Barriers to breast cancer screening among a sample of Egyptian females

Breast cancer [BC] is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services

Women health in poor urban settings in Alexandria

The aim of this paper is to investigate women health and status as well as to study gender gap in three poor urban settings in Alexandria. Poor families were identified and invited to participate in the study through the help of local informants. The study included 172 families, 53 from Abu- Kir, 57 from El-Dahreya and 62 from Wadi El-Kamar area. An interviewing questionnaire was used to collect data form the wives as well as their husbands about household family members. Wives and husbands who participated in the study were clinically examined. Their weight and height were measured. For those who accepted to participate, stool, urine and blood analyses were performed. Female to male comparison as well as sex ratio of some parameters were used to investigate gender gap. Results showed that females were the head of the family in 19.8% of the families. In 18% of the families, wives participated in the family income. Illiteracy represented 94.2% among females aged 45+ years, and unemployment was 97.4%. The rate of ill health increased with age from 36% for girls to 90% among older women [45+] compared to 71% among older males. Cardiovascular and orthopedic disorders represented the most reported problems among older females and males. Diarrhea and ARI episodes were rather more frequent among females than among males. About 60% of examined women suffered from obesity, 45% had gynecological problems, 38% had parasitic infections in stool, and 45% had anemia. Female to male sex ratio was low for <6 and 60+ years old. In conclusion, poor women suffer from high burden of socio-economic disadvantage, gender inequality and ill-health

Maternal serum alpha fetoprotein among pregnant females in Alexandria

Maternal serum alpha fetoprotein [MSAFP] was introduced as a screening test for congenital malformations especially neural tube defects [NTDs] two decades ago. However, many factors were known to affect its level. From these are racial differences and maternal weight. The aim of the present work is to illustrate the normal distribution of MSAFP among working pregnant women in Alexandria in gestational age 16- 18 weeks, to identify some of its determinants, and to determine the specificity and sensitivity of MSAFP for the detection of congenital anomalies and adverse pregnancy outcome. A sample of 608 pregnant working women who were 16-18 week gestation was recruited for the study from the antenatal clinic affiliated to Gamal Abdel Nasser Health Insurance Hospital in Alexandria. The enrolled women were interviewed using a structured questionnaire and a blood sample was collected from each of them to measure the level of MSAFP. At the expected time of delivery, Gamal Abd el Nasser Health Insurance Hospital was visited to collect data about the outcome of pregnancy of the enrolled women. The median of MSAFP level for deliveries with no congenital anomalies were 25.5, 33.5, and 53.2 IU/ml, at gestational weeks 16, 17 and 18 respectively. The significant variables related positively to MSAFP level included abortion or stillbirth, congenital anomalies in the index pregnancy, gestational age, bleeding during pregnancy, gestational diabetes, twin pregnancy, consanguinity between maternal parents, history of congenital or genetic diseases in maternal family, and caesarian section deliveries. Fatigue score was negatively correlated to MSAFP level. Using MSAFP multiples of median [MOM], 42.9% of abortions and stillbirths, 57.1% of twin pregnancies, 31. 25% of preterm deliveries and 27.3% of low birth weight had levels of 3 MOM or more. One fourth of the congenital anomalies were below 0.5 MOM and 41.7% were at or above 3 MOM. The sensitivity of MSAFP test for the detection of NTDs [cutoff point 2.5+ MOM] or Down syndrome [cutoff point <0.5 MOM] among the study sample was 100% [Cl: 19.8-100%]. Specificity for NTDs was 92.7% [Cl: 90.3-94.6%], while the specificity for Down syndrome was 89.1% [86.3-91.4%]. The sensitivity for adverse pregnancy outcome [cutoff point <0.5 or 2.5+ MOM] was 41.6, and the specificity was 85.8%.In conclusion, the cutoff points of MSAFP of the study sample are different from those for other populations. Different factors affect the level of MSAFP including adverse pregnancy outcomes. It is recommended to introduce antenatal screening for congenital anomalies as a routine screening test during pregnancy using levels adapted from the local population for cutoff point determination

