Cultural adaptation and validation of the "Kidney Disease and Quality of Life--Short Form (KDQOL-SF™) version 1.3" questionnaire in Egypt.

BACKGROUND: Health Related Quality of Life (HRQOL) instruments need disease and country specific validation. In Arab countries, there is no specific validated questionnaire for assessment of HRQOL in chronic kidney disease (CKD) patients. The aim of this study was to present an Arabic translation, adaptation, and the subsequent validation of the kidney disease quality of life-short form (KDQOL-SFTM) version 1.3 questionnaire in a representative series of Egyptian CKD patients. METHODS: KDQOL-SFTM version 1.3 was translated into Arabic by two independent translators, and then subsequently translated back into English. After translation disparities were reconciled, the final Arabic questionnaire was tested by interviewing 100 pre-dialysis CKD (stage 1-4) patients randomly selected from outpatients attending the Nephrology clinic at the Main Alexandria University Hospital. Test re-test reliability was performed, with a subsample of 50 consecutive CKD patients, by two interviews 7 days apart and internal consistency estimated by Cronbach's α. Discriminant, concept, and construct validity were assessed. RESULTS: All items of SF-36 met the criterion for internal consistency and were reproducible. Of the 10 kidney disease targeted scales, only three had Cronbach's α <0.7: quality of social interaction (0.23), work status (0.28), and cognitive function (0.60). All disease specific scales were reproducible. Results from discriminant validity showed that the study questionnaire could discriminate between patients' subgroups. As for concept validity, the correlation between all domains of the questionnaire with overall health ratewas significant for all domains except for the work status, sexual function, emotional wellbeing, and role emotional. Furthermore, the correlation between the disease specific domains and the two composite summaries of SF-36 (physical and mental composite summaries) was significant for all domains except for sexual function with mental composite summary. Construct validity was indicated by the observation that the majority of the domains of the kidney disease targeted scale of KDQOL-SFTM 1.3 were significantly inter-correlated. Finally, principal component analysis of the kidney disease targeted scale indicated that this part of the questionnaire could be summarized into 10 factors that together explained 70.9% of the variance. CONCLUSION: The results suggest that this Arabic version of the KDQOL-SFTM 1.3 questionnaire is a valid and reliable tool for use in Egyptian patients with CKD.

Controlling Blinding Trachoma in the Egyptian Delta: Integrating Clinical, Epidemiological and Anthropological Understandings.

Trachoma is a leading cause of preventable blindness in the world. The disease is hyperendemic in rural Egypt, where more than 75% of children show signs of having had at least one episode of infectious trachoma during the first year of life. Earlier anthropological and epidemiological observations suggested that trachoma prevalence would decrease if children had their faces washed with soap and water at least once each day. We conducted a community-based intervention to increase face washing in order to control trachoma. In this paper we describe the overall design of this intervention trial and discuss how we integrated anthropological methods and ethnographic data into the design of this successful multi-disciplinary, cross-cultural project to prevent trachoma.

Impaired renal function among children in Alexandria, Egypt.

OBJECTIVE: Impairment of renal function may occur as a result of a variety of conditions. Progression to chronic renal-disease may be prevented by early detection. This epidemiologic study aimed at revealing the predisposing factors and determinants for the development of impaired renal function among Egyptian children. METHODS: This is a case-control study conducted at Alexandria University Children's Hospital, Alexandria, Egypt. All cases below 12 years of age diagnosed with impaired renal function over a total duration of 6 months (October 1999 through to March 2000) were investigated. The primary study tool was a structured questionnaire, which focused on variables suspected to play a role in the impairment of renal function. For each patient, one control matched for age and sex was selected. RESULTS: Primary renal disease tends to account for a relatively small proportion of the etiologies of renal impairment in Egyptian children. Most of the cases encountered in this study suffered functional renal impairment secondary to severe dehydration or sepsis. Presence of congenital abnormalities of the gastrointestinal tract, heart or urinary tract, increased the possibility of suffering from impaired renal function approximately 9 times. Delays in seeking medical advice increased the risk substantially. CONCLUSION: Awareness of individuals at an increased risk, along with early diagnosis and adequate management of many predisposing conditions could prevent progression to more severe renal disease which has potentially devastating effects on every aspect of a childs' life.

Compliance with antituberculosis drugs among tuberculosis patients in Alexandria, Egypt

Tuberculosis is an important reemerging disease with increasing global morbidity and mortality. Tuberculosis control is hindered by patient noncompliance with treatment regimens. To study compliance to antituberculosis drug regimens, 172 patients diagnosed with tuberculosis during the first three months of 1995 were investigated. The patients were interviewed at their homes during July and August 1995. More than one-third [34.9%] of the patients were not adhering to the antituberculosis drug regimen. Factors increasing drug compliance included: disease symptoms, knowledge about the disease, family history of tuberculosis and hospitalization. More information about the disease and the importance of compliance should be provided to tuberculosis patients at the time of diagnosis and initiation of therapy. Supervision of drug administration by health care personnel is stressed