Levels of adulthood physical disability in a rural community in upper Egypt

Worldwide, the rapid increase in the elderly population have led to an ongoing debate about wheather longer lives can be matched by longer active lives that are free from disability [Ostir, et al., 1999]. In many developing countries, life expectancy is increasing very rapidly, but little information is available on survival free of disability [Jitapunkul et al, 2003]. Egypt is an example of a country in the middle of its demographic transition. The median age of population has risen with a life expectancy at birth from 51 years in 1970 to 70 years in 2005. Egypt's population is projected to reach 92 million in 2020 with 6.7% aged 65 years or above; approximately 7 million elderly people [CAPMAS, 1995]. To estimate the prevalence rate, identify types and factors associated with disability among adults residing in a rural area. A cross-sectional survey with total coverage of all adult population >/= 18 years residing in Gahdam village. Upper Egypt, was undertaken in 2001. A total of 2.505 adults were screened for disability using the ADL [Activities of Daily Living] and IADL [Instrumental activities of daily living instruments. This was followed by a more detailed questionnaire to describe disability by onset, duration, severity, underlying diseases, health seeking behavior and other factors. Disability was defined as deficiency in one or more of ADL or IADL items. 15.9% of adults were disabled in one or more of the ADL items. Using both ADL and IADL instruments the prevalence of disability among adult population aged >/= 18 years was 22.1%. Disability was associated with age, gender, marital status and educational attainment. Musculo skeletal disorders ranked as the first underlying cause of disability [41.9%] followed by chest disorders [16.5%]. Health services utilization declined from 90.9% at the onset of disability to 62.3% among currently disabled adults. Although private sector had the upper hand among providers sought, a large proportion of disabled adults relied on self medication 37.7%. Hospitalization during the last year was 16.4%; with an average length of stay 16.9 days. Disability among elderly population is a significant burden to individuals, families, and health care

Childhood disability levels in a village in upper Egypt

Long term physical disability among children and adolescents is a multi-dimensional problem and though the prevalence rate of disability across age groups is higher among elderly, yet, the severity of disability and psychological impacts among adolescents and young adults is much higher. Children < 18 years of age are more than 50% of the population in developing countries, even low disability levels can amount to substantial suffering. To estimate the prevalence of disability among children <18 years age in a village in Upper Egypt, its impact on the child and family life, and describe the patterns of health care seeking behavior. A cross-sectional survey with total coverage of all children 0-18 years old residing in Gahdam village, Upper Egypt "was undertaken in 2001. A child was considered disabled if he/ she was suffering from a disability in one or more of general activities specific for his/ her age or specific activities general for all age groups. Mothers of 3.448 children were interviewed via a semi-structured questionnaire in the screening phase '10 questions questionnaire' standardized instrument. A sub-sample of the disabled children's mothers was subjected to a more detailed questionnaire on disability. 340 children [9.9%] were perceived by their mothers limited by anyway because their disability or health. General disability was the most frequently reported type followed by speech disabilities. Disability was higher in magnitude and severity in males. Psychological burden among children's families ranked the first [66.7%] followed by economic burden, [31.4%] and lastly 15.7% of disabled children's families were suffering from 'physical effort' burden. The type of disability, course and economic burden were all significant predictors in seeking health care. Development screening is essential for early identification of childhood disability