The epidemiology of schistosomiasis in Egypt: Assiut governorate.

In the Assiut, Egypt Epidemiology 1, 2, 3 investigation, a sample of 14,204 persons in 10 villages, 31 ezbas (satellite communities), and 2,286 households was drawn from a rural population of 1,598,607. Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 5.2 +/- 0.5 (+/- SE). This varied considerably by village and ezba, ranging from 1.5% to 20.9%, with ezbas having a slightly higher overall prevalence than villages. The overall estimated geometric mean egg count was 6.6 +/- 0.5 eggs per 10 ml of urine and was consistently low throughout the communities. Infection with S. haematobium was associated with age (peak prevalence of 10.6 +/- 1.5% in 15-19-year-old age group) males, children playing in the canals, a history of blood in the urine, and reagent strip positivity for hematuria and proteinuria. The prevalence of either hepatomegaly or splenomegaly detected by physical examination was low (4.0% and 1.5%, respectively). The prevalence of hepatomegaly determined by ultrasonography was substantially higher, 24.1%. The prevalence of periportal fibrosis (PPF) was 12.0%, but grade II or III PPF was present in less than 1%. Ultrasonography-determined hepatomegaly, in both the midclavicular line and the midsternal line, increased by age to more than 30%. Periportal fibrosis was more common in the age groups in which infection rates were the highest. At the village and ezba level of analysis, the prevalence of hepatomegaly, splenomegaly, and PPF tended to be higher in communities having the highest prevalence of infection with S. haematobium.

The epidemiology of schistosomiasis in Egypt: Qena governorate.

Qena is the southernmost governorate of Egypt included in the Epidemiology 1, 2, 3 national study. A probability sample selected 17,822 individuals from 2,950 households in 34 ezbas and 10 villages from a total rural target population of 1,731,252 (based on the most recent 1986 census of the population by the Egyptian Central Agency for Public Mobilization And Statistics). Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, respectively, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 4.8 +/- 0.7% (+/-SE) and geometric mean egg count (GMEC) was 7.0 ova per 10 ml of urine. Considerable variation in prevalence was observed between the villages and ezbas, ranging from 0.0% to 20%, with the smaller ezbas having a slightly higher overall prevalence. The age- and sex-specific patterns of S. haematobium showed typical peak prevalence in early adolescence, with males having a higher prevalence than females. A history of hematuria was associated with current infection (odds ratio = 3.6, 95% confidence interval = 2.32-5.63). Hepatomegaly and splenomegaly determined by physical examination present in 7.9% and 3.0%, respectively. Ultrasonography-determined hepatomegaly of the left liver lobe was found in 10.1%. Ultrasonography-detected hepatomegaly in both the left and right lobes increased in prevalence from approximately 5% in children to 15-20% in adults. The prevalence of ultrasonography-detected splenomegaly increased slightly with age. Grade III periportal fibrosis was detected in only 2 individuals in the sample. Bladder wall lesions and obstructive uropathy were also very infrequent. Other associations with these measures are given. Most villages and ezbas had an S. mansoni prevalence of less than 1%. The exception was Nag'a El-Sheikh Hamad, where the prevalence was 10.3 +/- 0.5% (GMEC = 57.4 +/- 2.6). Two other communities also had a prevalence >1% (Ezbet Sarhan and Kom Heitin).

Foci of Schistosoma mansoni in Assiut province in middle Egypt.

Following detection of Schistosoma mansoni in a 12 years old boy who had both schistosomal polyposis and periportal fibrosis with hepatosplenomegaly, epidemiological studies to confirm local transmission were performed in his and 30 other villages in Assiut Governorate, Egypt. The index case's brother and 6 of 380 inhabitants of his village who provided stool specimens were infected with S. mansoni and a farmer with dysentery and hepatosplenomegaly had a positive rectal snip biopsy. All had hepatic abnormalities on ultrasound examination. Two of 221 schoolchildren in another village had mixed infections with S. mansoni and S. haematobium; 17 others had only S. haematobium. None of 419 inhabitants living near the infected boys had S. mansoni infection. Snails from canals and drains near both villages were netted, identified, counted and checked for infection: in the second village one of 1039 Bulinus truncatus was infected with Schistosoma sp. but none of 859 Biomphalaria alexandrina was infected. Schistosomiasis mansoni is being focally transmitted in 2 villages in Assiut Governorate and appears to be spreading from Lower to Middle and Upper Egypt. We believe B. alexandrina, which has been present in some of the waterways for at least 15 years, were infected recently by local inhabitants returning from Iraq or by cattle traders or military recruits from the Delta.

Exploring the relationship between alcohol and the driver characteristics in motor vehicle accidents.

This study examines the differences in alcohol-related accident involvement among different driver groups in the state of Florida. The driver characteristics considered in this study are: age, gender, race, and residency of the driver of a motor vehicle involved in an accident while under the influence of alcohol, drugs, or alcohol and drugs. The main objective of this study is to test whether there are associations between the different driver characteristics and alcohol involvement in traffic accidents, and to identify the high-risk group within each driver factor. This would improve our understanding of the relationship between alcohol involvement, accidents, and the four aforementioned driver factors. It would also enable us to better design educational and awareness programs targeting specific groups in the population to reduce drinking and driving in the state. The relationship between alcohol-related accident involvement and the driver factors are investigated using general descriptive statistics, conditional probabilities and log-linear models. The results showed that the 25-34 age group experience the highest rate of alcohol/drug involvement in accidents. The rates decline with the increase in the age of the drivers. The results also indicated that there are significant relationships between the driver characteristics and alcohol/drug involvement in accidents. Male, white, and in-state drivers were also more involved in alcohol/drugs-related traffic accidents.

