Selected infectious disease disasters for nursing staff training at Egyptian eastern border

Infectious disease disasters are events that involve a biological agent, disease and that result in mass casualties, such as a bioterrorism attack, an emerging outbreak of infectious disease; all disasters pose a risk of infection transmission. But, infectious disease disasters pose the great-risk to illness or death from an infectious disease. This study raised the awareness and improved knowledge by educational program for Military Nursing Staff on selected infectious disease disasters acquired at Egyptian Eastern Border. The selected arthropodborne diseases were Anthrax, Tick borne relapsing, Louse borne replasing fever and liver fluke; Clonorchis sinensis. An interventional study was used, for 125 staff nurse who accepted to participate. The tools dealt with four questionnaires: [1] Some socio-demographic characteristics data [2] Educational needs assessment a structured questionnaire. [3] Knowledge test [pre/ post-test] and [4] Participants' reactions questionnaire. The results showed that educational intervention significantly improvements the nursing staff knowledge, which were achieved at the immediate post intervention phase, and retained via three months post-test phase. In the service training programs about infectious disease disasters at Egyptian Eastern Border must be established and continued on regular basis. This would improve their knowledge about the epidemiology of these infectious disease disasters

Botulism as a food poisoning: what is it?

Botulism is a rare but potentially life-threatening neuroparalytic syndrome resulting from the action of a neurotoxin elaborated by the microorganism Clostridium botulinum. This disease has a lengthy history; the first investigation of botulism occurred in the 1820s with a case report on hundreds of patients with [sausage poisoning] in a southern German town. Several decades later in Belgium, the association was demonstrated between a neu-romuscular paralysis and ham infected by a spore forming bacillus that was isolated from the ham. The organism was named Bacillus botulinus after the Latin word for sausage, botulus

Hydrocarbon insecticides: their risks for environment and human health

Insecticides are used to control diseases spread by arthropods, but theys vary greatly in toxicity. Toxicity depends on the chemical and physical properties of a substance, and may be defined as the quality of being poisonous or harmful to animals or plants. Poisons have many different modes of action, but in general cause biochemical changes which interfere with normal body functions. Toxicity can be either acute or chronic. Acute toxicity is the ability of a substance to cause harmful effects which develop rapidly following absorption, i.e. a few hours or a day. Chronic toxicity is the ability of a substance to cause adverse health effects resulting from long-term exposure to a substance. There is a great range in the toxicity of insecticides to humans. The relative hazard of an insecticide is dependent upon the toxicity of the pesticide, the dose received and the length of time exposed. A hazard can be defined as a source of danger.The great majority of insecticides are poisonous to man and his beneficial insects and animals and are carcinogenic agents particularly, the halogenated hydrocarbons containing benzene ring

An interventional program for nursing staff on selected mass gathering infectious diseases at Hajj

