Screening for hypertension among adults: community outreach in Cairo, Egypt.

BACKGROUND: Studies have shown alarming levels of hypertension among adults in the Middle East. The aim of our study is to measure the prevalence rate of hypertension among adults in Cairo (Egypt), identify possible risk factors for the development of hypertension and assess the rates of undiagnosed and uncontrolled hypertension. METHODS: Cluster sampling was utilized and the fieldwork was conducted by 12 teams; each team consisted of a house officer, community worker and senior epidemiologist. A formulated questionnaire that addresses risk factors for hypertension was filled by all participants. Also, weight and height measurements were done to calculate the body mass index. Blood pressure measurement was done by calibrated sphygmomanometers. Blood pressure measurement was done twice, and a mean recording was calculated. A case which recorded both systolic blood pressure of ≥140 and diastolic blood pressure of ≥90 was considered hypertensive. RESULTS: The study included 774 adult residents of Al-Waily District (Western Zone of Cairo) in late 2011 and early 2012. The mean age of the study participants was 46.5 (SD 17.9) years. Female subjects constituted 67.1% of the studied sample. The prevalence rate of hypertension in our study was 16.5% (95% confidence interval (CI): 13.9-19.3). The rate of hypertension was higher among females and three times higher among obese compared with normal or overweight adults. The prevalence of undiagnosed hypertension was 11% (95% CI: 8.4-13.9), and uncontrolled hypertension was 30% (95% CI: 24.2-37). CONCLUSIONS: Community outreach campaigns should be conducted regularly in the future for early detection of hypertension cases and proper health education about hypertension and its dangerous consequences.

A measles and rubella (MR) catch-up vaccination campaign in an Egyptian University: vaccine uptake and knowledge and attitudes of students.

INTRODUCTION: In 2008, following a rubella epidemic, the Egyptian Ministry of Health implemented a Measles Rubella (MR) catch-up campaign, based on WHO recommendations for supplementary immunization activities to eliminate measles by 2010. The age group targeted was 10-20 years. This campaign was unique in Egypt as it was the first national vaccination campaign which included university students. AIM: To report uptake of MR vaccine and reasons for declining the vaccine among medical and non-medical students in the campaign and to assess the knowledge about the vaccine and the diseases. METHODS: The study was conducted in two stages. In the first stage during the vaccination sessions, medical and other students (N=310) were given a questionnaire to assess their knowledge of the campaign and the vaccine. The second stage (N=341) was carried out when the campaign was completed to assess vaccine uptake among medical students. RESULTS: Posters displayed inside the university were reported to be the main source of information about the campaign. Students were generally poorly informed about both vaccine adverse effects, and contraindications although medical students tended to be better informed than other students. Overall 64.8% medical students accepted the vaccine with higher uptake among females than males (85.9 and 58.3% respectively). Non-compliant students had a significantly higher mean age. Almost half of students who did not accept the vaccine gave their reason as having little information about the vaccine (43.3%). CONCLUSION: The MR campaign in Ain Shams University may have been more successful with better use of health education messages.

Nocturnal attacks, emergency room visits and ICU admission of pediatric asthma: frequency and associated factors.

UNLABELLED: Asthma is the most frequent cause of chronic illness in childhood and emergency department visits. This study aims to determine the frequency of emergency room (ER) visits, intensive care unit (ICU) admission, and nocturnal attacks among asthmatic children and to identify associated factors. Records of asthmatic children in the pediatric chest clinic, Ain Shams University during 1995-2004 were reviewed. Asthmatic children with documents of ER visits, ICU admission, or nocturnal attacks were compared with asthmatic children without previously mentioned events. Out of 691 asthmatic patients, 302 (43.7%) had nocturnal attacks, 258 (37.3%) had emergency room visits, 39 (5.6%) were admitted to ICU, and 249 (36%) had no reports of previous events. ER visits and nocturnal attacks were more in children above 4 years. ER visits and ICU admission were higher among those with positive family history of asthma (p< 0.01), those exposed to environmental tobacco smoke (ETS) (p< 0.01), and those who had previous respiratory infections (p< 0.05). Attacks of nocturnal asthma were associated with the previous factors in addition to animal contact (p<0. 01) and living in bad housing conditions (p<0.05). Logistic regression showed that family history (OR= 2.87, CI= 1.9-4.1) and bad housing conditions (OR= 2.65, CI= 1.3-5.3) were the significant factors for ER visits, while respiratory infections (OR= 5.24, CI= 2.1-12.0) and family history (OR= 3.48 CI, 1.3-9.2) were the significant factors for ICU admission. For nocturnal attacks, all factors were significant. CONCLUSION: Control of respiratory infections, limitation of ETS exposure and good housing conditions are needed to limit severe asthmatic attacks.

Prevalence and risk factors of violence among elementary school children in Cairo.

UNLABELLED: School violence is a growing problem that has received widespread attention. Violent behavior for elementary school children is primarily expressed as physical or verbal aggression. Various factors contribute to violent and aggression by children at homes, schools or individual risk factors. The aim of the present study is to measure the prevalence of violence, risk factors, and different forms among elementary school children, to identify consequence of violent exposure and children with abnormal behavior score. A cross-sectional study was done enrolling a total of 500 elementary students from two mixed schools (private and public) 250 from each in North Cairo Educational Zone. Data collected from students, parents and teachers were: violence behavior, home and family atmosphere, peer relation, exposure to violence at school; being victimized, witness, or initiator, and other risk factors. Standardized questionnaires were used as Achenback Child Behavior checklist, parent and teacher forms of Strength and Difficulty questionnaires (SDQ), and developmental history of child. Monthly grades of students, IQ assessment, physical examination of students were recorded. RESULTS: Prevalence of different forms of violence was higher in public school than private; physical violence 76%, 62% respectively. All forms of violence were higher among boys. Living with a single parent (OR = 2.3), absence of an attachment figure (OR = 13.6), instrumental delivery or cesarean section (OR = 1.9), corporal punishment (OR = 3), violent video games preference (OR = 2.5), exposure to verbal aggression (OR = 3), relations with aggressive peers (OR = 3) were risk factors for violence. Teacher's report of SDQ revealed abnormal score of student's behavior in (32.4%) and (22%) students of public and private schools respectively. The most frequent problems revealed by SDQ among victimized students of both schools was conduct problems (64.7%) in teacher's report and peer relation problems 93.6% in parent's report. CONCLUSION AND RECOMMENDATIONS: Abnormal and borderline scores of SDQ are high among studied students, Follow up and supervision is needed to prevent violence among them. An effective role model to direct student's behavior should receive more concern at the school and home level.