Trend of application of world health organization control strategy of tuberculosis in Egypt

World Health Organization [WHO] control policy for tuberculosis [TB] includes Bacillus Calmette-Guerin [BCG] vaccine at birth, case detection, and treatment of cases with directly observed therapy short-course [DOTS]. This policy has been applied through the Ministry of Health and Population in Egypt for more than 30 years. The controversies about the efficacy of the BCG vaccination against TB in adults initiate some suggestions for its discontinuation from compulsory vaccinations in countries with low incidence of TB. The present work aimed to study the trend of applying the WHO control policy for TB in Egypt among the Egyptian population throughout the last 20 years [1992-2011]. The documented database of the country, bibliographic review on MEDLINE, published studies and reports, WHO and EMRO databases that covered the period from 1992 to 2011 were used in this study. The incidence rate of all forms of TB [pulmonary and extrapulmonary] dropped by 50% from 34 cases to 17 cases per 100,000 population, as well as the prevalence rate declined by 60.6% from 71 cases per 100,000 population throughout the last 20 years. Case detection and treatment success rates have increased throughout the studied period while it flat-lined over the past 6 years which may need attention. The results of this study introduce an evidence-based recommendation for continuation of the WHO TB control policy in Egypt towards elimination of the disease

Screening of window HBV infection among Egyptian blood donors

Transfusion-transmitted viral infection is present worldwide among blood donors. In the present study prevalence of early acute HBV infection among the eligible blood units for donation was investigated. Sera [760] from Egyptian blood donors [636 [83.68%] males and 124 [16.32%] females], who met donor selection criteria, were routinely screened for HBsAg, HCV-Ab, HIV 1/2-Ab and Syphilis-Ab. Accepted blood units for donation were further tested for liver and kidney functions and the presence of HBc-IgM and HBV-DNA. Screening resulted in 38 [5%] HCV-Ab positive units, 9 [1.18%] HBsAg positive units and one [0.13%] Syphilis-Ab positive unit. Testing of the accepted units for donation [712, 597 [83.84%] male and 115 [16.16%] female] resulted in one [0.13%] HBc-IgM positive unit and 2/30 HBV-DNA positive units. The routine screening of blood unit, to some extent, discovered the current viral infection but failed to detect early acute or window HBV infections where HBsAg is absent. ALT and AST levels were not indicative in viral infection in accepted blood donors at window period. Our study suggests that sensitive methods for detection of HBV [e.g. PCR] may be recommended in screening of donated blood. Anti-HBc antibody should be tested routinely on all donated blood units

cross sectional study of hepatitis B, C, some trace elements, heavy metals, aflatoxin B1 and schistosomiasis in a rural population, Egypt

