Evaluating the indoor and outdoor environment: using a simple method

Housing is the conjunction of the dwelling, the home, the immediate environment and the community. Between 1960 and 1980, the urban population in developing countries more than doubled and is expected to reach 56% of the total population by the year 2025. In many cities, the development of squatter settlements and shanty towns had grown rapidly causing the destruction of green areas. The number of people living in urban slums and shanty towns is an indicator of conditions in the cities and the United Nations had estimated that about one-third of urban dwellers in developing countries live in such settlements. Poverty is highly prevalent among the residents of these areas. Outdoor environmental degradation, together with the social degradation affects the health of the urban population especially the poor causing a burden of ill-health, disability, poor indoor housing, and high maternal and infant mortality. The aim of the present study is to evaluate the indoor and outdoor environment using a simple method and to assess its reliability and validity. The scoring system, which was developed for the assessment of the indoor and outdoor environmental levels included 36 items [18 for the indoor and 18 for the outdoor] using a questionnaire. Results revealed that the proposed scoring system was able to reveal significance difference between served [water, electricity, and sewerage system were available] and unserved areas when using t-test, z-test, and chi-square testing. The proposed scoring system was reliable and valid especially in indoor assessment. Outdoor scores might need more modifications to improve its reliability

Perception of genital prolapse: a hospital-based study in Alexandria [Part II]

Genital prolapse is a common health problem, understanding women's perceptions and beliefs may illuminate our understanding of their health seeking behavior which form a first step in any effort to improve their health. The present study was designed to investigate the perception of genital prolapse among women attending the outpatient clinic in El-Shatby Maternity University Hospital in Alexandria. Data was collected from a sample of 291 women who had any form of genital prolapse. Women's knowledge about risk factors for genital prolapse, women's beliefs related to genital prolapse as well as their beliefs about assistance at delivery [beliefs were assessed through the Health Belief Model] were measured for women who knew that they were suffering of genital prolapse [n=40]. The results revealed that more than two thirds of cases [70.4%] had poor [36.4%] or fair knowledge [34%] and only 29.6% had satisfactory knowledge. The majority of women having positive perception to diagnosis and symptoms for genital prolapse had high perception of [susceptibility] to and [severity] of complications of genital prolapse [97.5%and 85% respectively].More than two thirds [67.5%] had high scores of [perceived benefits] of treatment and medical advice, while nearly one third [32.5%] scored moderate. The majority of women [82.5%] had either moderate scores [55%] or high scores [27.5%] of perceived barriers to compliance to medical instructions or recommended surgery. About two thirds of cases [65.6%] sought medical care later than one year of perception of symptoms. Women's knowledge and degree of genital prolapse were directly related to women's report of symptoms characteristic of prolapse, while the level of education was inversely related. Health education for women on different aspects of reproduction using appropriate materials is highly recommended

School absenteeism: a study of some risk factors

The aim of this study was to investigate some risk factors for prolonged and/or repeated school absence. A case-control study was carried out in the largest male secondary school in Alexandria city. A total of 100 absentees [absent from school for at least 8 days] were recruited by the end of the academic year 1993/1994. A control group of 300 randomly selected regular school attendants were matched for age and grade level. School absenteeism risk was shown to increase significantly with student's illness [OR=11.2 P<0.01], school failure [OR=3.3 P<0.01], non participation in athletic activities [OR=3.2, P<0.01], cigarette smoking [OR=1.9, P=<0.05], moderate to high family income [OR=1.9, P<0.05] and low level of mother's education [OR=7.0, P<0.01]. School absence risk did not appear to be related to the student's body mass index [BMI] or to father's education. Home was the favorite place to stay-in while absent from the school for 84% of the absent students. Besides student's illness, lack of transport to school, unsatisfactory school curriculum, school day and school personnel were contributing factors for such problem

Timing, pattern and determinants of breast feeding initiation

The current early breast feeding practices of 216 mother-infant pairs receiving specific breast feeding promotional information combined with perinatal service-practices ensuring early maternal-infant contact were investigated. To determine how far their current practices conform to those recommended by the WHO/UNICEF statement on [10 steps to successful breast feeding], an interviewing questionnaire was used eliciting some sociobiological variables,circumstances of delivery and puerperium, and the current feeding practices. Results revealed that only 27.4% of mothers initiated feeding within 1/2 an hour of birth, 17.7% delayed it beyond 24 hours and the rest [54. 9%] gave it within 1-24 hours. By the end of puerperium, 84.5% were feeding the breast milk only and 15. 5% gave mixed feeding. The practices of the special group of the present study were generally better than those reported by earlier studies. However, wrong practices as giving fluids between feeds and the use of pacifier and/or the bottle were still widely practiced. Normal delivery and older maternal age were the two statistically significant predictors for early initiation. Efforts to change scientifically wrong practices should be continued and reinforced. Malleability in implementation of recommended instructions is highly needed

Antepartum and postpartum depression and infant feeding pattern: a prospective study

