Colonoscopy screening for colorectal cancer in Egypt: a nationwide cross-sectional study

BACKGROUND

Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation.

METHODS

We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening.

RESULTS

A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p < 0.001) or had a discussion with their physician about CRC (25.8% vs 0.7%, p < 0.001). Few responders (3.2%) had good knowledge regarding CRC screening. After introducing the concept of CRC screening to all participants, most patients (66.7%) showed a positive attitude towards having the procedure. Financial burden and fear of results were the two most frequently cited barriers to undergoing CRC screening (81.1%; and 60.1%, respecteively).

CONCLUSIONS

Despite the positive attitude, there is insufficient knowledge about CRC screening among eligible participants in Egypt. This has probably contributed to low compliance with current CRC screening guidelines and needs to be addressed at the national level.

Medical students' perceptions, experiences, and barriers towards research implementation at the faculty of medicine, Tanta university

BACKGROUND

Research is essential for advancing medical knowledge and improving patient care. However, research capacity and output are low in low- and middle-income countries due to various challenges, including a lack of research training among medical students. Integrating research training into undergraduate medical curricula can help address this issue.

METHODS

A cross-sectional study was conducted between December 2022 and March 2023 among 462 undergraduate medical students at Tanta University, Egypt to assess their knowledge, attitudes, and perceived barriers toward conducting research. Data were collected using a self-administered questionnaire and analyzed using SPSS.

RESULTS

Nearly half (49.8%) of the students had an acceptable level of knowledge about research concepts while over two-thirds (66.2%) had a positive attitude. The most common barriers were lack of funding, time, and training in research methods. Previous research training was reported by 66.7% of students, but less than half had participated in or presented research. Students in the competency-based program had significantly higher knowledge and more positive attitudes than those in the mainstream program. Knowledge level was positively correlated with attitude.

CONCLUSION

While attitudes were generally positive, improvements are needed in research training and opportunities among undergraduate medical students at Tanta University to help address low research capacity challenges in low- and middle-income countries. Integration of formal research training into the curriculum may help increase knowledge and participation in research.

A nomogram proposal for early prediction of intensive care unit admission in patients with acute antipsychotic poisoning

Background

Early identification of antipsychotic poisoned patients who may have a potential risk for intensive care unit (ICU) admission is crucial especially when resources are limited. Nomograms were previously used as a practical tool to predict prognosis and planning the treatment of some diseases including some poisoning conditions. However, they were not previously investigated in antipsychotic poisoning.

Aim

The current study aimed to construct a nomogram to predict the need for ICU admission in acute antipsychotic poisoning. Patients and methods: This 2-year study included 140 patients acutely intoxicated with antipsychotics and admitted at Tanta University Poison Control Centre throughout July 2019 to June 2021. Personal and toxicological data, findings of clinical examination and electrocardiography, as well as, results of laboratory investigations at time of admission were recorded. According to the outcome, patients were divided into ICU-admitted and ICU-not admitted groups.

Results

The results of this study provided a proposed nomogram that included five significant independent predictors for ICU admission in acute antipsychotic intoxications; the presence of seizures (OR: 31132.26[108.97-Inf]), corrected QT interval (OR: 1.04[1.01-1.09]), mean arterial blood pressure (OR: 0.83[0.70-0.92]), oxygen saturation (OR: 0.62[0.40 to 0.83)], and Glasgow Coma Scale (OR: 0.25 [0.06-0.56]).

Conclusion

It could be concluded that the developed nomogram is a promising tool for easy and rapid decision making to predict the need for ICU admission in acute antipsychotic poisoning.

