Women's perception and experience of menopause: a community-based study in Alexandria, Egypt.

To determine symptoms, perceptions and practices after natural menopause by women aged 50-59 years, we conducted a cross-sectional study of 450 women from Alexandria. The most frequently recalled symptoms were tiredness (96.0%), headache (95.1%), hot flushes (90.7%), skin wrinkles (90.7%) and decreased sexual desire (89.1%). About 91% of women had never heard about hormone replacement therapy; 42.7% would expose their body to the sun; 12.4% were moderately active the year before menopause. Multiple regression analysis indicated that women's knowledge about menopause was related to marital status, education and employment status; practices were related to pattern of menopause, age of menopause and income.

Women's perception and experience of menopause: a community-based study in Alexandria, Egypt

To determine symptoms, perceptions and practices after natural menopause by women aged 50-59 years, we conducted a cross-sectional study of 450 women from Alexandria. The most frequently recalled symptoms were tiredness [96.0%], headache [95.1%], hot flushes [90.7%], skin wrinkles [90.7%] and decreased sexual desire [89.1%]. About 91% of women had never heard about hormone replacement therapy; 42.7% would expose their body to the sun; 12.4% were moderately active the year before menopause. Multiple regression analysis indicated that women's knowledge about menopause was related to marital status, education and employment status; practices were related to pattern of menopause, age of menopause and income

Reproductive tract infections among married women in Upper Egypt.

In a house-to-house survey using cluster sampling, 1344 married women from urban and rural areas of Upper Egypt (Minia, Assiut and Sohag) were interviewed and examined to study the magnitude and determinants of reproductive tract infections. Overall prevalence was found to be 52.8%, with the most prevalent forms being Candida albicans (28.0%), Trichomonas vaginalis (8.7%), Aspergillus species (7.4%), streptococci (4.6%) and Chlamydia trachomatis (4.2%). Multivariate analysis identified certain groups of women at high risk of developing reproductive tract infections (those currently using an intrauterine device, those who regularly practised internal vaginal washing). Discriminant analysis showed that symptoms were of low discriminating value. There is a great need to increase community and women's understanding of reproductive tract infections.

Reproductive health of married adolescent women in squatter areas in Alexandria, Egypt.

Through a house-to-house survey, 455 married adolescent women (< 20 years) and 455 married women aged 20-45 years from squatter areas in Alexandria were interviewed. Determinants of early marriage were consanguinity, illiteracy and unawareness of reproductive health. Of the currently pregnant adolescents, 22% were receiving antenatal care compared with 40% of the older women. Family planning methods were currently being used by 39% of the adolescents and 63% of the older wives. Determinants of non-use were: adolescence, illiteracy and previous miscarriage/stillbirth. There is a need to increase public awareness of reproductive health and change the behaviour of both groups of women in this under-privileged sector.

Reproductive health of married adolescent women in squatter areas in Alexandria, Egypt

Through a house-to-house survey, 455 married adolescent women [< 20 years] and 455 married women aged 20-45 years from squatter areas in Alexandria were interviewed. Determinants of early marriage were consanguinity, illiteracy and unawareness of reproductive health. Of the currently pregnant adolescents, 22% were receiving antenatal care compared with 40% of the older women. Family planning methods were currently being used by 39% of the adolescents and 63% of the older wives. Determinants of non-use were: adolescence, illiteracy and previous miscarriage/stillbirth. There is a need to increase public awareness of reproductive health and change the behaviour of both groups of women in this under-privileged sector

Reproductive tract infections among married women in Upper Egypt

In a house-to-house survey using cluster sampling, 1344 married women from urban and rural areas of Upper Egypt [Minia, Assiut and Sohag] were interviewed and examined to study the magnitude and determinants of reproductive tract infections. Overall prevalence was found to be 52.8%, with the most prevalent forms being Candida albicans [28.0%], Trichomonas vaginalis [8.7%], Aspergillus species [7.4%], streptococci [4.6%] and Chlamydia trachomatis [4.2%]. Multivariate analysis identified certain groups of women at high risk of developing reproductive tract infections [those currently using an intrauterine device, those who regularly practised internal vaginal washing]. Discriminant analysis showed that symptoms were of low discriminating value. There is a great need to increase community and women's understanding of reproductive tract infections

Malnutrition among children 6-24 months attending MCH centres in Alexandria an epidemiologic study. Part I: Prevalence.