Modeling traffic accident occurrence and involvement.

The Negative Binomial modeling technique was used to model the frequency of accident occurrence and involvement. Accident data over a period of 3 years, accounting for 1,606 accidents on a principal arterial in Central Florida, were used to estimate the model. The model illustrated the significance of the Annual Average Daily Traffic (AADT), degree of horizontal curvature, lane, shoulder and median widths, urban/rural, and the section's length, on the frequency of accident occurrence. Several Negative Binomial models of the frequency of accident involvement were also developed to account for the demographic characteristics of the driver (age and gender). The results showed that heavy traffic volume, speeding, narrow lane width, larger number of lanes, urban roadway sections, narrow shoulder width and reduced median width increase the likelihood for accident involvement. Subsequent elasticity computations identified the relative importance of the variables included in the models. Female drivers experience more accidents than male drivers in heavy traffic volume, reduced median width, narrow lane width, and larger number of lanes. Male drivers have greater tendency to be involved in traffic accidents while speeding. The models also indicated that young and older drivers experience more accidents than middle aged drivers in heavy traffic volume, and reduced shoulder and median widths. Younger drivers have a greater tendency of being involved in accidents on roadway curves and while speeding.

An assessment of the effect of driver age on traffic accident involvement using log-linear models.

Statistical models were developed to help understand the relationship between the driver age and several important accident-related factors and circumstances such as injury severity, collision types, average daily traffic (ADT), roadway character, speed ratio, alcohol involvement, and accident location. By using techniques of categorical analysis on the 1994 and 1995 Florida accident database, four long-linear models with three variables in each model with all possible two-way interactions were developed. In order to compare the differences in response between the age groups and a particular accident-related variable, odds multipliers were computed. The effects of age and accident-related factors were examined, and interactions among them were considered. The results indicated significant relationships between the driver age and ADT, injury severity, manner of collision, speed, alcohol involvement, and roadway character. The findings' contribution to the understanding of the effect of age on accident involvement is addressed. A discussion of how log-linear and logit modeling with estimation of 'odds multipliers' may contribute to traffic safety studies is also provided.

Overall adequacy of antenatal care in Oman: secondary analysis of national reproductive health survey data, 2008

Despite the good health status of women and children in Oman, there are still some gaps to be filled. This study explored the adequacy of antenatal care [ANC] utilization of Omani ever-married women and the sociodemographic and health service determinants of adequate and sufficient ANC. In a secondary analysis of a national dataset [N=1852 women], the percentages of women who had 4+ ANC visits, attended ANC in the 1st trimester and received care by trained personnel were 96.8%, 74.9% and 99.1% respectively. Overall adequacy of ANC [use and sufficiency of recommended basic services]for the surveyed women was 53.8%. After adjustment of other covariates, being pregnant with the 1st baby was the only significant predictor of overall adequacy of ANC [OR 2.2;95% Cl:1.6-3.2]. Greater awareness of the need for adequate ANC is required for mothers with more than one baby

Malgré la bonne santé des femmes et des enfants à Oman,il reste des lacunes à combler. La présente étude a exploré l'adéquation du recours aux soins prénatals par des femmes ayant été mariées à Oman et les déterminants sociodémographiques et des services de santé en termes de soins prénatals adéquats et suffisants. Dans une analyse secondaire d'un ensemble de données national [N = 1852 femmes], les pourcentages de femmes ayant bénéficié d'au moins quatre visites de soins prénatals, ayant reçu des soins prénatals au cours du premier trimestre de grossesse ou ayant été prises en charge par du personnel qualifié étaient de 96,8 %,74,9 % et 99,1 %, respectivement.L'adéquation globale des soins prénatals [accessibilité et suffisance des services de base]était de 53,8 % selon les femmes interrogées. Après ajustement des autres covariables,être enceinte de son premier enfant était le seul facteur prédictif important de l'adéquation globale des soins prénatals [OR 2,2 ; IC à 95 % : 1,6–3,2]. Une sensibilisation accrue au besoin de soins prénatals adéquats est requise pour les femmes ayant plus d'un enfant

Nutrition knowledge, beliefs and dietary habits among elderly people in Nizwa, Oman: implications for policy

The nutritional needs of the ageing population require special attention. We undertook a cross-sectional, community-based, household survey in Nizwa wilayat, Oman to study nutrition-related knowledge and beliefs and self-reported dietary habits among a sample of elderly people. The response rate for the household interview was 99.3% from a total sample of 2041. About 45% of the elderly were overweight or obese. Overall we found poor knowledge of nutrition plus some nutritional imbalances and low levels of physical activity. Significant sex differences existed in elderly peoples' nutritional knowledge, consumption of fluids, milk and sweets, use of dietary regimens and experience of appetite change. The findings warrant reorientation of the existing health promotion strategy for the elderly