Children patients with COVID-19: How can parental and peer support lessen the psychological burden of isolation.

AIM: To assess the effect of parental and peer support on children's self-esteem during the isolation period in COVID-19-infected children is the main objective of this study. DESIGN: This is a descriptive cross-sectional study. One hundred ninety children with a confirmed diagnosis of COVID-19 were included. METHODS: A survey questionnaire to assess family and children's demographic characteristics was used for this study. A 13-item scale to assess parental support during the isolation period and a 10-item scale to assess peers' support during the isolation period were evaluated. Along with it, a 10-item scale to assess self-esteem during the isolation period was also measured. RESULTS: Home isolation was associated with higher parental and peer support scores than hospital isolation. The mean age of study participants was 13.23 ± 4.05 years; 52.6% were isolated at home versus 47.4% in hospital isolation. Phone calling and WhatsApp/messenger chat were methods of communication for 44.2% and 33.2% of patients, respectively. 6.3% of them had no method of communication. Child self-esteem was significantly affected by both parental and peer support during isolation. The increase in pronounced negative psychological effects such as disorientation, anger, low self-esteem and post-traumatic distress may be caused by a lack of parental care. NO PATIENT OR PUBLIC CONTRIBUTION TO THIS STUDY: Patients or the general public were not involved in the design, analysis or interpretation of the data in this study. The study's aim and objectives were developed based on children's self-esteem, which was limited by questionnaire data information, so the researchers completed demographic and disease-related questionnaires by interviewing them.

Assessment of patient safety culture among paramedical personnel at general and district hospitals, Fayoum Governorate, Egypt.

BACKGROUND: Healthcare is a high-risk industry that requires regular assessment of patient safety climate within healthcare organizations. This addresses the organizational cultural issues and explores the association between organizational climate and patient outcomes. This study aimed to assess patient safety culture among paramedical health employees at Fayoum general and district hospitals and to determine factors affecting their perception of patient safety. METHODS: A descriptive cross-sectional study was conducted at the general hospital and four district hospitals in Fayoum Governorate, Egypt, among 479 paramedical healthcare workers. The standardized Hospital Patient Safety scale (HSOPSC) that composed of 12 safety culture dimensions was used. RESULTS: The mean total safety score varies according to the participant's position and work area. The total patient safety score was 46.56%. No dimension reported score above 75%. The highest mean composite scores were for organizational learning and continuous improvement (65.36%) and teamwork within hospital units (63.09%). The lowest reported score was for communication openness (17.9%). More perception of safety dimensions was seen in females than males, participants in direct contact with patients, and those with work experience less than 10 years. CONCLUSION AND RECOMMENDATIONS: Overall, the degree of patient safety is low at Fayoum public hospitals. No dimension scored above 75%, and 7 out of 12 dimensions scored less than 50%. Hence, continuous monitoring and updating of the ways of incident reporting is highly recommended. This may be done through setting up a web-based incident reporting system accessible for 24 h.

Prevalence of Stroke in Fayoum Governorate, Egypt: A Community-Based Study.

BACKGROUND: Stroke is a highly prevalent disease with consequent mortality and morbidity. Few community based studies have been conducted only in upper Egypt to estimate prevalence of stroke. OBJECTIVES: This study was designed to find out the prevalence of stroke in Fayoum Governorate & to study some associated risk factors. METHODS: through this community based cross-sectional study 4784 participants aged more than or equal to 18 years old were enrolled. A multi-stage random sample technique was followed to choose the study sample. A predesigned interviewer-administered structured questionnaire was used. Suspected stroke case by screening questionnaire was referred to the neurologist. RESULTS: The Crude prevalence of stroke was 16 out of 1000 with confidence interval of proportion (12.6%-19.7%). The age adjusted local (Fayoum 2017 census) prevalence rate was 7.97 out of 1000, age adjusted prevalence rate (Egypt population 2017) was 1.05 out of 1000. Age-adjusted World Health Organization standard world population prevalence rate was 1.69 out of 1000. The crude prevalence of ischemic stroke was significantly higher than hemorrhagic stroke 11.9 versus 3.9 out of 1000 population. The most prevalent risk factor was smoking among males, followed by obesity then hypertension. The prevalence of stroke was significantly higher among participants affected with hypertension, diabetes, heart diseases, obesity, and smoking. Logistic regression analysis showed that having hypertension, diabetes, heart diseases, atrial fibrillation, obesity, and smoking were reported risk factors of stroke. CONCLUSIONS: The prevalence of stroke in Fayoum governorate was 1.6%. Hypertension, diabetes, heart diseases, obesity, and smoking were reported risk factors of stroke.

