Risk assessment of some organic contaminants: a case study based on food consumption in Tanta and Ismailia cities, Egypt.

The impact of some organic pollutants on some residents of Tanta and Ismailia cities of Egypt through their consumption of vegetables, fruits and fish (Nile tilapia and catfish) was examined. Residues of organochlorine (OCS) and organophosphorus (OPS) as some polychlorinated biphenyls (PCBS) were compared with pesticides as well maximum residue limits (MRLS). Probable health risk to consumers was also assessed. P, P'-DDT, P, P'-DDE, P, P'-DDD, endrin, α-BHC, (lindane), and hexachlorbenzene (HCB) were the most detected organochlorine compounds, but did not exceed MRLs.However, OPS residues were the most frequently detected contaminants. PCBs congeners 28, 70, 52, and 180 were detected in tilapia fish from Tanta, but congeners 28 and 180 were the only detected congeners in samples collected from Ismailia region. ∑PCBS values in all matrices did not exceed MRLS. Hazard index (HI) exhibited unity for all compounds at 50 the decreasing order: catfish > vegetables > fruits > Nile tilapia in Tanta, while in Ismailia the order was Nile tilapia > fruit > vegetables. Results also revealed that risk values for adults were greater than those of children categories.

Maternal morbidity in rural upper Egypt: levels, determinants, and care seeking.

Although maternal morbidity constitutes a serious public health problem in Egypt, it has remained a neglected area for public health research. In this study we used a synthetic design combining quantitative and qualitative methods to determine the level of maternal morbidity as reported by mothers in rural Upper Egypt and to identify patterns and determinants of care seeking for perceived morbidity in pregnancy, childbirth, and the postpartum period. The reported incidence of danger symptoms indicated that maternal morbidity is a serious problem in Egypt and, therefore, warranted community-based interventions. The study suggested a model explaining the criteria women used to judge whether and from where they would seek care. The model incorporates three cognitive components related to the perceived frequency, and seriousness of the problem and the degree of personal responsibility for the problem. Utilization of care was shown to be low and significantly associated with poverty and husband illiteracy. Likewise, most deliveries were not attended by a trained health care workers, and these unattended deliveries were shown to be associated with nonutilization of antenatal care, illiteracy, nonownership of cattle, and inaccessibility to potable water.

Urging health system research: identifying gaps and fortifying tuberculosis control in Pakistan.

AIM: To assess the significance of health system research in reducing the burden of tuberculosis and improving the performance of National Tuberculosis Control Program in Pakistan. METHOD: Qualitative and quantitative content analysis of research papers on tuberculosis and influence of the research knowledge on the efficiency of the National Tuberculosis Control Program. RESULTS: We analyzed 268 research papers on tuberculosis in Pakistan published in the 1960-2002 period, from both national and international perspectives. The majority of the studies covered epidemiology of tuberculosis (n=76) in Pakistan, whereas the rest of the papers addressed issues like pediatric tuberculosis (n=53), tuberculosis among Pakistani immigrants (n=35), tuberculosis-HIV synergism (n=24), care seeking (n=19), adherence with tuberculosis treatment (n=14), tuberculosis among women (n=12), tuberculosis prevention (n=12), directly observed treatment short-course (DOTS) strategy modification (n=5), tuberculosis drug resistance (n=7), operational research (n=5), tuberculosis case management (n=4), and research on Mycobacterium (n=2). Qualitative analysis revealed that research and spending on tuberculosis policy and nationwide tuberculosis interventions are not sufficient. Available research knowledge has not yet been translated into the tuberculosis policy and interventions. Furthermore, the lack of insight of the health system on community dynamics and tuberculosis intervention has led to failure in achieving the desired targets in tuberculosis control. CONCLUSION: Health system in Pakistan needs to improve tuberculosis control interventions by conducting extensive research on the various potential weaknesses in the field. For an effective tuberculosis eradication program in a highly endemic country such as Pakistan, health system research should be an integral part of the National Tuberculosis Control Program.

Prevalence and risk factors of HBsAg in Gaza: implications for prevention and control.

The Epidemiology of hepatitis B virus (HBV) infection was not precisely known in Gaza. This study investigated the prevalence and risk factors of hepatitis B surface antigen (HBsAg) and simulated the incidence of HBV infection from reported cases of acute hepatitis due to HBV. Blood samples from 810 randomly selected individuals from the general population and from 17,060 blood donors were tested for HBsAg. The prevalence of HBsAg was found to be 3.5% in the general population and 3.8% in blood donors. The simulation model revealed the incidence of HBV infection decreased between 1990 and 1999 from 233 to 56 per 100,000 per annum. The decline started in 1994 and continued afterwards, presumably after the introduction of universal vaccination against HBV and screening blood donors for HBV. However, the authors discuss additional measures to control the transmission of HBV among non-vaccinated cohorts.