Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional survey at Cairo University Hospital.

Introduction: Healthcare workers have a significant chance of experiencing violence, with physical violence impacting anywhere from 8 to 38% of healthcare professionals throughout their careers. Besides physical abuse, many healthcare workers are subject to verbal aggression or threats, with patients and visitors being the most frequent sources of such incidents. Methods: This research examines the work atmosphere of healthcare professionals at Kasr Al-Aini University Hospital in Cairo, Egypt, during the pandemic. The study aims to evaluate the frequency of violence toward healthcare workers and health professionals training through a cross-sectional survey conducted among them. The research was conducted on Egyptian healthcare workers over 6 months, from November 2020 until the end of January 2021, using convenience sampling in a cross-sectional study. Over half of the respondents reported experiencing violence. Results: Among those who experienced violence, 93% reported verbal aggression, 43% reported physical and verbal abuse, and 59% claimed that violence increased during the pandemic. Additionally, 97% of those who experienced violence reported it occurring within the 4 months following the survey. About 42.5% of the respondents were female, and nearly 65% were over 30. 82% of the respondents did not receive training on handling violence while performing their job. Conclusion: This study highlights the high prevalence of verbal assaults in healthcare settings, primarily by patients' families or acquaintances. Despite reporting such incidents, most respondents did not see any significant government action. Furthermore, the COVID-19 pandemic did not significantly change the frequency of violent incidents, indicating that the root causes of violence are systemic and extend beyond the pandemic. These findings underscore the need for systemic changes in healthcare organizations to address and prevent violence against healthcare workers.

An e-learning reproductive health module to support improved student learning and interaction: a prospective interventional study at a medical school in Egypt.

BACKGROUND: The Public Health (PH) course at the medical college of Cairo University is based on traditional lectures. Large enrollment limits students' discussions and interactions with instructors. AIM: Evaluate students' learning outcomes as measured by improved knowledge acquisition and opinions of redesigning the Reproductive Health (RH) section of the PH course into e-learning and assessing e-course utilization. METHODS: This prospective interventional study started with development of an e-learning course covering the RH section, with visual and interactive emphasis, to satisfy students' diverse learning styles. Two student groups participated in this study. The first group received traditional lecturing, while the second volunteered to enroll in the e-learning course, taking online course quizzes. Both groups answered knowledge and course evaluation questionnaires and were invited to group discussions. Additionally, the first group answered another questionnaire about reasons for non-participation. RESULTS: Students participating in the e-learning course showed significantly better results, than those receiving traditional tutoring. Students who originally shunned the e-course expressed eagerness to access the course before the end of the academic year. Overall, students using the redesigned e-course reported better learning experiences. CONCLUSIONS: An online course with interactivities and interaction, can overcome many educational drawbacks of large enrolment classes, enhance student's learning and complement pit-falls of large enrollment traditional tutoring.

Elimination of schistosomiasis haematobia as a public health problem in five governorates in Upper Egypt.

The prevalence and intensity of Schistosoma haematobium infection was determined among schoolchildren living in five governorates in Upper Egypt. Between November 2016 and March 2017, urine samples were collected from 30,083 schoolchildren (6-16 years of age) from the governorates of Assiut (n = 7496; 6 districts), Bani Sweif (n = 4493; 7 districts), Fayoum (n = 4597; 6 districts), Menia (n = 7500; 9 districts) and Sohag (n = 5997; 11 districts). All samples were processed using urine filtration to detect and quantify S. haematobium eggs. The overall prevalence was 1.3% (95% Confidence Interval (CI) = 1.1%, 1.4%), but the prevalence varied considerably across districts in the studied governorates (from 0%, Fayoum to 13.4%, Sohag). The prevalence of heavy-intensity infections (≥50 egg/10 ml) varied from 0.05% (95% CI = 0.01-0.1) in Sohag to 0.3% (95% CI = 0.1-0.4) in Menia. No subject with heavy intensity of infection was detected in Fayoum and Bani Sweif governorates. Of the 39 studied districts 97.4% had prevalence of heavy intensity infection of <1%, indicating elimination of schistosomiasis haematobia as a public health problem in these districts. Of those studied 72.0% were male. Males were 2.9 times as likely to be infected (1.5% [95% CI: 1.4-1.7]) as females (0.5% [95% CI: 0.3-0.7]); χ2 = 51.2, p < 0.0001. Heavy intensity of infection was detected only in males. The prevalence of S. haematobium infection increased steadily with age, and the age group >15 years was 7 times as likely to be infected as the younger age group (6-<9; 0.8%); χ2 = 44.9, p < 0.0001. The national schistosomiasis control programme (NSCP) adopted a new elimination strategy by readjusting thresholds for MDA using praziquantel and targeting all transmission areas. The NSCP, after this major achievement of elimination of schistosomiasis haematobia as a public health problem, is now moving to interruption of its transmission.