Seroprevalence of varicella-zoster virus among pregnant women in Fayoum Governorate, Egypt.

BACKGROUND: Chickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program. OBJECTIVE: To assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics. SUBJECTS AND METHODS: A descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016-2017. RESULTS: VZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17-0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17-0.70)). CONCLUSIONS: Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara. TRIAL REGISTRATION: Ethical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).

Study of Adverse Drug Effects of Direct-Acting Antivirals for Chronic HCV Infection at Fayoum Governorate, Egypt - A Pharmacovigilance Study.

BACKGROUND: Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients. Despite being effective and characterized by a very low rate of adverse effects in clinical trials, few data are available on adverse events in real life studies. OBJECTIVES: The aim of this study was to identify the incidence and pattern of Adverse Drug Reactions (ADRs) caused by DAAs; daclatasvir and sofosbuvir and their combination with ribavirin and to assess the causality and the severity of the reported ADRs. METHODS: A prospective observational study was conducted over six months at treatment HCV center of Health Insurance Hospital in Fayoum Governorate, Egypt. A pre-tested, interviewed structured questionnaire was used by authors to gather required data from 345 enrolled patients regarding demographics, co-morbidity and ADRs. Causality and severity of ADRs were assessed. RESULTS: According to our data. we have found that 75.7% (261out of 345) patients reported 36 different ADRs involving different systems, of these 1.2% experienced Serious Adverse Events (SAEs), including three deaths (0.9%). A majority of ADRs were more significantly reported with ribavirin-containing regimen. Out of 345 patients, 23.5% have comorbidities. Among them, 92.6% reported ADRs. Causality assessment of ADRs by WHO-UMC criteria revealed that 38.89% were probable while 61.11% were possible. CONCLUSION: New antiviral drugs require careful follow-up of any significant adverse event that may occur and can affect adherence. Special population as the elderly and those with comorbidities should always be managed with caution to avoid development of serious side effects.

Acanthamoeba keratitis in noncompliant soft contact lenses users: Genotyping and risk factors, a study from Cairo, Egypt.

Acanthamoeba keratitis (AK) is a severe corneal infection that may occur as a serious outcome of improper use of contact lenses (CL). OBJECTIVES: The study aimed to diagnose AK in soft CL users presenting with infectious keratitis, and to identify the prevalent genotypes isolated from different cases. Another aim was to determine the CL hygiene-related risk behaviors, and to explore the risk of water exposure for developing AK. METHODS: A cross sectional study was performed. A questionnaire was carried out including 260 clinically diagnosed cases as infectious keratitis (170 females and 90 males); all of them were soft CL users for the suspected risk factors. Corneal scrapes from the affected eyes were cultured to diagnose bacterial and AK. PCR was performed and the amplified products were sequenced and compared with GenBank data. RESULTS: The parasite was positively amplified from 32 samples (12.3%). Acanthamoeba T4 genotype was identified in 27/32 (84.4%) of isolates. Other detected genotypes belonged to T5 and T3 genotypes at rates of 9.4%, and 6.25%, respectively. The most important risk factors associated with development of AK were female sex, sleeping while wearing CL, and exposure to water resources through different practices. These practices included rinsing the CL case in tap water, swimming and/or showering while wearing CL, using multipurpose solution for cleaning the lenses, using water from over-building tanks. Rubbing the eyes due to discomfort when applying CL was an additional important risk factor associated with AK. The protective factor was regular hand washing before using CL. CONCLUSION: CL users were more exposed to AK and should gain enough health education regarding proper lens hygiene and dangers of tap water exposure.

Malnutrition and Its Associated Factors among Rural School Children in Fayoum Governorate, Egypt.

Malnutrition is an increasing health problem among children in developing countries. We assessed the level of malnutrition and associated factors among school children in a rural setting in Fayoum Governorate, Egypt. A school based cross-sectional survey was conducted on children (6-17 years) in Manshit El Gamal village in Tamia district of Fayoum Governorate. Weight, height, and age data were used to calculate z-scores of the three nutritional indicators using WHO anthroPlus. Sociodemographics and lifestyles Data were collected. Prevalence of stunting, underweight, and wasting was 34.2%, 3.4%, and 0.9%, respectively, while obesity was 14.9%. Prevalence of obesity was significantly higher in younger age group of 6-9 years in comparison with older age and was higher in males versus females in 10-13-year-age group. Increasing age, reduced poultry consumption, and escaping breakfast were associated factors for stunting with OR (95% CI) 1.27 (1.17-1.37), 2.19 (1.4-3.4), and 2.3 (1.07-5.03). Younger age and regular employment of the father were factors associated with obesity (OR = 0.753; 0.688-0.824 and OR = 2.217; 1.4-3.5). Malnutrition is highly prevalent in Fayoum in line with the national prevalence and associated with age, gender, regularity of father's employment, and dietary factors.

