Prevalence, risk factors, and predictors of nonalcoholic fatty liver disease among schoolchildren: a hospital-based study in Alexandria, Egypt

Nonalcoholic fatty liver disease [NAFLD] is an emerging problem in children and adolescents worldwide. This study was done to investigate the prevalence of NAFLD in children and adolescents as well as to determine the associated risk factors of fatty liver and to explore the ability of some obesity indices to predict and consequently be used as a screening method of fatty liver disease at certain cutoff points in schoolchildren. Patients and A cross-sectional, nested case-control study was carried out. Cases and controls were randomly selected from outpatient schoolchildren aged 6-18 years attending the radiology clinic at Sporting Health Insurance Paediatric Hospital in Alexandria. They were subjected to ultrasonic examination as well as complete anthropometric and laboratory measurements including fasting plasma glucose [FPG] level, fasting insulin, alanine aminotransferase [ALT] level, and lipid profile. Fatty liver was prevalent in schoolchildren [15.8%] and increased significantly with age [p = 0.004]. Positive family history of diabetes mellitus [DM], hypertension [HTN], obesity, and liver disease were all statistically significant risk factors for fatty liver. Waist circumference [WC], body mass index [BMI] and its Z-score were significantly sensitive predictors. BMI was considered the best predictor of paediatric NAFLD at a cutoff = 22.9. NAFLD was significantly associated with high triglycerides [TGs], low high-density lipoprotein cholesterol [HDL], homoeostatic model assessment [HOMA] percentile, and the number of metabolic syndrome [MS] components. Paediatric NAFLD is a substantial problem in schoolchildren and has a close relationship with obesity, dyslipidaemia, insulin resistance [IR], and consequently MS. BMI and WC can be used as useful predictors and screening tools for NAFLD in schoolchildren

Occult hepatitis B virus infection among hepatitis C virus seropositive and seronegative blood donors in Alexandria, Egypt

Background and aims: Occult hepatitis B virus infection [OBI, serum hepatitis B surface antigen negative but hepatitis B virus DNA positive] is an emerging problem in the safety of blood transfusion. The introduction of hepatitis B surface antigen in the screening panel for blood bank donors has substantially reduced, but not entirely eliminated, the risk of hepatitis B virus infection. It has been suggested that infection with hepatitis C virus may inhibit hepatitis B virus replication. Therefore, this study aimed at estimating the prevalence and risk factors for OBI among blood donors and determining its relationship with hepatitis C virus infection

Subjects and methods: Presence of hepatitis B virus DNA and hepatitis C virus RNA was investigated for among 508 hepatitis B surface antigen-negative blood donors in Alexandria, Egypt. Half of the donors were identified as hepatitis C virus antibody reactive

Results: OBI was detected in 21 donors [4.1%] from the studied population: eight were among hepatitis C virus antibody positive donors [3.2%], among whom seven [33.3%] had hepatitis C virus RNA in their serum, and 13 [5.1%] were among hepatitis C virus antibody negative donors, with no statistically significant difference. The only significant risk factor for OBI among the studied blood donors was visiting local barbers

Conclusion and recommendations: OBI is a considerable risk in blood banks, making screening for hepatitis B virus infection only on the basis of surface antigenemia insufficient

Human chronic fascioliasis: Hepatitis B and C among infected cases

Sera from one hundred and fifty three chronic Fasciola cases were screened for the presence of HB markers [HBsAg, anti HBc and anti HBs] and anti HCV using ELISA technique. Quantitative stool examination and estimation of liver enzymes [AST-ALT-bilirubin] levels of the study population were performed. HBsAg was present in 5 [3.3%], anti HBs in 13 [8.5%], HBexposed [HBex] in 44 [28.8%] and anti HCV in 13 [8.5%] of examined sera. HBV and HCV markers were significantly higher among older age groups. Concerning familial aggregation of hepatitis markers, 7 [15.9%] of the 44 HBex cases had two individuals per family who had evidence of exposure to HBV. No significant change in Fasciola GMEC and liver function tests have been noticed

Fungal and parasitic infections among institutionalized elderly in Alexandria

A total of 190 elderly [mean age 73.07 +/- 8.92 years] and 29 workers serving at these institutions were included in this study. Clinical evidence of superficial fungal infections was detected in 37.9% of the elderly. The most frequent clinical types were foot infection [61.1%], followed by intertriginous lesions [44.4%] and onychomycosis [33.3%]. Microscopic examination revealed that significantly higher percentages of samples from intramammary infection, foot lesion and onychomycosis showed the presence of yeast. Results of parasitological study indicated that protozoal infection was more prevalent than helminthic infection among both elderly [9.6% and 2.6%] and workers [16% and 4%], respectively. Ascaris lumbricoides, Trichuris trichura and Fasciola species were the helminths encountered in this study, while Giardia lamblia and Entamoeba histolytica were the protozoal infections. Among elderly, bad hygiene was associated with a significant high rate of infection, while females and eating outside the institution were associated with nonsignificant high infection rates

