positive controls. Urine cytology detected urinary tract infection, Crystaluria, dysplasia and atypia, squamous metaplasia and transitional cell carcinoma [TCC]. PCNA positivity was found in TCC [100%], dysplasia [50%] and squamous metaplasia [28.6%]. So, microscopic examination of urine proved valuable for tract abnormalities as pyuria, haematuria and crystaluria. Also, urine cytology is a must for malignancy of urinary tract especially in adult males

Epidemiology of Schistosoma mansoni infection and its relationship to snail distribution in a village at the Nile Bank south to Cairo

The relationship between epidemiology of S.mansoni infection and snail distribution at a village, related to Guiza Governorate and lies south to Cairo, was investigated. A systematic random sample of houses was selected. All inhabitants of the houses were invited to share in the study. The Number examined was 704. Urine and stools were examined using Nucleopore filtration and standard Kato-Katz techniques, respectively. Snail collection was done from 35 sites along the water bodies related to the village. Snails collected were examined by cercariae shedding under light. Snail differentiation was done. The results showed that the prevalence of Schistosoma mansoni human infection was 25.1% and GMEC was 2.4 +/- 5.5. Schistosoma haematobium infection was zero percent. Biomphlaria alexandrina snail infection rate was 3.7% with density equal 0.5 +/- 1.3. Bulinus truncatus snail infection rate was zero percent. The pattern of S. mansoni human infection was closely related to snail distribution and infection. Presence of a hybrid species of B.alexandrina and B.glabrata may explain the epidemiological pattern found in the studied village

Upgrading of Kato-katz technique for diagnosis of S. Mansoni infection in rural Egypt

Processing of the same stool samples was done using standard Kato-Katz [KK] technique with 41.7 mg of stools and one of the three modifications. These included KK technique using a higher concentration of glycerin for preparation or another stain [negrosin- eosin] with a specified formula instead of the standard malachite green or processing a smaller volume of stools [20 mg]. The results showed that using cumulative infection rate from the two comparable tests as the reference KK with higher concentration of glycerin was more sensitive than standard KK [sensitivities 77.6% and 61.2%, respectively]. Using negrosin-eosin stain showed higher sensitivity [75.0%] in relation to standard KK technique [70.8%]. KK with higher concentration of glycerin showed the same sensitivity as KK with negrosin-eosin stain [85.7%] in relation to others. All comparisons showed statistically insignificant differences. Using 20 mg of stools showed very low sensitivity in relation to standard KK technique [57.9% and 100%, respectively]. The statistical difference was highly significant. All specificities were 100%. Other screening indices showed the same trend of sensitivities. Degree of microscope clarity was optimal with higher concentration of glycerin. Negrosin-eosin showed better visualization of ova than the standard KK. All modifications took only an hour after processing to be examined. KK technique used with any of these modifications is simple, inexpensive, use with either a higher concentration of glycerin or negrosin-eosin stain

Assessment of the diagnostic system of schistosoma infection at rural health unit level, Egypt

The study sample was six rural health units and 405 attendants. Assessment of inputs was done through review of documents, charts, interviews, questionnaires and direct observation. Assessment of accuracy of the techniques was done by cross matching the results of urine and stools examination using different techniques [filtration and sedimentation for urine, and Kato-Katz and direct smear for stools]. Results of technicians were compared with that of investigators using the same technique. Two days examinations of urine and stools samples were done by investigators using nucleopore and Kato-Katz, respectively. Environment assessment showed that, political and economic environments were the most influencing components that affect the system of diagnosis. Mean daily workload of urinary examinations per technician ranged between 5.8 and 34.8. That of stools examinations was 5.3 and 32.4. Satisfaction rates ranged between 51.3% and 100% for different rural health units. Strengths and opportunities should be intensified. Weaknesses and threats should be treated