Sero-epidemiological study of measles after 15 years of compulsory vaccination in Alexandria, Egypt

Cases of measles among 165 vaccinated and unvaccinated children were studied and the level of measles antibody in 230 previously vaccinated children was determined. Associations between demographic factors and immunological response to vaccination were also investigated. Approximately 80% of the children with measles had been vaccinated; their cases had significantly lower rates of complication. Rural areas accounted for significantly higher numbers of unvaccinated cases. Vaccination status did not correspond to place of exposure, duration of prodrome or accuracy of preliminary diagnosis. The seropositivity rate among vaccinated children was 86.1% with no significant variation with age. We recommend a second dose of measles vaccine and maintaining high vaccine coverage

Poliomyelitis, measles and neonatal tetanus: a hospital based epidemiological study.

Vaccine-preventable diseases constitute a major health problem contributing to the morbidity and mortality in many developing countries including Egypt. WHO adopted resolutions to eradicate poliomyelitis by the year 2000, eliminate neonatal tetanus by the year 1995, and reduce measles mortality by 95% and morbidity by 90%, compared to the pre-immunization levels by 1995. Evaluation of preventive programs for these diseases necessitates availability of up to date information on their occurrence. The present study was undertaken to determine the current epidemiological features of poliomyelitis, neonatal tetanus and measles, to identify the trends of these diseases as well as to determine their outcomes and hospital loads. Data about the admitted cases of poliomyelitis, neonatal tetanus and measles were collected from the hospital register of Alexandria fever hospital for five successive years (1992-96). Available information on age, sex, residence, diagnosis, outcome of treatment, dates of admission and discharge were collected. The total number of cases of the three diseases admitted to the hospital during the period 1992-96 were 1406, measles represented 85.4%, neonatal tetanus 13.9% and poliomyelitis 0.7%. The results revealed that in the year 1994 only one case of poliomyelitis was admitted and since then no other cases were reported. The number of measles cases increased gradually in the latter years and about 78% of them were older than five years of age. A significant increase in the age of measles occurrence was observed. A gradual decline in the number of neonatal tetanus cases was observed. These cases were more apt to occur among early neonates but still clustered in certain geographical areas. The results of the study pinpoint the long term impact of the well run program aiming at eradicating poliomyelitis in Alexandria. However, for elimination of neonatal tetanus and controlling measles morbidity, further activities are required including strengthening the surveillance activities for detection of the high risk geographical areas and the high risk factors.

Comparative study of mothers' knowledge of children immunization before and after mass media.

Past experience about immunization programs calls for continuous monitoring of a healthy attitude among users towards vaccination. The aim of this study was to assess the effect of health education messages (mass media) on knowledge and practice of mothers as regards compulsory vaccination schedule. Data were collected from 250 females attending MCH centers during the first half of 1991 for either vaccinating their children or receiving antenatal care (exposed group). These data were compared to the data collected from a group of mothers before implementation of the intense mass media campaign on immunization (1983), (non-exposed group). There was a significant increase in the mean score of knowledge among the exposed mothers. The mass media messages became the main source of information among the majority of the exposed group. Females utilizing mass media as their main source of information were largely having a satisfactory level of knowledge. This study recommends enforcement of mass media educational campaigns on childhood immunization as well as reconsideration paid to the nature and content of messages.

PIP: The effect of health education messages in mass media on the knowledge and practice of mothers regarding compulsory vaccination was assessed during the 1st half of 1991. 250 mothers attending MCH centers for vaccinating their children during 1983 comprised Group I those not exposed to mass media. 150 mothers attending MCH centers for vaccinating their children during 1991 made up Group II those exposed to mass media. Group III consisted of 100 primigravidae attending the same MCH centers for antenatal care in 1991 who were exposed to mass media. Questions were administered on education of mothers, sources of information about the compulsory schedule, seriousness of the disease, vulnerability of children to the immunizable conditions, names of the vaccines, timing of vaccination, and the effectiveness of vaccines. In scoring knowledge levels scores of 50%, 75%, and 100% were taken as the upper limits of unsatisfactory, satisfactory, and very good knowledge, respectively. The mean scores of knowledge were: 43.6% + 16.0, 65.7% _ 12.8, and 57.0% + 16.1 for groups I, II and III, respectively. Mass media changed its rank from last in group I (2.8%) to 1st in group II (74.0%), and vice versa, as regards health workers (86.0%) and 12.0% in group I and II, respectively). Family members and neighbors improved slightly: 11.2% and 14.0% in groups I and II, respectively. The mean score of knowledge increased with higher levels of education in group I, II, and III. The group with unsatisfactory knowledge had the highest percentage of completion of immunization schedule in both groups I and II (62.9% and 100.0%, respectively). Mothers with satisfactory knowledge among those completing the schedule were significantly higher in Group II (87.9%) than in Group I (46.2%). 73.5% of mothers in Group II had very good knowledge and completed the schedule compared to 60% in Group I.

Knowledge about menstruation and practices of nursing students affiliated to University of Alexandria.

All secondary school nursing students enrolled in the Main University Hospital during the scholastic year 1987-1988 were studied for knowledge and practices related to menstruation. Over 85% of the students were acquainted with age of menarche, length of the menstrual cycle, and duration of menstrual bleeding. Only 71.54% gave correct answers about age of menstrual cessation. Students' practices revealed that one quarter of the sample avoid bathing during their bleeding period. About two thirds of the students stated that they use 3-8 sanitary pads per day. First year students significantly used less pads than those at higher grades. Menstrual pains and fear of bleeding were the causes of absenteeism from school among 37.62% of the sample. The higher the grade the more likely that the student carries out her normal daily activities without any difficulties. The main source of knowledge on the topic was the mother. The nursing school education was not mentioned except by minority of students in relation to menstrual hygiene.

Beta-adrenergic receptors and the effect of beta-adrenergic blocking agent propranolol on histamine and reserpine stimulated gastric acid secretion in man: normals and duodenal ulcer cases.

The effects of the beta adrenergic stimulant drug, "Nylidrin", and the beta adrenergic blocking agent, "Propranolol", on human basal gastric acid secretion were studied in 20 healthy volunteer subjects and 10 chronic D.U. cases. Nylidrin increased gastric acid secretion and volume. All effects of nylidrin were blocked by prior administration of beta adrenergic inhibitor propranolol. Propranolol diminished both acid secretion and volume in both normal and D.U. cases. The presence of beta adrenergic receptors in the human stomach was suggested. The effects of beta adrenergic blocking agent propranolol on gastric secretion, stimulated with histamine, were studied in 10 normal subjects and 10 cases of chronic duodenal ulcer patients. Pretreatment with propranolol produced a signigicant depression of the 90 minute acid response to histamine in both volume and acidity in normals and duodenal ulcer cases. It is concluded that propranolol has an antisecretory effect, not only on basal gastric secretion but also on histamine stimulated secretion in man. Reserpine stimulated gastric acid secretion and volume in normals but showed no similar effect in D.U. cases. After pretreatment with propranolol it reduces the gastric acid secretion and volume in normals and D.U. cases.