Perceived Risk of Cervical Cancer and Barriers to Screening among Secondary School Female Teachers in Al Hassa, Saudi Arabia

Background: No previous studies had addressed the perceived risk of cervical cancer (CC) and its influence on screening practices and perceived barriers in Saudi Arabia. Methods: This cross-sectional study was conducted on 506 randomly selected Saudi female secondary school teachers in Al Hassa, Saudi Arabia to assess their level of knowledge about risk factors and signs of CC in relation to perceived risk and to characterize CC screening compliance using a self-administered questionnaire. Results: Of the included female Saudi teachers, 65.4% and 63.4% were considered less-knowledgeable about CC risk factors and early signs and symptoms respectively. Only 17.2% reported being previously examined for CC. The majority of participants perceived themselves to be at an average or below average risk of CC. Residing in urban areas was the strongest predictor of CC screening (Odds ratio 'OR'= 3.39; 95% confidence intervals 'CI= 1.76-6.46; P=0.001). Awareness of risk factors was significantly associated with higher awareness of signs of CC (OR 2.5; 95% CI=, P=0.001). Exploratory factor analysis showed that personal fears (of screening being embarrassing) was the major factor that hindered CC screening with a high loading eigenvalue of 4.392, explaining 30.8% of the barriers toward utilization, followed by health care related factors. Conclusion: Secondary school teachers in Al Hassa, Saudi Arabia showed low perceived risk, poor awareness about risk factors, signs and symptoms of CC and limited uptake of screening practices. This underlines the need for education programs on CC targeting this group.

Colon Cancer among Older Saudis: Awareness of Risk Factors and Early Signs, and Perceived Barriers to Screening.

BACKGROUND: Colon cancer screening (CRCS) uptake is markedly affected by public awareness of the disease. This study was conducted to assess levels of knowledge of CRC, to explore the pattern of CRCS uptake and identify possible barriers to screening among Saudis older than 50 years of age and primary care providers (PCPs) in Al Hassa region, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted in randomly selected primary health care (PHC) centers, 884 Saudis and 39 PCPs being enrolled for data collection. Structured interviews were conducted to obtain information regarding socio-demographic characteristics, personal information relevant to CRC, awareness about early signs/symptoms and risk factors, and barriers to CRCS. Also, a self- administered data collection form was used to assess barriers to CRCS from the physicians' perspectives. RESULTS: More than 66% of participants were lacking knowledge about CRC. Participants with higher educational levels, having ever heard about CRC, and having relatives with CRC had a significantly higher awareness of the disease. The rate of reported CRCS was low (8.6%). After conducting a logistic regression analysis, it was observed that female gender (OR=0.28; 95% CI=0.14-0.57; P=0.001), being unmarried (OR=0.11; 95% CI=0.10-0.23; P=0.001), lower levels of education (OR=0.36; 95% CI=0.16-0.82; P=0.015), and having no relatives with CRC (OR=0.30; 95% CI=0.17-0.56; P=0.001) were significantly associated with a lower CRCS uptake. There was a significant difference between most of the perceived barriers to CRCS and gender. Exploratory factor analysis showed that personal fear (especially fear of the screening results and shyness) was the major factor that hindered CRCS with high loading Eigen value of 2.951, explaining 34.8% of the barriers of the included sample toward utilization of CRCS, followed by lack of awareness of both person and providers (high Eigen value of 2.132, and explaining 23.7% of the barriers). The most frequently cited barriers to CRCS from the physicians' perspectives were lack of public awareness, lack of symptoms and signs, and fear of painful procedures. CONCLUSIONS: Poor levels of knowledge about CRC were found among older Saudis attending PHC centers in Al Hassa, Saudi Arabia. It is crucial to implement an organized national screening program in Saudi Arabia to increase public awareness.