Out of Pocket Expenditure on Hypertension among Patients Attending at Tanta University Hospitals

Aims: Determine the level of out-of-pocket expenditure incurred by hypertensive patients at Tanta University Hospitals. Identify different determinants of out-of-pocket health expenditure among hypertensive patients in Tanta University Hospitals. Study Design:  A cross sectional study. Place and Duration of Study: The study was conducted from July 2020 up to July 2022, at Tanta University Hospitals, Cardiovascular medicine department. Methodology: Collection of data was conducted by a questionnaire-based interview. The study included 195 hypertensive patients attending outpatient clinics. Their ages ranged from 36.0 to 75.0 years old. Males represented 57.4% while females’ percentage was 42.6%. Expenditure was estimated over the last three months, then the monthly average was calculated. Results: All included patients incurred out of pocket expenditure on medications. Their cost had a mean of 550.4±325.0 and ranged from 45 L.E up to 1215.0 L.E. As regards outpatient visits’ cost, more two third of the patients (69.2%) incurred cost for physicians’ visits with a mean of 98.1±80.6 and ranged from 50.0 L.E. Concerning investigations’ cost, (61.0%) of the study patients incurred investigations’ cost that ranged from 65.0 to 150.0 with a mean of 115.0±21.8 L.E. Overall direct OOP expenditure had a mean of 682.4±283.8 with a markedly wide range from 60.0 to 1550 L.E. Regarding the factors affecting the incidence of catastrophic health expenditure, those who were unemployed, or housewives represented had the highest level of CHE (70.3%) with a statistically significant differences in CHE regarding the employment status (p=.001). Patients without regular fixed income had higher CHE (58.9%) than patients with regular monthly salary (16.7%) with a statistically significant difference (p=.001). Conclusion: Hypertensive patients incur substantial direct and indirect costs. High rates of catastrophic costs illustrate the urgency of improving financial risk protection of these patients and strengthening primary care to ensure affordability of hypertension care.

Profile and outcomes of acute poisoning in the toxicology treatment and control center at Tanta University Hospital, Egypt

BACKGROUND

Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality.

AIM

To identify the profile of acute poisoning in the Toxicology Unit at Tanta University Hospital, Egypt (2017-2021).

METHODS

A cross-sectional study using data extracted from medical records from beginning of January 2017 to end of December 2021. Data including demographic data, Glasgow coma scale, type of poisons, manner of poisoning, time of admission and discharge and state at discharge.

RESULTS

This study included 9713 cases. Rodenticides represented the most frequent cause of poisoning among both males (30%) and females (27%). Pharmaceutical drugs, CNS abused pharmaceutical drugs, and chemicals represent the most common categories (24%, 22%, and 21%, respectively) among children (up to 12 years). Rodenticides and pharmaceutical drugs represent the highest categories among other age groups. Evening admissions represented 52% of cases. Glasgow coma scale was 15 among 86.3% of cases. Intentional poisoning was more common than accidental poisoning (58.6% and 34.7%, respectively). One half (52.2%) of the admitted cases were discharged within 24 hours of admission and 44.4% of them were discharged after 48-72 hours. Family request was the main reason of discharge of cases (70.3%), 15.7% were improved, 4% died. Mortality by rodenticide was 12.5%.

CONCLUSION

Rodenticides, pharmaceutical and CNS abused pharmaceutical drugs were the most common categories of poisoning. Intentional poisoning was more common than accidental poisoning. Rodenticides were responsible for most deaths.

Sexual harassment: perception and experience among female college students of Kafrelsheikh University

BACKGROUND

Increasing concerns are rising over women and adolescence in Arabic societies generally, and in Egyptian society specifically.

OBJECTIVES

To identify the profile and reasons of the problem of sexual harassments among female college students.

METHODS

A cross-sectional study including randomly selected 976 female students from different faculties of Kafrelsheikh University using a predesigned questionnaire sheet.

RESULTS

The main perceived concept of sexual harassment was touching body (63.9%) followed by uncomfortable behaviors by the assault (51.8%). Among urban students, 47.1% reported frequent sexual harassment as compared to 26.5% among rural students. The main motives to harassment were absence of sanctions (42.8%) followed by masculine culture. Absence of punishment ranked first (54.1%) as one of reasons for the phenomenon of harassments in the community followed by wrong concepts about women (46%). The main reaction to harassment was feeling bad and wishing to act (32.9%) followed by feeling bad but helpless (26.0%). Only 25.5% reported taking proper action. Experience of harassment was significantly more reported by urban students compared to rural ones (12.6% and 4.1%, respectively (P = 0.001).

CONCLUSION

Sexual harassment is not uncommon from of violence especially in urban areas mainly due to absence of sanctions and majority did not have capacity to take proper actions.