This work improved military nursing staff knowledge on selected mass gathering infectious diseases at Hajj. The results showed that only [20%] of the participating nurses attended training program about health hazard during pilgrim. But only [40.0%] of them found the training programs were specific to nurses. Majority found the program useful [70.0%], and the average duration of this training program in weeks was 3.5+1.1. There was significant improvement P=<0.001, of correct knowledge about meningitis regarding causes, organisms-, mode of spread, people at risk, transmission, prevention and treatment, the highest improvement was in causes of meningitis the lowest was in adult vaccination. 25% of participants had adequate knowledge [>60% from total score] in pre-test 93% in post-test 72% after 3 month with significant difference among tests regarding adequate knowledge.There was significant improvement of correct knowledge P=<0.001 about seasonal influenza and respiratory diseases during pilgrim, the highest improvement was in influenza vaccine strains the lowest was in antiviral drugs. 23% of nurses had adequate knowledge [>60% from total score] in pre-test 94% in post-test 66% after 3 month with significant difference among tests regarding adequate knowledge. There was significant improvement P=<0.001 of correct knowledge about gastrointestinal diseases and food poisoning during pilgrim among nurses at military hospital, the highest improvement was in risk factors of food poisoning the lowest was in what GE patient should do. 22% of participants had adequate knowledge [>60% from total score] in pretest 91% in post-test 58% after 3 month with significant difference among tests regarding adequate knowledge. There was significant improvement P=<0.001 of correct knowledge about heat exhaustion during pilgrim among nurses at military hospital, the highest improvement was in non-communicable diseases the lowest was in sun stroke prevention. 27% of participant had adequate knowledge [>60% from total score] in the pre-test 94% in the post-test 74% after 3 month with significant difference among pre, post and FU regarding adequate knowledge. Also, there were significant improvement P=<0.001 of correct knowledge about hypertension, dengue fever, skin scalding and others diseases during pilgrim among nurses at military hospital, the highest improvement was in skin scalding prevention the lowest was in first aid bag. 28% of participant had adequate knowledge [>60% from total score] in the pre-test 92% in the post-test 61% after 3 month with significant difference among pre, post and FU regarding adequate knowledge. There was a significant difference between total knowledge score according to education, and work experience [P>0.05] in the pre, post and after 3 month in age and in all intervention time in department the highest was ICU then ward then operation room

Management of hearing impairment in children

Hearing loss in children is often a silent and hidden handicap. Children with hearing loss frequently appear to be normal, and often their handicaps are not apparent. Hearing loss that is undetected and untreated can result in speech, language, and cognitive delays. Early identification and intervention with hearing inquired child improve language, communication, and cognitive skills. Sudden or progressive sensorineural hearing loss accompanied by dizziness following barotrauma should prompt consideration of traumatic perilymph fistula. Early surgical exploration is recommended to improve hearing and vestibular symptoms

Infection control to avoid surgical site infection

Infection control is a discipline that applies epidemiologic and scientific principles and statistical analysis to prevent or reduce rates of nosocomial infections. Effective infection control programs proved to reduce the rates of nosocomial infections and to be cost-effective. It is a key component of the broader discipline of hospital epidemiology. As an example, the anesthesia team acts every day in a highly complex and high risk environment for the transmission of pathogenic organisms and induction of infectious complication. In order to achieve the main goal of preventing or reducing the risk of hospital-acquired infections, a hospital epidemiology program should have the following oversight functions and responsibilities: Surveillance, either hospital-wide or targeted Education about prevention of infections. Outbreak investigations cleaning, disinfection and sterilization of equipments and disposal of infectious waste hospital employee health, specifically after exposure to either blood-borne or respiratory pathogens, Review of antibiotic utilization and its relationship to local antibiotic resistance patterns, Prevention of infections due to percutaneous intravascular devices. Development of infection control policies and procedures oversight on the use of new products that directly or indirectly relate to the risk of nosocomial infections

Mosquito vectors of infectious diseases: are they neglected health disaster in Egypt?

In spite of the great technological progress achieved worldwide, still arthropod borne infectious diseases is a puzzle disturbing the health authorities. Among these arthropods, mosquitoes from medical, veterinary and economic point of view top all groups. They are estimated to transmit disease to more than 700 million people annually worldwide mainly in Africa, South America, Central America, Mexico and much of Asia with millions of deaths. In Europe, Russia, Greenland, Canada, the United States, Australia, New Zealand, Japan and other temperate and developed countries, mosquito bites are now mostly an irritating nuisance; but still cause some deaths each year. Mosquito-borne diseases include Malaria, West Nile Virus, Elephantiasis, Rift Valley Fever, Dengue Fever, Yellow Fever and Dog Heart- worm…etc. Apart from diseases transmission, mosquitoes can make human life miserable. The successful long term mosquito control requires the ecological and biological knowledge of where and how they develop. The importance of mosquitoes is given herein to clarify the problem and to think together what one must do?

