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Biomedical subjects

M K Farag

Publications and source records attributed to M K Farag.

12 recordsLinked to original sources

Screening for cervical carcinoma using visual inspection with acetic acid.

OBJECTIVE: To assess the performance of visual inspection with acetic acid (VIA) as a screening test for early detection of cervical carcinoma in the Dakahlia Governorate in Egypt. METHODS: Diluted acetic acid (5%) was applied to the cervix during routine gynecologic examination. Women with positive results were referred for colposcopy. Those with negative results were referred for colposcopy only when they had clinical indications. RESULTS: Among the 5,000 women who were screened using VIA, 409 were referred for colposcopy. Cervical intraepithelial neoplasia (CIN) was diagnosed in 151 (60%) of the 253 women with positive screening results and in 4 of the 156 women with negative screening results. There were 39 women with high-grade and 116 with low-grade CIN. The sensitivity and negative predictive value of the VIA screening test was 97%. Its positive predictive value was 60% for all grades of CIN and 90% for high-grade CIN. CONCLUSION: Visual inspection with acetic acid, although associated with a relatively high rate of false-positive results, is a valuable test for the screening of cervical carcinoma.

Acetic Acid↗

Epidemiological, clinical and laboratory studies on parasitic infections as a cause of fever of undetermined origin in Dakahlia Governorate, Egypt.

Forty-three patients who fulfilled the international criteria for prolonged fever were exposed to thorough history taking, clinical and laboratory investigations. The latter included urine and stool examination, urine and blood culture, haemogram, liver and renal function tests, chest X-ray, tuberculin test, bone marrow, liver biopsy, blood films, serological tests including ELISA, IHA and IFA for detection of schistosomiasis, toxoplasmosis and malaria. Parasitic infections were detected in 30/43 (69.7%), 55.8% of whom had pure parasitic infection and 14% had in addition other causes. The majority of cases with positive etiology were coming from rural areas. The pattern of fever was predominantly intermittent especially with malaria and schistosomal cases. Fever of 21-41 days duration was noted in 70% of patients and 23.3% lasted up to more than 56 days. Visceromegaly (hepatomegaly and/or splenomegaly) was observed in all patients except one case. Lymphadenopathy was detected in ten cases, six of whom were visceral leishmaniasis. The IHA test for leishmaniasis detected ten cases at titres of 256, 512 and 1024 reciprocally. The dot-ELISA gave seropositivity in only 8/10 cases diagnosed by IHA test. So eight cases of VL were diagnosed by two serological tests at high titres. The detection of seropositive cases of visceral leishmaniasis in the studied area, suggests a focus or foci and warrants epidemiological study to establish the actual situation. Generally speaking, parasitic aetiology should be in mind in any case of FUO in Dakahlia. Serological tests are valuable, simple and safe tools for conforming the diagnosis of schistosomiasis, leishmaniasis, toxoplasmosis and malaria.

Adolescent↗

Prevalence and intensity of schistosomiasis haematobium among school children in respect of family social conditions in a village in Dakahlia Governorate, Egypt.

A probability sample (n = 2000) of primary and preparatory school children (6-15 years old) in a rural area, in the eastern part of Nile Delta, Egypt, were examined for S. haematobium eggs using the sedimentation technique. A sub-sample, consisting of all children whose urine samples were positive, was subjected to short interview and urine examination for egg counting using the modern monofilament polyamide (Nytrel) filters. The overall prevalence of S. haematobium was 5.5% with significant (P < 0.05) difference between males (7.9%) and females (3.1%). The sample mean egg count was 163 eggs/10 ml urine, while those of males and females were 625 and 52, respectively (P < 0.001). The age category 9-12 years old had the highest prevalence rate and mean egg count. Also, these patients had highest frequency distributions in the severe grade of infection intensity. Significant relationships were detected between fathers' occupation and mothers' education on one hand and mean egg counts and intensity grade of infection on the other hand.

Adolescent↗

Maternal and child health in Saudi Arabia. Study design and methodology.

Saudi Maternal and Child Health Survey was designed to study the utilisation of maternal health services by ever-married women of child-bearing age, by measuring level of tetanus vaccination coverage; breastfeeding and weaning knowledge, attitude and practices; and by measuring the level of vaccination coverage with BCG, DPT, Poliomyelitis and measles vaccines among children 1-2 years old at the national level. The standard world health organization (WHO) cluster technique was employed. The kingdom was divided into five geographical areas. The sampling frame used was available at the Ministry of Health (MOH) in the form of ascending cumulative frequency tables where the catchment areas of 1625 health centres (HC) constitute primary sampling units (PSUs). Thirty clusters were randomly selected from each of the five geographic areas, and 40 household per cluster were used. The target populations included: (i) the ever-married Saudi females in the child-bearing age (15-49 years), (ii) children less than 5 years old, and (iii) children 1-2 years old. The respondents were interviewed using a questionnaire. The quality of data was assured by pre-coding of data which was edited throughout the field work period. A 4-day workshop was held for the interviewers and supervisors 48 hours prior to commencement of the survey. During the workshop, interviewers were instructed to read the questions precisely, were acquainted with survey methodology in general, pretested the questionnaire, received guide manual, instruction notes, progress sheets and follow-up formats for referring to when needed. The investigators were in the field during the first few days to solve any problem arising.