Perceptions and experiences of COVID-19 vaccines’ side effects among healthcare workers at an Egyptian University Hospital: a cross-sectional study

Background

A safe and effective vaccine is the ultimate key to mitigating the COVID-19 pandemic. Vaccine acceptance is influenced by various factors, including perceptions about the vaccine’s safety and side effects. The side effects vary depending on the type of the vaccine, but they are mainly mild, local, temporary, and self-limiting.

Methods

A cross-sectional study was carried out at Tanta University Hospitals, including 1246 healthcare workers who received either the first or the second dose of the COVID-19 vaccine, selected via a systematic random sampling technique using a self-administered structured validated questionnaire for data collection from November 2021 to January 2022. Qualitative data were presented as frequencies and percentages and analyzed using Chi-square and Fisher’s exact tests.

Results

The prevalence of one or more side effects was 91.3%. Among participants, about two-thirds believed in vaccine safety and its necessity (65.4% and 63.6%, respectively). Significantly more participants (46.9%) were concerned about AstraZeneca thrombotic complications than other vaccine types. The top five side effects reported by participants were injection site pain (64.8%), sense of fatigue (57.1%), headache (49.9%), muscle pain (48.7%), and fever (46.5). Most of the side effects were significantly higher among participants vaccinated with AstraZeneca. Side effects impacted work capacity of 23.4%, which was significantly higher among participants who received AstraZeneca (33.6%).

Conclusion

Participants had a good level of belief in vaccination safety and necessity. Healthcare workers who got the AstraZeneca vaccination reported more adverse effects than other vaccines. Injection site pain, fatigue, headache, muscle pains, and fever were the most frequently reported side effects. More research on vaccination safety is needed to understand the long-term adverse effects of vaccinations better, improve the public trust, and accelerate vaccine adoption.

Work environment characteristics as determinants of work to family conflict among working females, Egypt

BACKGROUND

Positive work environment is the corner stone for control and relief of work to family conflict (WFC).

OBJECTIVES

To determine the prevalence work-family spillovers and to study the relations between them and work environment characteristics among full-time female employees at Tanta University Medical Campus.

PARTICIPANTS AND METHODS

A cross-sectional study was carried among female employees working in the five faculties that are present at Tanta University Medical Campus. A total of 442 female workers were recruited. Data were collected using a self-administered questionnaire including personal characteristics, work-related data, and home responsibilities. Job characteristics scales, work to family, and family to work spillovers scales were used to study their correlation.

RESULTS

Participants' mean age was 39.87 ± 10.07 years. Approximately half of participants had moderate degrees of both positive and negative work to family and family to work spillovers. Significant positive correlation was detected between skills discretion and both of positive work to family and family to work spillovers (r = 0.361, r = 0.288, P = 0. 0.001, respectively); similar relations were reported regarding decision authority, coworkers' support, and supervisors' support. The negative work to family and family to work spillovers significantly increased by increasing in work demands (r = 0. 0.315, r = 0.218, P = 0. 0.001, respectively). Significant and negative correlations were found between each of skills discretion and supervisors' support scales and the negative impact of family to work spillover (r = - 0.130; P = 0.006, r = - 0.167; P = 0.001, respectively).

CONCLUSION

The prevalence of both positive and negative work to family and family to work spillovers was relatively high. Significant relations were detected between work-family spillovers and work environment characteristics regarding skills discretion, work demands, decision authority, coworkers, and supervisors' support.

COVID-19 Pandemic: Knowledge, Attitude, and Perception of Medical Students Toward the Novel Coronavirus Disease

BACKGROUND

Medical students are vulnerable to infection by the coronavirus. Their awareness of the disease is crucial for their safety and for the management of the epidemic by spreading supportive information in their communities. The aim of this study was to assess coronavirus disease 2019 (COVID-19)-related knowledge, attitude, and preventive practices among Egyptian medical students.

METHODS

We conducted a cross-sectional study from the beginning of April to June 2020; a total of 439 undergraduate medical students (1st to 6th academic years) were assessed using an online questionnaire. The questionnaire consisted of 33 questions, including 5 items regarding socio-demographic features, 23 items concerning COVID-19 related knowledge, 2 items regarding attitude, and 3 items related to preventive measures.

