Anaemia among young male workers in Alexandria, Egypt.

In a cross-sectional survey, we investigated exposure to and the presence of factors associated with anaemia, such as socioeconomic conditions, dietary habits, intestinal parasitic infections and lead among 355 young male workers (7-19 years of age) employed in private workshops. Of the total study sample, 44.5% (158 participants) were found to be anaemic. The major risk factors for anaemia were multiple parasitic infection, high intensity of parasitic (Ascaris lumbricoides) infection and drinking tea soon after a meal. A significantly lower prevalence of anaemia was noted after Ramadan; it appeared to be the main factor associated with the presence or absence of anaemia and warrants further attention.

Anaemia among Egyptian adolescents: prevalence and determinants.

We aimed to estimate the nationwide prevalence of anaemia among adolescents in Egypt and to study possible risk factors. A cross-sectional approach was used. Blood samples were collected from 1980 adolescents for haemoglobin estimation. The overall prevalence of anaemia was 46.6%, most of which was mild or moderate, with severe cases in less than 1.0% of the sample. Gender difference was almost nonexistent. A significant inverse relationship was observed between the level of anaemia and age (especially among boys), socioeconomic level and educational level. Anaemia was more prevalent in rural areas and in Upper (southern) Egypt. Anaemia is a major public health problem among Egyptian adolescents and wide-scale public health education is warranted.

Anaemia among Egyptian adolescents: prevalence and determinants

We aimed to estimate the nationwide prevalence of anaemia among adolescents in Egypt and to study possible risk factors. A cross-sectional approach was used. Blood samples were collected from 1980 adolescents for haemoglobin estimation. The overall prevalence of anaemia was 46.6%, most of which was mild or moderate, with severe cases in less than 1.0% of the sample. Gender difference was almost nonexistent. A significant inverse relationship was observed between the level of anaemia and age [especially among boys], socioeconomic level and educational level. Anaemia was more prevalent in rural areas and in Upper [southern] Egypt. Anaemia is a major public health problem among Egyptian adolescents and wide-scale public health education is warranted

The impact of intestinal parasitic infections on the nutritional status of primary school children in Alexandria, Egypt.

In order to investigate the relationship between intestinal parasitism and nutritional status, stool specimens obtained from 1674 school children aged 6-13 years, enrolled in primary governmental schools in the Eastern zone of Alexandria, Egypt were examined for helminth and protozoan parasites. The findings were collated with anthropometric data (weight and height) on the same children. The prevalence of parasitic infections was found to be 31.5%. The most common infections were found to be with Giardia lamblia (15.4%) and Ascaris lumbricoides (10.2%). Children infected with both helminths and protozoa showed an increased but insignificant risk of underweight relative to those without infections. The risk of stunting was found among all types of parasites as compared to children with no parasites. Also there was a higher non significant risk of wasting among those with protozoal infection especially Giardia lamblia. Children infected with three species or more of intestinal parasitic infections were significantly underweight than non infected children (OR = 4.68, 95% confidence limit = 1.04-18.03). Using stepwise logistic regression analysis, number of parasites appeared to be the most effective variable of the nutritional status of children indicated by weight for age Z score, followed by education of the mother.

Use of breast feeding indicators for assessment of current feeding practices.

To investigate the current breast feeding practices, a survey was conducted cross sectionally on 2000 children aged less than 2 years recruited from 6 MCH centers in Alexandria governorate. The median duration of breast feeding was 19.4 months. Only one quarter of infants were exclusively breast fed for the first four months of age with a mean duration of 2.4+2.5 months. Predominantly breast feeding rate was 0.36, while timely complementary breast feeding rate(6-9 months) was 0.66. Continued breast feeding rate(one year) was 0.73 while that for two years was 0.3. Results also indicated that 40% of infants were receiving food from a bottle with a nipple/teat regardless of whether or not the infant was breast fed. These findings implicate that promotion of breast feeding should receive priority in health programs activities.

Human fascioliasis in an Egyptian village: prevalence and some epidemiological determinants.

A cross-sectional survey was conducted in Abis area, 15 kilometers south east of Alexandria city, to determine the prevalence of human fascioliasis and to study some of the epidemiological determinants which may affect the infection. A specially designed questionnaire interview was completed, and a total number of 3475 stool samples were examined. The results revealed a prevalence rate of fascioliasis of 11% in the studied area which was only second to S. mansoni. The prevalence of infection was significantly higher among females in general and specifically in the age group 5 to less than 15 years and 25 to less than 35 years. Family aggregation of fasciola infection was noticed among the studied group. The prevalence and also the risk of infection were significantly higher among children whose mothers were infected. They were, however, insignificantly higher among illiterate, single males, and low social class group. In addition, the prevalence and risk of infection were significantly higher among individuals obtaining their raw green leafy vegetables from multiple sources. From the results it was concluded that human fascioliasis is an important public health problem in Abis area with increased risk of spread of infection to Alexandria city through raw green leafy vegetables which represent the main source of infection.

Dietary patterns and nutritional assessment of working children at Abou El-Dardar industrial area in Alexandria City.