Prevalence, impact and risk factors of hepatitis C infection

The present study was designed to investigate the status of hepatitis C virus [HCV] infection and associated risk factors among Egyptian military recruits. The impact of HCV infection on liver function was also assessed. The sera of 726 military recruits were tested for HCV antibodies using second generation ELISA technique [Ortho]. The overall prevalence was 330.4%. Considering the presence of hepatitis B and/or schistosomiasis infection, HCV antibodies were detected in 30.0% of HBsAg carriers, 36.8% of bilharzial patients and 48.8% of those with concomitant infections. Among individuals without schistosomiasis or HBV infection, the rate decreased to 22.5% positive with HCV. The present study indicated that parenteral exposure to the virus might be the most important route for acquiring infections while blood transfusion had a very minor role. The study of the impact of HCV on liver functions revealed that a single infection with HCV only was associated with almost normal liver function tests. However, infection with more than one hepatitis virus revealed a greater impact on the liver function. Morbidity also increased when schistosomiasis infection was superimposed

effects of praziquantel administration on the course of hepatitis B among cases with concomitant schistosome infection

The present work was designed to study the course of HB virus infection among bilharzial and non-bilharzial patients and to assess the therapeutic effect of praziguantel administration on subsequent course of HB among individuals with concomitant infections. This study included 26 bilharzial. cases, 14 cases with HB and 40 cases with both infections [HB and schistosomiasis]. Praziquantel was administered to all bilharzial positive cases. Sera were Collected from all groups prior to antibilharzial chemotherapy, and then later at three and six months post treatment. The results show improvement of both liver function tests and cell mediated immunity as estimated by increased mean value of CD[3], CD[4], helper/suppressor ratio among individuals who received praziquantel in the two groups with schistoscmiasis and concomitant infection. Furthermore the individuals who lost their HB surface antigenaemia were found to have a higher mean pan T cells, CD[4] values, normal helper/suppressor ratio and absence of C1C in their sera than those who retained their carrier state. The follow up of HB carriers demonstrated a higher cure rate [clearance of HBsAg] among the group with concomitant infection as compared to the group with virus hepatitis only. RBV type two infection was common among the study population accounting for 25.9% of HBsAg positive cases. 42.9% of them cleared their antigeneamia after treatment with praziquantel

Study of opinion and level of knowledge about AIDS problem among secondary school students and teachers in Alexandria

The level of knowledge and the opinion about HIV/AIDS problem of 571 students [179 females, 392 males] and 211 teachers [85 females, 126 males] were assessed using an interview - questionnaire .The results explored the little priority given to sex education in Egyptian schools in addition to the very minor role of schools as source of knowledge [about AIDS problem] for students and teachers who revealed much interest towards the problem and wanted to know more about it, reflecting the need for urgent organized health educational programme

Vertical transmission of HBsAg in Alexandria

A total of 735 pregnant women at delivery and their babies were screened for HBsAg to assess the vertical transmission of HB virus infection. The carrier rate among pregnant women was 5%, evidence of intrauterine transmission reached 8.1% and that of perinatal transmission was 33.3%. The most important factors affecting the carrier rate in mothers were the social class, parity injections, dental manipulation and hospitalization. Nevertheless among the factors increasing the rate of materno-fetal transmission were the presence of [e] Ag, high titer of HBsAg in mothers serum, cord blood antigenaemia, age of the mother, prolonged duration of labour and breast-feeding

Study of the sensitivity of blood spotted on filter paper in the detection of HBsAg and anticore using Elisa technique

The sensitivity of the filter paper method was compared with that of whole serum in the detection of HBsAg and antic using ELISA technique. It was found that analysis of eluates of blood spotted on filter paper should be recommended in field surveys and of HBsAg screening prior to an immunization campaign. On the other hand, in the detection of anti HBc the eluted technique is less sensitive and should not be performed if accurate epidemiological data are to be collected

Intra familial spread of asymptomatic hepatitis B in Alexandria

A total of 107 family members were examined for HBsAg, 86 members were in families with a persistent carrier index and 21 of them were in families free from a carrier index. Rate of HBsAg transmission was 100% in families with a carrier index and absent in those free from a carrier. Horizontal transmission of hepatitis B virus infection reached about 80% in the total sample examined. All babies born to a carrier mothers became positive at one year of age stressing the importance of screening of the mother in the planning for vaccination programmes for the prevention of hepatitis B infection in newly-born