Pediatric skeletal injuries in emergency department; an alarm of child maltreatment in Egypt: A cross-sectional study.

BACKGROUND: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children. OBJECTIVE: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children. METHODS: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians. RESULTS: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries. CONCLUSION: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs.

Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country.

BACKGROUND: Undernutrition is a crucial cause of morbidity and mortality among children in low- or middle-income countries (LMICs). A better understanding of maternal general healthy nutrition knowledge, as well as misbeliefs, is highly essential, especially in such settings. In the current era of infodemics, it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well. AIM: To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC, and to determine the sources of such information and their assessment methods. METHODS: This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old. The data were collected through online questionnaire forms: One was for the general nutrition knowledge assessment, and the other was for the nutritional myth score. Sources of information and ways of evaluating internet sources using the Currency, Relevance, Authority, Accuracy, and Purpose test were additionally analyzed. RESULTS: The mean general nutrition knowledge score was 29 ± 9, with a percent score of 70.8% ± 12.1% (total score: 41). The median myth score was 9 (interquartile range: 6, 12; total score: 18). The primary sources of nutrition knowledge for the enrolled mothers were social media platforms (55%). Half of the mothers managed information for currency and authority, except for considering the author's contact information. More than 60% regularly checked information for accuracy and purpose. The mothers with significant nutrition knowledge checked periodically for the author's contact information (P = 0.012). The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information (P = 0.016). Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13% (P = 0.044). However, using social media increased the likelihood of having myths among mothers by approximately 1.2 (P = 0.001). CONCLUSION: Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics. However, healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.

Nutrition and diet myths, knowledge and practice during pregnancy and lactation among a sample of Egyptian pregnant women: a cross-sectional study.

BACKGROUND: Globally, the burden of maternal malnutrition remains an enormous public health problem; malnourished pregnant women are at increased risk of having low-birth-weight (LBW) infants. Several reports suggest a possible association between malnutrition among lactating mothers and the production of smaller quantities of breast milk. Many women have incorrect nutrition knowledge during pregnancy due to false beliefs derived from popular practices. Our study was conducted to assess nutritional knowledge, myths, and practices among Egyptian women during pregnancy and lactation. METHODOLOGY: A pretested 2-page interview questionnaire was used to collect data from the study participants after written informed consent was obtained from them after clarification of the study's aim. Obstetrics and gynecology experts collected the data from pregnant females who agreed to participate in private and university hospital antenatal care clinics in Cairo, Egypt. RESULTS: A total of 468 pregnant females completed the interview questionnaire. The mean knowledge score was 5 ± 3, with a median score of 5 and an IQR of 3-7, and the mean holding myths score was 3 ± 2, with a median score of 2 and an IQR of 2-4. Regarding the correct answers to the knowledge questions, more than 70% of the participants correctly answered that during the first six months of life, breast milk is the only food a baby requires, and less than 20% of them correctly answered that caffeine consumption could provoke premature birth. Regarding the holding myths questions, more than half of the participants held the myth that drinking moghat and helba increases the breast milk supply. We found that the most common source of knowledge during pregnancy and lactation among the participants was family and friends' advice (60%), followed by others (doctors, previous education in school or university) (45%). CONCLUSION: Among a sample of Egyptian women, more than half held at least one myth about nutrition and diet during pregnancy and breastfeeding, so health education at antenatal outpatient clinics should be directed toward those myths to correct them. Older women with sufficient family income showed significantly higher knowledge scores than others.

Stress among health care providers in NICU department, tertiary pediatric care hospital during COVID-19 pandemic in Egypt.

Background: Many of the pediatric health care workers (HCWs) suffered from sleep disturbance, anxiety, and potential stress disorder during the COVID-19 pandemic. Work-related stress is a potential cause of concern in HCWs and is associated with decreased job satisfaction, anxiety, depression, medical errors, and near misses. This study aims to investigate the various psychological consequences on medical personnel working in the neonatal intensive care unit (NICU) in the context of the COVID-19 pandemic. Design and methods: A cross-sectional analytical study was conducted on a convenient sample of doctors and nurses working in NICU in pediatric hospitals at Cairo University teaching hospitals, Egypt. Two anonymous self-administered validated questionnaires were used to assess the level of stress, and the COVID-19 Rapid Quantitative Assessment Tool to assess the knowledge, attitude, and perception about COVID-19. Results: Among 96 participants, 66.7% were nurses, and 33.3% were physicians, 79.2% of the participants showed a reasonably safe level of stress. The mean work stress score was 43.89 ± 5.77. The mean score for commonly experienced stress symptoms was 7.53 ± 4.54, median 7, IQR (4, 10). Females and physicians were found to be with a statistically significantly higher median score of commonly experienced stress symptoms than males (p-value < 0.001 and 0.028 simultaneously). Conclusion: While such descriptive research provides valuable information on the scope of the problem, a strong theoretical framework is required to interpret these findings appropriately and develop preventive and therapeutic strategies. Particular attention should be warranted to the mental health well-being of women treating patients with COVID-19.

Promoting the culture of key performance indicators (KPIs) among primary health care staff at health district level: An intervention study.