The present study was undertaken in order to evaluate the nutritional status of young working children aged 8 to 18 years, working in workshops at Abou-El-Dardar industrial area in Alexandria Governorate. A total sample of 154 of young male workers were recruited from workshops. The nutritional status was assessed using anthropometric, dietary and biochemical criteria. The results of the study revealed that 45% of the working children were considered malnourished: 16% were wasted, 23% were stunted and 3% were both wasted and stunted and 3% were overweight. Analysis of nutrient intake revealed that the intakes were less than the recommended for energy, calcium, vitamin A, vitamin C and niacin, while the intake of protein, iron, thiamin and riboflavin were more than sufficient. About 77% of the young workers were found to have haemoglobin levels below the cut-off levels issued by WHO. A high prevalence of parasitic infection (food-borne) (72%) was found among young workers. The results also revealed that stunting, wasting and stunting together and overweight were more common in young workers who were both anaemic and had evidence of parasitic infection than those who were anaemic only or had parasitic infection only.

Breastfeeding and fertility. Part II: Breastfeeding practices.

A cross-sectional survey described the current breastfeeding status and antenatal care of 1134 urban mothers, attending MCH centers in Alexandria governorate and gave birth within the last two years, was carried out. The results indicated that the median duration of breastfeeding was 14 months. At six month postpartum the proportion of breastfeeding mothers was 0.8. The mean age of weaning was 20.7 (+/- 4.1) months. Less than 80% of mothers attended the antenatal visits. Information about breastfeeding was provided to 80% of mothers who attended the antenatal visits.

Breast-feeding and fertility. Part I: Lactational amenorrhoea.

A cross-sectional survey describing the current fertility performance and breast-feeding of 1134 urban mothers, who gave birth within the last 2 years was carried out. Mothers were recruited from MCH centers in Alexandria governorate. The results indicated that the mean time elapsed since birth before return of menstruation was (5.1 +/- 4.3) months for breast-feeding mothers and (2.5 +/- 2.3) months for non-breast feeding mothers. At four-month of postpartum period, 50% of the mothers were still amenorrhoeic and at six-month, 31% of the mothers were still amenorrhoeic. A total confirmed pregnancies was 8.5% and 3% of new pregnancies occurred during amenorrhoea and while women were breast-feeding. Use of contraceptives was practiced by 57% of mothers, with 65% of all users starting as early as the second month.

Socio-cultural and nutritional risk factors of adolescents and young pregnant women in an endemic area of schistosomiasis.

The present study was undertaken in order to investigate the social, cultural, behavioral and environmental factors and their impact on the health and nutrition of young pregnant women and adolescent girls aged between 11 and 22 years, living in a rural area known to be endemic of schistosomiasis. A total sample of 34 pregnant women, 30 adolescent girls and 5 married never-pregnant women were recruited initially. The results revealed that early marriage before legal age still occur in rural areas in Egypt (15%). The mean age of marriage was 17.5 years (+/- 1.8) while the mean age at the first conception was 17.9 years (+/- 1.6). A high rate of illiteracy (72%) which was statistically significant was found among married women than adolescent girls. The daily intake of most nutrients were below the RDA except for protein and vitamin C among pregnant respondents. Iron, calcium and riboflavin were the nutrients most poorly supplied by the diets of pregnant women and adolescent girls. A significant statistical difference was found between the two groups in the intake of iron (z = 3.20, p < 0.05). About 60% of pregnant women and 80% of adolescent girls reported contact with canal water during household activities and field work. There was a lack of knowledge as regards schistosomiasis among respondents especially pregnant ones. Home deliveries with the assistance of traditional birth attendants is still the first choice by most of the pregnant respondents.

Malnutrition among children 6-24 months attending MCH centres in Alexandria an epidemiologic study. Part I: Prevalence.

A cross-sectional nutritional survey of children aged 6-24 months (weaning period) attending MCH centres in Alexandria governorate through the year 1988-1989 was conducted with the aim of determining the prevalence of protein calorie malnutrition. The sample size was 1000 children chosen from 6 MCH centres in Alexandria (one centre for each zone). The sample was distributed along the six centres in proportion to the total number of infants recorded to have attended those centres through 1985. The centres were visited during the period starting November 1988 through June 1989. Each centre continued to be visited until the number decided to be included was completed. The study included the determination of age and the measurement of height and weight. Anthropometric standards issued by WHO were used to classify the children's length for age, weight for age, and weight for length in terms of a cut off point of 2 SD below the median of that of reference (Waterlow system). Gomez classification using weight/age as a parameter was used to diagnose undernutrition. The results of the study revealed a prevalence rate of undernutrition of 25.6% which was mostly of the first degree as expressed by Gomez categories. When expressed using waterlow system a prevalence of stunting of 29.7% was observed while wasting was observed in only 0.7% and concurrent wasting and stunting constituted 0.1%. These results were considered to be relatively lower in comparison to earlier similar studies. It was thus recommended that similar surveys for preschool age children in Alexandria and other regions of Egypt would be valuable.