RESULTS

We observed an acceptable level of knowledge (74.3%) among the sample studied. Preclinical and female students were significantly more optimistic as 69.1% expected successful control of COVID-19, and 48.9% predicted that Egypt will win the fight against COVID-19. The majority of participants reported wearing a facemask in public places as a preventive measure (56.7%).

CONCLUSIONS

Egyptian medical students had an acceptable level of knowledge, positive attitude, and good practices of preventive measures regarding the COVID-19 virus. There is no significant difference in almost all items of knowledge, attitude, and practices in relation to gender or academic grade.

Vaccine hesitancy: Beliefs and barriers associated with COVID-19 vaccination among Egyptian medical students

Background

Vaccine hesitancy poses serious challenges for achieving coverage for population immunity. It is necessary to achieve high COVID‐19 vaccination acceptance rates and medical students’ coverage as future health care providers. The study aimed to explore the level of COVID‐19 vaccine hesitancy and determine the factors and barriers that may affect vaccination decision‐making.

Methods

A cross‐sectional study was carried out among medical students in Tanta and Kafrelsheikh Universities, Egypt. Data collection was done via an online questionnaire during January 2021 from 2133 students.

Results

The majority of the participant students (90.5%) perceived the importance of the COVID‐19 vaccine, 46% had vaccination hesitancy, and an equal percentage (6%) either definitely accepted or refused the vaccine. Most of the students had concerns regarding the vaccine's adverse effects (96.8%) and ineffectiveness (93.2%). The most confirmed barriers of COVID‐19 vaccination were deficient data regarding the vaccine's adverse effects (potential 74.17% and unknown 56.31%) and insufficient information regarding the vaccine itself (72.76%).

Conclusion

The government, health authority decision‐makers, medical experts, and universities in Egypt need to work together and make efforts to reduce hesitancy and raise awareness about vaccinations, consequently improving the acceptance of COVID‐19 vaccines.

Health disorders and safety measures among workers in Tanta Flax and Oil Company, Egypt

Flax industry has an adverse effect on health status of exposed workers especially in developing countries with lack of appropriate safety measures to identify the health hazards, health disorders among workers in flax and oil company, and to assess the applied safety measures in the factory. A cross sectional study was conducted in Tanta Flax and Oil Company in Egypt. The company includes eight factories which are divided into four departments according to the manufacturing end products. The study was conducted from August 2018 to December 2019 on 353 workers out of 400 workers. An interview questionnaire and clinical medical examination were done to assess the health status of exposed workers. Check list from occupational safety and health administration (OSHA) standards was filled by researcher to check safety measures in work place environment. Respiratory manifestations were detected in 65% of the examined workers in flax manufacturing departments while allergic manifestations were more obvious in formaldehyde factory department. Approximately one quarter of workers complained that personal protective equipment's are not available. Regarding the mask for dust, nearly half (44.5%) of the workers rarely used them, and only 7.1% always use them. Byssinosis was obvious among workers in flax manufacturing and particle board manufacturing department with statistically significant differences between the four departments, in which 36.9% and 24.1% of workers in these two departments suffered from chest tightness, respectively. The safety measures were inadequate in flax manufacturing departments and to somewhat sufficient in formaldehyde factory department. Most of exposed workers had inadequate health status due to lack of standard safety measures. Therefore, periodic medical examination should be done regularly with investigation of pulmonary functions of exposed workers with application of high level of safety measure standards in the work place environment.

Job satisfaction among physicians in secondary and tertiary medical care levels

To identify level of job satisfaction among physicians at secondary and tertiary care levels. Random sample of 450 secondary and 523 tertiary care physicians filled in structured questionnaire about job satisfaction. Among secondary care physicians, 37.4% had extra work compared with 16.1% of tertiary care workers. More than 87% of both groups reported exposure to work-related violence. Physicians reported somewhat satisfaction for general work condition, promotion and financial aspects, work activities, and total satisfaction score with significant differences between studied groups. Significantly higher tertiary care physicians reported satisfaction with relationship in work and supervision at work compared with secondary care workers. Job satisfaction was significantly affected by age in years, number of shifts per month, years of experience, gender, being single or ever married, and having extra work. There is moderate level of satisfaction with significant differences in relation to level of care.