Arsenic pesticides and environmental pollution: exposure, poisoning, hazards and recommendations

Arsenic is a metalloid element. Acute high-dose exposure to arsenic can cause severe systemic toxicity and death. Lower dose chronic arsenic exposure can result in subacute toxicity that can include peripheral sensorimotor neuropathy, skin eruptions, and hepatotoxicity. Long-term effects of arsenic exposure include an in Due to the physiologic effects of the arsenic on all body systems, thus, chronic arsenic-poisoned patient is a major nursing challenge. The critical care nurse provides valuable assessment and interventions that prevent major multisystem complications from arsenic toxicity

rift valley fever: could re-emerge in Egypt again?

The Rift Valley fever [RVF] is a neglected, emerging, mosquito-borne disease with severe negative impact on human and animal health and economy. RVF is caused by RVF virus of the family of Bunyaviridae, genus Phlebovirus. RVF is an acute, febrile disease affecting humans and a wide range of animals. The virus is trans-mitted through the bites from mosquitoes and exposure to viremic blood, body fluids, or contact with tissues of infected animals or by inhaling natural virus aerosols, also possibly by consumption of infected unpasteurized milk. The RVF-virus replicate at the site introduction and in local lymphatic followed by viremia and spread to other organs as the liver and central nervous system, causing the hepatic necrosis and eosinophilia cytoplasmic degeneration. The main signs and symptoms are fever, headache, myalgia, arthralgia, photophobia, bradycardia, conjunctivitis and flushing face. Main complications include jaundice, hemorrhagic, meningoencephalitis and retinal lesions. Generally speaking, in the21[st] Century, the vector-borne infectious diseases, was accepted as the disaster issues with the considerable significant morbidity and mortality. These facts should be considered by the public health, veterinary and agricultural authorities

mosquito borne west nile virus infection: is it threating to Egypt or a neglected endemic disease?

West Nile virus [WNV] is a mosquito-borne zoonotic arbovirus belonging to the genus Flavivirus in the family Flaviviridae. The virus is found in temperate and tropical regions worldwide, but first identified in the West Nile sub-region in the East African nation of Uganda in 1937. Prior to the mid-1990s WNV infection was sporadically and considered a minor risk for humans, until an outbreak in Algeria in 1994, with cases of WNV-caused encephalitis, and the first large outbreak in Romania in 1996, with a high number of cases with neuroinvasive disease. WNV has now spread globally to Europe beyond the Mediterranean Basin and the United States, is now considered to be an endemic pathogen in worldwide especially in Africa. The WNV transmission is mainly by various mosquitoes species, also ticks were incriminated. The birds especially passerines are the most commonly infected animal and serving as the prime reservoir host In Egypt more than 110 mosquito species and subspecies and more than 32 genera of ticks were identified. Besides, not less than 150 species of migratory birds visit Egypt annually in addition to 350 resident ones. This review provided an overview of the current understanding flaviviruses mainly WNFV. Primary care physician and senior nurse should be able to include the disaster diseases in differential diagnosis of various clinical conditions. They should take a thorough history to request specific dependable laboratory test[s] as soon as possible, and positive patient should be transferred to the fever hospital

Threat of dengue fever and dengue haemorrhagic fever to Egypt from travelers

Dengue [DF] and dengue hemorrhagic fevers [DHF] are present in urban and suburban areas in the Americas, South-East Asia, the Eastern Mediterranean and the Western Pacific, but dengue fever is present mainly in the rural areas of Africa. Several factors have combined to produce epidemiological conditions in developing countries in thejropics and subtropics that favour viral transmission by the main mosquito vector, Aedes aegypti as the rapid population growth, rural-urban migration, inadequate basic urban infrastructure [eg. the unreliable water supply leading householders to store water in containers close to homes] and the increase in volume of solid waste, such as discarded plastic containers and other abandoned items which provide larval habitats in urban areas. Geographical expansion of the mosquito has been aided by the international commercial trade particularly in used car-tyres which easily accumulate rainwater. Increased air travel and the breakdown of vector control measures have also contributed greatly to the global burden of dengue and DH fevers. The presence of Ae. aegypti and endemicity of DF and DHF in the neighboring regional countries must be in mind of the Public Health Authorities