Adolescent↗

Antenatal care, attitudes, and practices.

This paper discusses attitudes and practices of antenatal care in Saudi Arabia, based on the results of the maternal and child health survey of 1991. The survey covered a cluster random sample of 6306 households, with 6294 ever-married Saudi women 15-49 years of age out of whom 1050 were pregnant. The interview questionnaire included maternal care data on current pregnancies and births in the sample, totaling 4777 children less than 5 years old. Coverage of antenatal care and frequency of visits among pregnancies identified, by whom and where, and reasons for not attending antenatal services by age, urban-rural, geographical, and educational differentials. Proportions pregnant at the time of the survey were 17 per cent; antenatal care attendance for the whole sample reached 86 per cent; frequencies of one or two visits were 37 per cent; and three or four visits 25 per cent; those checked by a physician were 85 per cent, while 88 per cent attended governmental facilities. Those with timely attendance were 85 per cent. However, almost one-third of non-attenders (30 per cent) believed they did not need antenatal care. Though utilization of antenatal care services is already high, it has to be further increased through health education and publicity, emphasizing the couples role.

Adolescent↗

Coverage and quality of natal and postnatal care: women's perceptions, Saudi Arabia.

This paper discusses natal and postnatal care services in Saudi Arabia, as revealed by the National Maternal & Child Health Survey of 1991. The latter was based on a national random sample of 150 clusters, with 6306 households, from urban and rural areas, of five geographic regions. The target of 6294 ever-married Saudi women, 15-49 years old included 6020 currently married women, of whom 1050 reported a pregnancy. Data on maternal care were analysed, including where and why natal care was attended, and for both natal and postnatal care, how much and by whom, by respondents' age, urban-rural residence, geographical location, and education of wife and husband. About three-quarters of the respondents had one or more births within the 5 years preceding the survey, with a total of 4777 children under six. Institutional deliveries reached 86 per cent and about 90 per cent of deliveries were attended by physicians or nurses with a ratio of 2:1. Postnatal care attendance amounted to 88 per cent mainly by physicians than nurses with a ratio of 5:1. In general, the above results describe relatively high coverage with natal and postnatal care services, which can still be improved through health education and community support, particularly of the women. Judging by the high level of institutional care and physician involvement, good quality of care is implied, but needs to be further confirmed, by defining morbidity and mortality patterns.

Adolescent↗

Overview on breastfeeding patterns in Saudi Arabia.

A national cross-sectional study was carried out in 1991 to investigate child feeding patterns in addition to other MCH issues. The target population was the last live birth born within 5 years preceding the data of the interview. The data were collected by interviewing the mothers of the eligible children using a precoded questionnaire. The total sample size was 3608 children and their mothers were chosen randomly through a multistage cluster sampling technique with representation of different regions. The results observed revealed a previous history of breastfeeding among 92.4 and 94.5 per cent of urban and rural studied children, respectively. The mean duration of breastfeeding among studied children in the urban and rural communities, were 11 and 13 months, respectively. Illiteracy of the parents was associated with a longer breastfeeding duration. Moreover, the results revealed that, the higher the current age of mothers, the longer the average duration of breastfeeding. Governmental health facilities and mass media constituted the main source of essential information about child feeding. The results are further interpreted and suitable recommendations are made.

Adolescent↗

Role of social factors in the prevalence of diarrhoeal diseases in under-five Saudi children.

Social factors influencing diarrhoea prevalence rates, in Saudi communities, were studied during 1991 taking statistically representative samples from the whole population. The factors included mother's age, child's age, birth order, parent's education, feeding pattern, and urban, rural, and regional residences. This study was a part of the National Maternal and Child Health Survey which involved interviewing of 6308 women with 8292 children under 5 years. The social factors and diarrhoea occurring in children during the preceding 14 days prior to the date of survey were inquired into and recorded in the pre-coded and field-tested questionnaire forms. There were 3.8 episodes of diarrhoea per year per child under 5 or 15 per cent per 2 weeks. This was higher than previously reported. The factors associated with higher prevalence rate were the children of youngest (15-19-years-old) mothers (28 per cent), the last children (18 per cent), and the children aged 6-17 months (24-31 per cent). Additionally, by birth order, the last (third) child on the average had highest rate (18 per cent) than the second (9 per cent) and the second had higher rate than the first (6 per cent) child. The rate in those who lived in rural setting was higher (15 per cent) than in those who lived in urban setting (14 per cent). The rates were almost identical between the areas of the country (13-17 per cent) except having higher rate in the northern area (17 per cent).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

ORS use in diarrhoea in Saudi children: is it adequate?