Recently, identifying performance indicators and developing measurement frameworks have become crucial concerns. Our study first sought to analyze service statistics of Primary Health Care (PHC) facilities for the years 2017 and 2018 to develop PHC key performance indicators (KPI).This was then followed by a thorough discussion of these KPIs with staff and service providers. Finally, re-rating these PHC (KPI) changes by analyzing service statistics infographs for 2017 and 2018 relative to 2019. El-Aiat Health District-Giza Governorate and its 15 PHC facilities served as the study's setting. A quasi-experimental intervention design was used based on operation research with quantitative and qualitative data analysis. The pre-test consisted of a mathematical analysis of service and vital statistics for 2017 and 2018 to calculate composite indices and create infographs (simple colored matrices) for these indices. The intervention included two discussion meetings (2 h each). It included reviewing the Performance Knowledge Matrices (infographs) with the service providers for subsequent problem specification, solving, and suggestion extraction to enhance performance. The SWOC (Strengths, Weaknesses, Opportunities, and Challenges) framework was used to analyze the qualitative data extracted from these conversations. Among the identified flaws were a deficiency in the number of physicians and nurses, inadequate training, insufficient work environments, and a lack of moral appreciation and recognition for the staff. The proposed solutions include providing health education services by nurses and follow-up services in certain units via home visits and mobile clinics. Post-test also entailed analyzing service and vital statistics for 2019 and redisplaying KPI infographics. Four of fifteen PHC facilities achieved a positive response based on the staff-suggested info-action-based intervention, according to our findings after comparing data for the pre-intervention and post-intervention periods of 2017-2018 and 2019. We concluded that reviewing the information derived from the "knowledge performance colored matrix" inspired district and PHC service providers to identify their weaknesses (avoided them as much as possible) and their strengths (practiced the solutions they suggested themselves) in the meetings which eventually improved their performance. Ultimately, the outcome scores and impact indicators of the provided PHC services were enhanced.

Patterns of respiratory tract infections in children under 5 years of age in a low-middle-income country.

BACKGROUND: Respiratory tract infections (RTIs) are among the most commonly encountered major public health problems, with a higher prevalence of lower RTIs among children and more generally the poor. The present study aimed to describe the pattern of respiratory tract infections in Egyptian children aged under 5 years and explore possible associations between socio-demographics and nutritional status and types of RTIs. METHODS: Over 6 months beginning in September 2018 (including one winter season), a cross-sectional, observational, epidemiological study was conducted on a sample of patients with upper and lower RTIs diagnosed clinically and/or radiologically in the outpatient clinics at Cairo University Children's Hospital in Egypt. An interview questionnaire was employed to collect socio-demographic and nutritional data. Heights/lengths and weights were measured and analyzed using the World Health Organization's (WHO) Anthro Plus [Computer Program]. Patients with pneumonia (n = 28) were compared to 97 healthy children of the same age and sex. RESULTS: The total number of children diagnosed with upper and lower respiratory infections was 611. Malnutrition was present in 12.4% of all children with upper and lower RTIs. Lower RTI and malnutrition were substantially more prevalent among children aged under 2 years (p = 0.048 and p < 0.001, respectively). The strongest predictor of lower RTI was a younger age (OR 0.797, CI 0.713-0.89, p < 0.001). CONCLUSION: At our center, approximately one-third of infections in under-fives were lower RTI. Malnutrition was one of the significant risk factors for lower RTI in children below 2 years. The nutritional status of infants and young children should be improved by encouraging exclusive breastfeeding during the first 6 months of life and strengthening the healthcare and nutritional counseling available for vulnerable children, particularly in rural regions.

Climate change-related knowledge and attitudes among a sample of the general population in Egypt.

Introduction: Identifying the public awareness and risk perception regarding climate change, are fundamental preliminary steps in determining gaps and paving the way for awareness campaigns that address climate change causes and counteraction mitigation measures. However, few studies were conducted in Egypt; thus, the researchers conducted the current cross-sectional study among a sample of the Egyptian population to identify general knowledge and perception about climate change and its effects, as well as attitudes toward mitigation measures. Methods: An exploratory population-based electronic-open survey, was conducted among 527 members of the general population between January and April 2022, using a convenience sampling technique. A pre-tested 2-page (screen) electronic included three sections: sociodemographic characteristics, global warming/climate change-related knowledge, and attitude toward climate change mitigation. Results: The average global warming knowledge score was 12 ± 3. More than 70% (71.1%) of the participants were knowledgeable (percentage score >70%). Approximately half of the enrolled participants (48.2%) agreed that everyone is vulnerable to the effects of global warming/climate change. More than three-quarters (78.3%) of the participants agreed that carbon emissions from vehicles and industrial methane emissions were the first factors that contributed to climate change, followed by the ozone holes (731%). Global warming/climate change-related knowledge was statistically higher in participants aged of >30 years, married participants, urban residents, highly educated individuals, and employed individuals (p-value ≤ 0.05). Approximately 80% of the participants agreed that responding to the questionnaire drew their attention to the topic of climate change and its effects. More than two-thirds of those polled agreed that increasing public transportation use could help mitigate the effects of climate change/global warming, followed by the materials used and the direction of construction. Conclusion: More than two-thirds of the participants were knowledgeable regarding climate change. Social media and the internet were the main sources of information. However, participants need to get the information in a different way that could help in changing their attitude positively toward the issue of climate change mitigation. The current study recommends the need for various initiatives that work should be launched.