Cost containment'adoption and its impact on quality of patient care 'commitment as perceived by middle - level nurse managers: a pilot exploratory study

Nowadays, the containment of health care costs and the improvement of quality of care are two essential concerns in a nation's health care system. For that, the nurse manager is accountable for quality of care and for containing costs of health care. Aim: To identify the impact of cost containment adoption on the commitment to quality of patient care as perceived by Military middle. - level nurse managers. Descriptive exploratory correctional design was used in carrying out this study. The study was conducted in a Military Institute, where'the participants were attending a continuing education program. Purposive sample consisted of thirty Military middle - level nurse managers who were in supervisory position, accepted to participate in the study and met the inclusion criteria were included in the study. Study tool: Modified questionnaire developed by Muehsam [1998] was adapted to measure cost containment and commitment to quality of patient care as perceived by middle - level nurse managers. indicated that a cost conscious behavior was found on the units' level than hospital as whole. On the whole, a strong level of commitment towards quality of patient care was found among nurse managers. No leaner relationship was found between cost containment and commitment to quality of patient care. This study can be replicated for other participants in the healthcare industry such as doctors who are contracted with organizations. Finally; middle - level nurse managers should participate in the selection of programs that influence nursing such as productivity programs, inventory management and documentation systems

Zoonotic brucellosis: an underestimated or misdiagnosed disease in Egypt

Over six months, 329 suggestive consecutive brucellosis human cases were diagnosed in attending the out-patients clinics of Al Azhar and Ain Shams Universities Hospitals and Giza Governorate Farmers. They were 100 females and 229 males with ages ranged between 15-65 years old. A total of 213 [64.75%] were working in dairy farm and/or consumed raw milk, 16 [14.85%] used home slaughtering of sheep, and 100 [30.4%] were working in Giza Government slaughter-house. Clinically and by ELISA-IgM 259 out of 329 the subjects were proven brucellosis patients [77.8%]. Besides, other patients had toxoplasmosis, or Schistosomiasis mansoni or fascioliasis. Double infection was encountered with toxoplasmosis and either schistosomiasis or fascioliasis. The causes of endemic liver parasitosis that may give false-clinical diagnosis were excluded. Signs and symptoms of brucellosis patients were fever [91.5%], chills [84.1%], Myalgia [69.5%], headache [58.2%], fatigue [77.2%], anorexia [54.1%], tachycardia [38.6%], hepato-and/or splenomegaly [46.2%], lymphadenopaqthy [19.6%] lower back abdominal pain [8.8%] and/or constitutive symptoms [13.1%]

Babesiosis in an Egyptian boy aquired from pet dog, and a general review

Human babesiosis has been documented in many countries. It is a zoonotic protozoan disease of medical, veterinary and economic importance. In this study, a twelve years old boy was referred to the hospital with intermittent fever of unknown origin. On clinical, parasitological and serological bases the case proved to be babesiosis. The boy acquired the infection from his pet dog which was heavily infested with Rhipicephalus sanguineus and suffered a mild feature of animal babesiosis. The patient was successfully treated with Atovaquone plus Azithromycin without relapse for one month follow up. The pet dog was sent to Governmental Veterinary Hospital at Abbassia for treatment from babesiosis and tick infestation

Echoguided pair technique in diagnosis and treatment of abdominal hydatid cystic disease in Egyptian patients: clnical and ultrasonographic follow up