The prevalence of diarrhoea and especially the pattern of diarrhoea therapy in Saudi children under 5 years were studied as a part of the Maternal and Child Health Survey during 1991. A statistically representative sample of over 6300 mothers, from all over the country was interviewed by trained nurses. There were 3.8 episodes of diarrhoea per child under 5 per year. For treating diarrhoea, ORS, salt-sugar solution (SSS), other available solutions, intravenous fluid and various drugs were the therapeutic agents. In 73 per cent of cases ORS, nearly 3 per cent SSS, 33 per cent other solutions and in over 4 per cent intravenous fluid were used. Anti-diarrhoeal drugs and antibiotics were used in over 40 per cent of cases. Over 9 per cent of cases did not use any treatment. Young mothers used ORS at a higher rate (84 per cent) for their children compared to the average for all (73 per cent). Children of illiterate parents used ORS at a higher rate than children of literate parents. In urban area, the use-rate was lower (68 per cent) than in rural area (80 per cent). The regional use-rates were almost similar excepting a higher rate in the northern area. In over 87 per cent of cases, advice on diarrhoea therapy was obtained from government health centres (physicians/nurses), while only 3 per cent of the diarrhoea cases acquired information from national media. The overall use-rate of ORS was thus better than many other countries and there was a 25 per cent increase over the previous Saudi findings in 1987.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

National Immunization Coverage Survey Saudi Arabia, 1991.

A nationwide survey was carried-out aiming at determination of immunization coverage level against the six killer diseases of childhood (tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, and measles). Variations between geographical zones, urban-rural settings, age, education and mother's employment, father's education, and child's birth order were studied. The standard WHO cluster technique was used. The sample (1102 children) was restricted to Saudi children 1-2 years old. Interviewers were exposed to training and methods of calibration, and involved in a pilot survey. Nationally, the survey showed very high coverage levels, BCG was the highest (99 per cent), measles was the lowest (90 per cent), whereas the three doses of DPT (diphtheria, pertussis and tetanus) and TOPV (trivalent oral polio vaccine) were in between (98, 96 and 94 per cent, respectively). There was no marked differences between urban-rural settings. The western zone showed the lowest coverage by all vaccines. The national coverage by the six vaccines reached 86 per cent correctly immunized (according to WHO standards), 14 per cent partially immunized and 1 per cent non-immunized. Immunization coverage was higher for children to younger mothers. The non-immunized group belonged exclusively to illiterate mothers (1 per cent). Children to mothers with basic education showed the highest coverage (88 per cent). Birth order had negative effect on coverage. Nationally, 88 per cent of children had immunization certificate while 12 per cent had not. The eastern and central zones had the highest percentages of children with certificates (92 and 91 per cent, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Order↗

Nuptiality pattern in Saudi Arabia.

The data of this work are based on the 'Saudi Maternal and Child Health Survey' conducted in 1991. This was a nationwide house to house field survey. The study included 6294 ever-married Saudi female in the childbearing age who represent the target population. They were randomly selected from both urban and rural settings of the five geographical areas of Saudi Arabia. The mean current age of the sample of ever-married women was 31 years and the mean age at first marriage was 17 and 16 years for urban and rural females, respectively. Education was associated with upward shift of the age at first marriage. About 20 per cent of the sampled ever-married Saudi females got married before their 15th birthday and 83 per cent before reaching 20 years of age. These percentages are even higher in rural than urban settings. The overall percentage of women who were currently married at the time of the survey was 96 per cent. The divorced and widowed women of childbearing age were 2 and 3 per cent, respectively, of the total. Husband's educational level had positive impact on the frequency of divorce. The latter was highest among women married to illiterate husbands with a dose response pattern. Comparison has been made with the situation 4 years ago. An increase in literacy rates among Saudi ever-married women and their husbands was observed, however, a significant (P < 0.05) difference still exists between female and male literacy rates (38 and 71 per cent, respectively). The events of early marriage, before the age of 15 years, became less frequent. There is an overall decline in teenage marriages which explains a large part of the recent changes observed in nuptiality and pattern of birth in Saudi Arabia.

Adolescent↗

Impact of the current National Bilharzia Control Programme on the epidemiology of schistosomiasis mansoni in an Egyptian village.

In a population-based study in the Nile Delta of Egypt, the modified Kato thick smear technique was used to study the epidemiology of Schistosoma mansoni. After 2 years of implementation of the National Bilharzia Control Programme by the Ministry of Health, the general prevalence dropped from 47.2% to 21.9%. The peak prevalence rate has shifted downwards in magnitude (40.4% compared to 72.1%) and backwards over the age scale (5-14 in contrast to 15-19 years age group). Redistribution of various infection grades has taken place. More than three-quarters (75.6%) of the infected individuals have light infections in contrast to only one-fifth (20%) 2 years ago. The mean egg count for the entire sample population has dropped significantly (P < 0.05) from 128 to 17 eggs/g stools with no significant difference between males and females. This positive impact can be attributed largely to the case finding and treatment component of the programme. However, the incidence rate remained nearly the same before and 2 years after implementation of the programme (18.7 and 18.1%, respectively). The non-changing high incidence rate indicates that the knowledge, attitude and practice (KAP) of the population concerning water contact have not yet changed. Insufficient improvement in environmental sanitation may be a contributing factor. Continuation of serious efforts in case finding and treatment is recommended, with special emphasis on schoolchildren. This should be coupled with an intensive health education programme.

Adolescent↗