Screening for antepartum anxiety and depression and their association with domestic violence among Egyptian pregnant women.

BACKGROUND: Greater attention has been paid recently to prenatal mental disorders and their association with exposure to domestic violence (DV) as both have serious reproductive consequences. OBJECTIVES: The aim of this study was to screen for anxiety and/or depression among pregnant women, as well as identify the frequency and association of exposure to DV. PARTICIPANTS AND METHODS: This cross-sectional study was conducted in 2013 and included a systematic random sample of 376 pregnant women attending the antenatal care outpatient clinic at the largest university hospital in Egypt. Participants were interviewed using a structured questionnaire including three components: sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale questionnaire (HADS), and the Hurt, Insulted, Threaten, Scream (HITS) inventory for screening for DV. RESULTS: Women who expressed simultaneous anxiety and depressive manifestations accounted for 63%, whereas 11.4% and 10.4% of them expressed only anxiety and only depression, respectively. Exposure to DV was detected in 30.6% of all participants, of whom 25.2% were physically hit by their husbands often to most of the time. Simultaneous anxiety and depression was independently associated with lifetime exposure to DV (odds ratio=3.27, 95% confidence interval: 1.28-8.34, P=0.013), whereas having a university-graduated husband was a protective factor from DV (odds ratio=0.22, 95% confidence interval: 0.64-0.75, P=0.01). CONCLUSION AND RECOMMENDATIONS: Symptoms of anxiety and depression were highly reported among this sample of pregnant Egyptian women and were significantly associated with exposure to intimate partner violence. Screening of pregnant women for mental disorders associated with exposure to DV with provision of supportive mental health services, as well as interventions to reduce exposure to DV, should be considered for integration into antenatal care services.

Development of an accessible self-assessment tool for research ethics committees in developing countries.

In response to increased research being performed in developing countries, many research ethics committees (RECs) have been established, but the quality of their ethics review systems remains unknown. Evaluating the performance of an REC remains a challenging task. Absent an accreditation process, a self-assessment mechanism would provide RECs a way to review their policies and processes against recognized international standards. We describe a self-assessment tool that was developed and reviewed by REC members and researchers from the Middle East. This tool reflects pragmatic aspects of human subjects protection, is based on international standards, is straightforward in its completion, and its items are relevant to the administrative processes that exist in many RECs in the developing world.

Rubella: serosusceptibility among Egyptian females in late childhood and childbearing period.

Our objective was to determine age-specific rubella susceptibility among Egyptian females. This was a cross-sectional survey in eight randomly selected communities, with the largest number of reported rubella cases in the 2007 Rubella surveillance. A sample of 5672 females between the ages of 6 and 45 years were interviewed. Of those 602 blood samples were obtained and tested for rubella IgG. The proportion of seronegative females was 9.7%. The highest proportion of susceptible females was in the ages between 6 and 25 years and the highest risk of susceptibility was among unmarried females [odds ratio (OR)=7.2]. The knowledge of interviewed females about rubella, the vaccine and the effect rubella infection on pregnancy and on the fetus was very limited. In conclusion more vaccination coverage is needed, with simultaneous increase of public awareness to minimize the susceptible female population.