The introduction of the percutaneous puncture, aspiration, injection of scolecidal agent and reaspiration [PAIR] technique is gaining an increasing acceptance in diagnosis and treatment of abdominal cystic hydatid disease [CHD]. Thirty-three patients [12 male and 21 female with age between 15 and 70 years] had 46 cysts in liver, spleen and kidneys [75.7%, 18.2% and 6.1% respectively]. Puncture, aspiration, injection of 95% sterile alcohol for 20 minutes and reaspitation [PAIR] was used for treatment of hydatid cysts of different types and sizes. Follow up both clinically and ultrasonographically was done over a period of 2 years. The commonest ultrasound picture was type la [overall echofree] in 80.4%, commonly in the liver [75.7%] mainly in the right lobe [88%]. Improvement of symptoms had occurred its 85% within 3 weeks. As regards ultrasound follow up of 41 non-complicated cysts within the 1[st] six months, was disappearance of 5 cysts, 34 reduced in size and 36 showed different grades of solidification. After 1.5 year 10 more cysts disappeared while the pseudotumour appearance was shown in remaining 26 cysts. Ultrasound follow up of the 5 infected cysts revealed complete cure within a period of 8-16 weeks in 4 of them. The last patient discontinued drainage therapy and was referred to surgery. This makes ultrasound cure reaching 97%. Minor complications were skin reaction only in 2 patients [6%]. No fatal anaphylaxis cyst recurrence or rupture into the peritoneal cavity or bleeding from renal or splenic puncturing. PAIR technique under ultrasonographic guidance is the first choice method for treatment of abdominal CHD especially in the developing countries and inoperable hydatid cysts

impact of three anopheline mosquito species in Toshka, on the introduction of chloroquine / resistant P. Falciparum to Egypt

Malaria still tops the prevalent human arthropod-borne diseases. In Egypt, sporadic cases of human malaria were reported with a focus in Al-Fayoum. Besides, many Egyptian Anopheles species were reported allover which are either malaria vectors or incriminated ones. This study recorded An. multicolor, An. sergentii, and An. algeriensis in Toshka. Many authors reported that A. sergentii is a malaria-vector and A. multicolor is a suspected vector. Consquently, the endemicity of Chloroquine resistant Plasmodium falciparum on the Egyptian-Sudanese border pave the way for malignant malaria transmission particularly among travelers returning back from Sudan

Aedes aegypti re-emerging in Egypt: a review and what should be done?

Mosquitoes are main vectors of varieties of pathogenic agents affecting man and animals. There-emergencein Aswan and approach of Aedesaegypti, the vector of the Dengue hemorrhagic fever, Yellow fever and Chikungunya fever, which are encountered in Africa, needs to alert for this public health threat. The presence of Dengue and dengue hemorrhagic fever in Saudi Arabia is another issue

Imported malaria as a threat to Egypt

This work evaluated the clinical and parasitic status of malaria as a cause of fever among patients admitted to the Military fever hospitals. Thirty six patients were included twenty already diagnosed as malarial patients, who were recruited from Peace Keeping Mission Forces in Africa and sixteen cases presented with prolonged fever coming from different locations in Egypt. The results showed that El-Gabal El-Ahmar area [Cairo] was the most extensively infested region [37.4%]. This might be due to change of its ecolo-gical pattern since the year 2003 and the environmental conditions favoured by breeding and flaring mosquitoes. El-Sharkia and El-Fayoum Governorates [G.] were next in order [18.7%] and [12.5%] and this might be due to increased rural areas and agricultural projects and re-establishment. Plasmodium vivax was the main species among locally acquired patients [8 1.25%], while the imported patients coming back to Egypt from Africa especially [Sudan] had P. falciparum [100%]. However, P. falciparum was also present in 6.2% of cases from El Fayoum Governorate while P. ovale and P. malaria were not encountered. Of interest, was a case recruited from Ard-El- Golf, Heliopolis, an area with high social and hygienic standard, and the same condition applied to that from El-Nozha El-Gidida. Such cases included the [runway] or [airport] malaria, in which local transmission of disease has been attributed to an infected mosquito that was transported on a long haul flight. The two locally acquired cases were malaria positive by bone marrow smears and negative by peripheral blood examination. However, the thick blood film was the most sensitive [97.2%]. The patients [75%] were clinically and parasitologically cured, but one patient died. The best therapeutic response for locally acquired malaria infection was the monotherapy-based one such as Chloroquine or Mefloquine