Mother's depression during pregnancy and postpartum is a risk factor that can adversely affect mother's relationship with her infant. As breast feeding is an important situation for early mother-child interaction the effect of mother's depression on her breast feeding attitude and practice was decided to be studied prospectively. In this study, 158 primigravidae attending antenatal clinics in two MCH centres were interviewed at third trimester. The interview data covered social background, attitudes to breast feeding as well, as self rating of depression using the Edinburgh postnatal depression Scale [EPDS]. At postnatal interview 72 mother-infant pairs could be reached between 6-16 weeks- after birth. They were subjected again to EPDS along with inquiry about type of infant feeding and breast feeding practices. Findings revealed that the prevalence of antepartum depression was 25.32%. Antepartum depression was significantly linked to postpartum depression and negative attitudes to breast feeding. Persistent maternal depression [ante- and postpartum] was a risk factor for early resorting to mixed infant feeding, retarded infant growth as well as some adverse maternal and infant health outcomes. Logistic analysis indicated that negative mothers' attitudes to breast feeding and postpartum depressive scores taken together predicted mixed infant feeding. Hence, preventive programs should be directed specifically towards modifying the mother's psychological. status and her attitude on behalf of her infant

study on accidents among preschool children attending MCH centres in Alexandria

A retrospective cohort study investigating the problem of accidents among preschool children attending 6 MCH centers in Alexandria was carried out. Mothers of 1134 preschool children aged 1- <6 years were inquired about all "significant" accidents that happened to their children. Amongst the total sample. 378 children suffered 429 accidents with a mean of 1.13 accident/child. The overall accident rate was 130.5/1000 child years and the risk of developing accidents for an accumulated period [5 years] by one year interval increased from 0.197 in he first to 0.788 in the fifth year of life. The majority of accidents took place in home [87.42%], at day time [80.88%] and during the summer months [64.57%]. Complete cure was the result in 72.73% while only 3.73% of accidents caused permanent disability. More than 60% of accidents were among young children [1- <3 years]. Accidents among boys were higher than those among girls with a male to female ratio of 1.33. Falls were the commonst cause of accidents [42.56%], followed by burns [22.61%], wounds [14.92%] poisoning [8.62%], electricity [5.13%] and motor vehicle accidents [3.95%]. The results revealed higher risk of developing accidents among children of illiterate mothers, of large family size, living in crowded houses and in poor housing conditions where cooking took place in the same sleeping room

simplified method of developmental assessment of infants and preschool children and some associated findings

This study aimed at the construction of a modified simple developmental screening test, and the determination of some risk factors for developmental delay using this test. Many developmental screening tests were revised, and the modified test was constructed containing the four areas of development: gross motor, fine motor-adaptive, personal social, and language. According to this test, the child is assessed 4 times in the first year of life [every 3 months], 2 times in the second year [every 6 months], and once a year afterwards. The test was applied upon 220 children who attended the well-baby clinics in 4 MCH centers in Alexandria within 2 weeks. Out of those children, 7.7% were classified by the test as developmentally delayed in gross motor. 12.7% in fine motor. 7.7% in social and 14.5% in language development. Parents of all children were interviewed by a questionnaire including some risk factors for developmental delay. Relative risk was estimated using the odds ratio for statistical determination of risk factors. Hospitalization was a significant risk factor for delay in all areas of development. Frequent attacks of cough and diarrhea were risk factors for delay in social and language development. Close child spacing was a risk factor for delay in gross motor development, while consanguinity of parents was a risk factor for delay in social development. The use of this modified test in the assessment of children in MCH centers was recommended

Inservice training program for nurses working in Zagazig vaccination centres

The aim of this study was to test the effectiveness of the implementation of inservice training program upon the level of nurses' knowledge and practice in the field of vaccination. The study was conducted in 7 vaccination centers in Zagazig City. The number of nurses was 57. They were pretested by an observation sheet made of 10 recommended items related to knowledge and practice in vaccination. Then an inservice training program of two month-duration was implemented. Post-test was carried out one month later. A scoring system was adopted for individual evaluation of nurse performance in pre-post tests. The degree of success of the training program was estimated using the "Effectiveness Index" [EI] which was equal to 72.85%. Inservice training program in the area of vaccination was recommended

Screening of high risk pregnancy among mothers attending MCH centers in Alexandria

A cross-sectional study was carried out on a sample of 900 pregnant women attending MCH centers in Alexandria to determine the incidence of high risk pregnancy and to demonstrate the common risk factors among them. The simplified scoring system developed by Morrison and Olsen [1979] was used. Mothers with scores 0-2 were considered at low risk those with score 3 and more were categorised as high risk. Results revealed that high risk women constituted 27.78% of the sample. Twenty three risk factors were identified among all pregnant women screened. The most frequently encountered were anaemia [37.33%], age 35+ [15.66%], parity 5+ [16.66%], previous gynecological surgery [8.88%] and history of previous stillbirth or neonatal death [6.11%]. The mean number of risk factors in the low risk group was 0.95 compared to 3.03 in the high risk group. Stepwise regression analysis indicated that the reproductive history score was the best one variable predictor of total risk score explaining about 74% of the variation in the total score while the present history score explained a further 16% of the variation and the associated conditions score explained 9% only of the variation. The use of scoring technique is recommended to be used in identification of high risk pregnant women in MCH centers

Impact of health care of lactating mothers on: their health, adequacy of lactation, and the health status of their infants Part [1] Effect of health care of mothers on the health of their infants

This work aimed at providing a comprehensive postnatal care to lactating mothers in Abbis [2] village for a period of 6 months and evaluating the impact of this care on their health and the health status of their infants. This was done through a longitudinal study on 2 purposive samples each including 50 breast-feeding mothers. A comprehensive postnatal care [nutritional,medical, educational and dental care] was provided to the experimental group while the mothers of the control group were given the ordinary care of the rural health center. The results showed that during the post-neonatal period infants of the experimental group showed lower incidence of all diseases than infants of the control group. More than 80% of infants of the experimental group received the primary doses of vaccination due for their ages corresponding to 38% only of infants of the control group. Growth and development of experimental group was better than that of the control group but the difference was not statistically significant