A cross-sectional nutritional survey of children aged 6-24 months (weaning period) attending MCH centres in Alexandria governorate through the year 1988-1989 was conducted with the aim of determining the prevalence of protein calorie malnutrition. The sample size was 1000 children chosen from 6 MCH centres in Alexandria (one centre for each zone). The sample was distributed along the six centres in proportion to the total number of infants recorded to have attended those centres through 1985. The centres were visited during the period starting November 1988 through June 1989. Each centre continued to be visited until the number decided to be included was completed. The study included the determination of age and the measurement of height and weight. Anthropometric standards issued by WHO were used to classify the children's length for age, weight for age, and weight for length in terms of a cut off point of 2 SD below the median of that of reference (Waterlow system). Gomez classification using weight/age as a parameter was used to diagnose undernutrition. The results of the study revealed a prevalence rate of undernutrition of 25.6% which was mostly of the first degree as expressed by Gomez categories. When expressed using waterlow system a prevalence of stunting of 29.7% was observed while wasting was observed in only 0.7% and concurrent wasting and stunting constituted 0.1%. These results were considered to be relatively lower in comparison to earlier similar studies. It was thus recommended that similar surveys for preschool age children in Alexandria and other regions of Egypt would be valuable.

Screening of high risk pregnancy among mothers attending MCH centers in Alexandria.

A cross-sectional study was carried out on a sample of 900 pregnant women attending MCH centers in Alexandria to determine the incidence of high risk pregnancy and to demonstrate the common risk factors among them. The simplified scoring system developed by Morrison and Olsen (1979) was used. Mothers with scores 0-2 were considered at low risk those with score 3 and more were categorised as high risk. Results revealed that high risk women constituted 27.78% of the sample. Twenty three risk factors were identified among all pregnant women screened. The most frequently encountered were anaemia (37.33%), age 35+ (15.66%), parity 5+ (16.66%), previous gynecological surgery (8.88%) and history of previous stillbirth or neonatal death (6.11%). The mean number of risk factors in the low risk group was 0.95 compared to 3.03 in the high risk group. Stepwise regression analysis indicated that the reproductive history score was the best one variable predictor of total risk score explaining about 74% of the variation in the total score while the present history score explained a further 16% of the variation and the associated conditions score explained 9% only of the variation. The use of scoring technique is recommended to be used in identification of high risk pregnant women in MCH centers.

PIP: Data on 900 pregnant women attending 4 maternal and child health (MCH) centers in Alexandria, Egypt between June-August 1989 were analyzed to screen for high risk pregnancies and identify common risk factors among these pregnancies. The Morrison and Olsen scoring system revealed high or extreme risk pregnancy in 27.78% of the women. Women in the low risk group had a mean of 0.95 risk factors. Women in the high risk group had a mode of 2 risk factors and a mean of 3.03. The most frequent combination of 3 risk factors were maternal age of at least 35, parity =or 5, and anemia. Total scores ranged form 0 to 14. Among women of the high risk group, 49.6% received scores of 3-4, 28% of 5-6, and 22.3% of =or 7. The mean total risk score for the low risk group was 1.03 compared with 5.25 for the high risk group. The most common risk factors in order of frequency were anemia (37.33%), parity =or 5 (16.66%), maternal age of at least 35 (15.66%), previous gynecologic surgery (8.88%), and history of stillbirth or neonatal mortality (6.11%). All of these risk factors except anemia occurred significantly more often in the high risk group than in the low risk group. Reproductive history accounted for 74% of the variation in the total risk score. Present pregnancy score and associated conditions accounted for 16% and 9% respectively. It is suggested that health workers use a scoring system to screen pregnant women attending antenatal clinics. They should also learn how to identify and manage high risk pregnancies. Trained personnel should design and distribute uniform records for assessment of high risk pregnancy to all primary health care units with antenatal services. Each MCH center should register perinatal deaths so health workers can use the data to make antenatal diagnoses and determine care.

Patterns of blood pressure among pregnant mothers attending MCH centres in Alexandria.

The present study was conducted to illustrate the range of normal blood pressure among pregnant mothers attending MCH centres and its biological and socioeconomic determinants. A total sample of 630 pregnant mothers were selected from 6 centres representing the 6 zones of Alexandria. Mothers of blood pressure above 140/90 mm Hg were excluded. The results showed that the mean systolic blood pressure in the first trimester was 112.16 mm Hg, decreased to 109.42. mm Hg for mothers in the 2nd trimester and raised again to 114.41 mm Hg in the 3rd trimester. A variety of socioeconomic and biological factors were involved in changing the range of blood pressure within normal limits specially during specific trimesters of pregnancy. It is recommended to record blood pressure for pregnant mothers from the first antenatal visit at any trimester. Single value can be used as potential marker. Those with higher trends of normal pressure values should be systemically followed.