Management of TB in the private sector in Khartoum, Sudan: quality and impact on TB control

Sudan has a large and growing private health sector. No survey was done in Sudan to show the extent of the use of private health care services by the population. Also precise data on tuberculosis [TB] diagnosis and treatment in the private sector are not available. A facility-based cross-sectional survey was carried out during February 2007 - June 2007 in Khartoum state, whereby consented private physicians working in the all private clinics [n=110] were interviewed. This study showed that a large private sector exist in the country and deliver care to TB patients and reported the non-adherence of this sector to National Tuberculosis Program [NTP] guidelines. 59.1% of the interviewed physicians correctly mentioned the TB treatment regimens, only 8 [12.3%] physicians that reported management of TB patients actually prescribed these regimens to their patients. Similarly, only 10 [15.4%] physicians required sputum smear examination for TB diagnosis. A considerable proportion of cases is inadequately managed by the private sector and is not notified to NTP. The information delivered by this study can be used to develop a workable Public-private mix [PPM] model with the private sector

Distribution pattern of cancer and quality of data in Alexandria Cancer Registry

A Cancer Registry is an important informative source for cancer incidence. No population-based cancer registry is available in Egypt. Alexandria Cancer Registry [ACR] is a central hospital-based cancer registry located in the Department of Medical Statistics, Medical Research Institute, covering all the governorates. During 1972-2001, 76,028 cases were accessioned into the registry and stored on the computer using the [ICD-10] code. In males, there were 37,851 cancer cases; the urinary bladder accounted for 15.2% of all cancers, lymphatic and hematopoietic tissue were 19.3%, brain and nervous system were 9.2%, digestive system and peritoneum were 17.7%, respiratory system was 14.4%, oral cavity and pharynx were 5% skin was 2%, bones were 2.5%, soft tissue was 1.9%, and breast was 1.6%. In females there were 38,177 cancer cases; breast cancer accounted for 40.9%, urinary bladder was 3.4%, genital organs were 10% oral cavity and pharynx were 2.7%, lymphatic and hematopoietic tissues were 11.9%, brain and nervous system were 6.6%, digestive system and peritoneum were 10.3, skin was 1.1%, soft tissue was 1.6%, bones were 1.7%, and respiratory system was 3.3%. Incidence rates were calculated for total cancers and for each type of cancer separately in each year of the studied period

Performance of IgG avidity in an area endemic for schistosomiasis in Egypt

We assessed the performance of IgG avidity in the diagnosis of acute, chronic and recent [reinfection] on top of chronic schistosomal infections in patients treated with praziquantel. Immunoglobulin levels were studied in 111 patients with Schistosoma mansoni infection and 28 partially cured patients [not responding to the first dose of praziquantel treatment and almost cured after a second one]. Before treatment all patients with schistosomiasis had elevated IgG levels, 75% of them also had increased IgM levels. Avidity index was high among all age groups. The increased IgM/IgG ratio and avidity index among children with schistosomiasis before treatment support the idea of reinfection. Treatment had no significant effect on the studied parameters. We conclude that unlike IgM and IgG antibody levels, IgG avidity test cannot be used to distinguish between recent and chronic infections

Breast self-examination practice and its impact on breast cancer diagnosis in Alexandria, Egypt

This study estimated the frequency of breast-self examination practice and its possible relation to the stage of the disease at diagnosis and patient-related delay in diagnosis among newly diagnosed breast cancer patients. Breast self-examination was practised in 10.4% of cases. It was performed by patients from higher socioeconomic levels and those with a positive family history of breast cancer or benign breast mass. There was significant association between failure to practise breast self-examination and diagnostic delay. We emphasize the need for breast self-examination awareness campaigns as a key measure for ensuring earlier diagnosis and hence better prognoses for breast cancer patients in our community

Profile of secondary prophylaxis among children with rheumatic heart disease in Alexandria, Egypt

A cross-sectional study was conducted in specialist children's hospitals in Alexandria, which aimed to evaluate the current regimen of secondary prophylaxis for children suffering from rheumatic heart disease. Two-thirds of the patients had complied with their prophylactic regimen. Prophylactic failure occurred in one-third of the patients, raising doubts about the efficacy of the brands of penicillin prescribed. Recurrence of rheumatic fever was recorded in 37.3% of the patients, with semiurban or rural residence and non-compliance with secondary prophylaxis the significant risk factors. These unsatisfactory findings suggest the need for a more effective strategy of primary and secondary prophylaxis for controlling rheumatic fever in our community

use of medication in infants in Alexandria, Egypt

In Egypt, the determinants and rationale for drug use among infants have not been previously studied. We give an overview of the use of prescribed and non-prescribed medication over a 1-month period in infants in Alexandria, Egypt. In 89.6% of cases mothers stated that their infants had suffered some ailments which necessitated intervention; 27.5% used traditional therapies or non-prescribed medication and 72.5% sought medical advice. The non-prescribed medicines used were mainly antispasmodics and antipyretics. This study provides the first overview of the frequency of use of non-prescribed medication in infants and detected some indicators of irrational drug prescribing by physicians

Current health care of childhood bronchial asthma in Alexandria, Egypt

A cross-sectional study was conducted in the outpatient clinics of all specialized children's hospitals in Alexandria. The aim was to describe the health care delivered to children suffering from asthma and how far it complied with recent therapeutic guidelines. The pattern of asthma management was characterized by a significant underuse of prophylactic drugs in moderate/severe chronic asthma, underuse of the inhalation mode of delivery, and corticosteroids abuse as a prophylactic in between acute exacerbations in mild asthma. Also, assessment of pulmonary function [peak-flow rate] was rarely performed