Chronic liver diseases are disastrous to health. Many factors are associated with their prevalence, hence endemicity. These are mainly infectious, parasitic and toxic. A survey was conducted in a village south to Cairo. Large industries concerned with iron and steel industry, metals smelting, cement manufacturing and electric station were located north to the village. A systematic random sample of houses was selected. All individuals inside the houses were invited to share in the study. Sample size was 84 individuals. Hepatitis markers were done [HBsAg and anti-HCV antibodies]. The levels of some heavy metals were assessed; which were lead, mercury, arsenic, aluminum, manganese, nickel, chromium and cadmium. Levels of some trace elements were assessed. These were copper, iron, selenium and zinc. Aflatoxin B1 was assessed in serum. Assessment of schistosomal circulating antigen and antibodies was carried out. Abdominal ultrasonograghy was done to assess liver condition. Univariate logistic regression analysis was done to assess the association between studied variables and HBsAg or anti-HCV sero-positive subjects. The association between studied variables and bilharzial or fatty liver, diagnosed by ultrasonography, were also assessed. The univariate logistic regression analysis revealed odds ratios at the following results. For HBsAg sero positive subjects, aflatoxin B1, lead, chromium and schistosomal antigen and antibodies were higher than negative ones where odds ratios were; 6.2, 1.6, 1.6, 1.6 and 1.7, respectively. None of the variables showed statistically significant difference. For anti-HCV antibodies sero-positive subjects, aflatoxin Bi and chromium had the highest odds ratios among the studied variables, [odds ratios were 2.5 and 2.4, respectively]. Bilharzial liver showed higher significant positivity of anti-HCV antibodies and insignificant decreased level of zinc than negative ones [odds ratios were 7.2 and 4.5, respectively]. Fatty liver cases showed higher statistically significant positivity of anti-HCV antibodies and chromium than negative ones. Odds ratios were 8.0 and 7.1, respectively. Statistically significant lower level of aflatoxin B1 was shown in fatty liver than normal liver subjects. Multivariate logistic regression analysis for fatty liver showed that only anti-HCV antibodies sero-positivity had statistically significant odds ratio in comparison to chromium level and aflatoxin B1. It is concluded that some heavy metals, and Aflatoxin B1 had a definite association with liver diseases in the area under study. Having anti-HCV antibodies had a relation with fatty liver and with bilharzial liver more than having HBsAg. It is recommended that environmental management to factories nearby the village is urgently needed to decrease exposure to heavy metals. Prevention of hepatitis infection and aflatoxin exposure through different means is also recommended, other wise health care authorities would be confronted with unusual cases of HCC in the nearby future

Adult tetanus: immunity, awareness and behavior among a group of male farmers in Rural Upper Egypt

This is a cross sectional study. It was conducted in one of the small villages in Giza, Upper Egypt that was randomly selected. A convenience sample of 100 of the resident male farmers aging 20 years and older were included. All the selected farmers were practicing agriculture on regular basis since their childhood. The aim of the study was to portray their serum tetanus antitoxin antibodies levels and to recognize these farmers; perception; knowledge, attitude and beliefs about tetanus. As well, motives behind related health seeking behavior. Their tetanus serum antitoxin levels were measured by ELISA method. Interview questionnaires, focus group discussions and in depth interviews were used to collect the required data. The studied farmers were found to have good general knowledge about tetanus which was amounted principally to communal sources; 80.0%. The majority have never heard about the term “El Kazaz” which is the Arab is titling of the disease that is frequently used across the mass media; 85.0%. In fact, usually these farmers did not seek for medical care for their wounds. A very few; 9.0% were knowledgeable about adult tetanus vaccine from which only one farmers had a claim of being vaccinated in the last 10 years. Meanwhile, the progressive increase in the price of the prophylactic tetanus shot may threaten the chance of most of the farmers to have it when necessary. Substantial waning of the antitoxin antibody titer with age was found leaving many farmers specially those above 40 years unprotected. The study concluded that more emphasis should be placed on routine tetanus toxoid booster shots to farmers, especially to the elderly, given that level of tetanus antibodies decline with time. Extensive outreach communication and social mobilization activities aiming at increasing awareness and creating demand are crucial prerequisites for adult tetanus immunization activities to gear up

Discriminant analysis of free fatty acids of some Egyptian snails as a step for schistosomiasis control: new trends

Discriminate analysis of the estimated free fatty acids was done in this study in Biomphalaria alexandrina, Biomphalaria glabrata and Bulinus truncatus, viz. Lymnaea truncatula and Physa acute [Schistosoma intermediate and non-intermediate, respectively]. The objective of the study was to determine biochemical difference that attracts the infestation of Schistosoma miracidium to the target snails as a step of the new control trends. Caprylic acid [C8: 0] and oleic acid [C18: 1] are significantly lower in the tissues of Schistosoma intermediate snails compared to the non-intermediate snails; while capric acid [C10: 0], margaric acid [C17: 0] and linoleic acid [C18: 2] of the intermediate snails are significantly higher than that of non-intermediate snails. The percent of the correct medical classification of snails was more than 80% according to caprylic acid, margaric acid and linoleic acid and that of the other 15 fatty acids was less than 80%