Risk factors of puerperal sepsis in Alexandria

Puerperal infections are an important cause of maternal morbidity and mortality in developing nations. Investigators have noted several risk factors for developing puerperal sepsis. However, the relative importance of these risk factors varies and has to be determined for each setting. Therefore the aim of the present work was to determine the risk factors for puerperal sepsis in Alexandria, Egypt. A case-control design was used to study the risk factors of puerperal sepsis in Alexandria. The study included 160 puerperal sepsis cases and 160 controls. Puerperal sepsis cases were recruited from the fever hospital as well as from 3 rural health units and three urban health offices in Alexandria. A pre-designed interviewing questionnaire was used to collect data about risk factors of puerperal sepsis. Logistic regression analysis indicated that very low socio-economic score [OR=6.4], no ANC [OR= 4.5], delivery at a governmental maternity hospital [OR= 203.4], frequent vaginal examinations [OR=5.1], anemia during puerperium [OR= 4.3], unsanitary vaginal douching during puerperium [OR=19.9] and unhygienic preparation of diapers used immediately after delivery [OR= 12.1] were significantly related to the occurrence of puerperal sepsis. Improving infection control measures during delivery, limiting the frequency of vaginal examinations, and avoiding all unhygienic practices related to delivery are strongly recommended

Practices related to treatment of diarrhea among children attending MCH centres in Alexandria

The purpose of the present study was to describe practices related to treatment of diarrhea among children attending MCH centers in Alexandria. The study was carried out in 6 randomly selected MCH centers of Alexandria Governorate for a period of three weeks during summer 1993. Using scheduled interviewing questionnaire, data were collected from mothers attending these centers and had an under-five child who experienced a diarrheal attack during the last 2 weeks. The total sample consisted of 496 children. Their mean age was 11.86 +/- 9.67 months. Among presently breast-fed children, 90% continued breast feeding during the diarrheal attack. ORS use rate was 67%, home fluids use represented 48% and the use of both or either accounted for 81% of the sample. About 70% of the children used at least one drug with a mean of 1.29 +/- 1.15 drugs during the previous attack. Drugs were prescribed by MCH physicians [30.4%], and private physicians [29%], or obtained over the counter [33.6%] in pharmacies. There were no gender differences regarding ORS or drug use and their sources. Continued health education and training programs are required to maintain and improve the achievement of ORT usage. Different policies to combat the extensive drug misuse are highly recommended

Use of breast feeding indicators for assessment of current feeding practices

To investigate the current breast feeding practices, a survey was conducted cross sectionally on 2000 children aged less than 2 years recruited from 6 MCH centers in Alexandria governorate. The median duration of breast feeding was 19.4 months. Only one quarter of infants were exclusively breast fed for the first four months of age with a mean duration of 2.4+2.5 months. Predominantly breast feeding rate was 0.36, while timely complementary breast rig rate [6-9 months] was 0.66. Continued breast feeding rate [one year] was 0.73 while for two years was 0.3. Results also indicated that 40% of infants were receiving food from a bottle with a nipple/teat regardless of whether or not the infant was breast fed. These findings implicate that promotion of breast feeding should receive priority in health programs activities

Parasitic infections and gastrointestinal symptoms among preschool children in day care centers in Alexandria, Egypt

There is a considerable amount of speculations concerning the presence of symptoms in various parasitic infections. The aim of the present study was to determine the prevalence of different parasitic infections among children in day care centers [DCCs], and to establish the relation of such infections to gastrointestinal symptoms. A total of 623 stool samples were collected from 700 preschool children aged 2-5 years who attended 3 DCCs of different soocial classes in Alexandria. These samples were tested for parasitic infection by the conventional microscopy. Parents were interviewed as regards the gastrointestinal symptoms frequently suffered from by their children included in the sample during the 3 months period preceding the interview. The prevalence rate of parasitic infection was 56.0%. Giardiasis was the. commonest infection [34.7%], followed by Ascariasis [24.4%] and Trichuriasis [4.6%]. Boys showed a significantly higher prevalence than girls [58.3% vs. 52.9%, p < 0.01]. Social. children were more infected with G. lamblia than unsocial ones [39.6% vs. 22.1%, p < 0.01]. Vomiting was strongly associated with 0. lamblia infection [OR = 7.1, p < 0.01], diarrhea with multiple infections [OR = 48.2, p < 0.01], while abdominal pain was not significantly associated with any of these infections. The high prevalence of Giardiasis in DCCs emphasizes the need for increased surveillance for G. lamblia. as a cause of vomiting in Children, especially among active and social boys. Routine and periodic administration of a protozoan treatment to such Children is recommended