Transfusion transmitted infections in frequently transfused thalassemic children living in Fayoum Governorate, Egypt: Current prevalence and risk factors.

Regular blood transfusion therapy remains the primary treatment in thalassemia major (TM). Transfusion-transmitted infections (TTIs) and iron overload are considered to be the major drawbacks of this therapy. This cross-sectional study aimed to update the prevalence of the hepatitis C virus (HCV) antibody, PCR-confirmed HCV, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV) antibody among TM children. Clinical and epidemiological factors that can affect HCV infection prevalence rate were studied. This study evaluated 121 children with ßTM, including 61 males and 60 females with a mean age of 7.99±3.57years. Patients were evaluated for the HCV, HBsAg, and HIV-1 & 2 antibodies. All tests were performed using ELISA. HCV positive cases were confirmed by RT-PCR. Twenty-five patients were positive for the HCV antibody (20.7%); 22 were confirmed positive by PCR. Six patients (5%) were HBsAg-positive. No patients were HIV-positive. Older age were associated with an increased frequency of HCV positive infection (P<0.003). More frequent transfusion, ≥10 times/year, and older age, ≥10years, were reported as predictors of HCV infection (P=0.018 and 0.011, respectively). A significant association of HCV between HBV infections was reported (P value=0.01). There was no significant effect of the pre-transfusion or post-transfusion hemoglobin level on the frequency of HCV positive cases. HCV still represents a major health challenge for frequently transfused Egyptian patients. The prevalence rate of HBV infection remains relatively high. Therefore, it is necessary to implement measures to improve blood transfusion screening.

Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies.

The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their efficacy, acceptability and cost effectiveness. Two hundred cases with ordinary scabies were randomized into four groups. First group received ivermectin 200 µg/kg body weight single oral dose, repeated after one week. The second received benzyl benzoate 20% cream. The third received permethrin 2.5%-5% lotion, whereas the fourth group received 5-10% sulfur ointment. Topical treatments were applied for five consecutive nights. Patients were followed up for two weeks for cure rate and adverse effects. At the end of the study, permethrin provided a significant efficacy of 88% and acceptability in 100% of cases, but had higher cost to treat one case (20.25 LE). Ivermectin provided efficacy and acceptability rates of 84% and 96%, respectively, and had a cheaper cost (9.5 LE). Benzyl benzoate provided 80% for both rates and was the cheapest drug. Sulfur ointment provided the least rates, and it was the most expensive. Treatment choice will depend on the age, the general condition of cases, patient compliance to topical treatment and his ability to stick to its roles, and the economic condition of the patient.

Hospital outpatient clinics as a potential hazard for healthcare associated infections.

Healthcare acquired infections are no longer confined to the hospital environment. Recently, many reported outbreaks have been linked to outpatient settings and attributed to non-adherence to recommended infection-prevention procedures. This study was divided into two parts: The first is a descriptive cross-sectional part, to assess the healthcare personnel's knowledge and compliance with Standard Precautions (SP). The second is an intervention part to assess the role of health education on reducing the level of environmental and reusable medical equipment bacterial contamination. Assessment of the doctors' and nurses' knowledge and compliance with SP was performed using a self-administered questionnaire. Assessment of environmental cleaning (EC) and reusable medical equipment disinfection has been performed using aseptic swabbing method. The extent of any growth was recorded according to the suggested standards: (A) Presence of indicator organisms, with the proposed standard being <1cfu/cm(2). These include Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus, MRSA), Enterococci, including vancomycin-resistant Enterococci (VRE) and various multidrug-resistant Gram-negative bacilli. (B) Aerobic colony count, the suggested standard is <5cfu/cm(2). The effect of health education intervention on cleaning and disinfection had been analyzed by comparing the difference in cleaning level before and after interventional education. Good knowledge and compliance scores were found in more than 50% of participants. Primary screening found poor EC and equipment disinfection as 67% and 83.3% of stethoscopes and ultrasound transducers, respectively, were contaminated with indicator organisms. For all indicator organisms, a significant reduction was detected after intervention (p=0.00). Prevalence of MRSA was 38.9% and 16.7%, of the total S. aureus isolates, before and after intervention, respectively. Although 27.8% of the total Enterococcus isolates were VRE before intervention, no VRE isolates were detected after intervention. These differences were significant. Development and monitoring of the implementation of infection prevention policies and training of HCP is recommended.