Tramadol abuse among workers in an industrial city in mid-Nile Delta region, Egypt

Tramadol abuse is an increasingly alarming phenomenon among Egyptian Community especially among workers and drivers. Study profile and factors affecting tramadol abuse among industrial workers in Mid-Nile Delta Region. A cross sectional study among minibus drivers, construction and textile industries workers. From each target group 300 males were chosen randomly. The total sample size was 900 persons. Interview questionnaire was used for data collection. Diagnosis of tramadol abuse was according DSM-5 Criteria. Intake of tramadol was high among construction workers (92.3%) followed by bus drivers (53.0%) and lastly textile workers (25.3%). The main source of tramadol was friends (45.4%) followed by drug dealers (16.6%). The main reason of abuse was to improve mood (54.3%) followed by relief of pain and help to continue work (37.3%). Tramadol is prevalent among industrial workers due to different reasons related to the work load and stressful events. Ever intake of tramadol was high among construction workers followed by bus drivers and lastly textile workers. Drug testing for workers in workplace is a must to ensure community safety.

HIV/AIDS-related stigma and discrimination among health care workers at Tanta University Hospitals, Egypt

HIV/AIDS-related stigma and discrimination among health care professionals is one of the most important factors of this disease expansion. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLHIV) at Tanta University Hospitals. The study is a cross-sectional survey. Data was gathered from randomly selected 310 health care workers at Tanta University Hospital using a structured questionnaire. Among studied participants, only 24.0 % had previous contact with HIV patients during work and 21.3 % felt worried to touch cloths of HIV patients, 26.4 % were worried to dress the wounds of HIV patients and 27.4 % were afraid to get blood sample from HIV patients. Those who were unwilling to care for HIV patients represented 40 % and only 36 % reported that if discriminating against HIV patients, they may get in trouble. Less than one half (42 %) reported having enough supply for reducing risk of nosocomial infection with HIV and 86 % reported having no guidelines to deal with HIV patients. Out of the participants, 78.7 % reported that HIV patients should be ashamed of themselves. Among the participants, 35, 48, and 43 % preferred not to provide medical services to injecting drug users, men having sex with men and sex workers suspected to have HIV infection, respectively. Infection control is defective in the supplies and procedures. There is absence of policy and protocols with regard to dealing with PLHIV. Health care providers showed high levels of stigma and discrimination against PLHIV.

Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt

Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. To assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals, this cross-sectional study included 401 HCWs (physicians, nurses, technicians, and workers) from seven departments (general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator, and laundry). Data were collected through interview questionnaire to assess six types of physical hazards (noise, electric hazards, temperature, radiation, fire, and lighting,). Most of the physicians (63.7%) were aware of the level of noise. All physicians, nurses, technicians, and majority of workers reported that hearing protective devices were not available, and all HCWs reported that periodic hearing examination was not performed. Most of the nurses (75.2%) and workers (68.5%) did not attended emergency training, and more than two thirds of all HCWs were not briefed about emergency evacuation. Most HCWs were not given appropriate radiation safety training before starting work (88% of workers, 73.7% of nurses, 65.7% of physicians, and 68.3% of technicians). The majority of physicians, nurses, and technicians (70.5, 65.4, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Health education programs on health and safety issues regarding physical hazards should be mandatory to all healthcare workers to improve their awareness and protect them from undue exposures they may face due to lack of adequate awareness and knowledge. There is urgent need of expanding the occupational healthcare services in Egypt to cover all the employees as indicated by the international recommendations and the Egyptian Constitution, legislation, and community necessity.

Assessing of policies and practices for occupational exposure to blood-borne viral infections in Tanta University Hospitals, Egypt

One of the best ways to investigate and improve the effectiveness of polices for prevention and control of infections is through systematic and rigorous evaluation of the structural, functional, and practical elements of these polices. To assess the policies for managing occupational exposure to blood-borne viral infections in Tanta University Hospitals. A cross-sectional survey was carried out. A checklist was used to collect data related to the hospital policy regarding occupational exposure to blood-borne viral infections which was filled by direct personal interviews with the members of infection control (IC) committee of Tanta University Hospitals where the percentage of those in compliance with specific occupational management policies were reported. All studied participants reported lack of access to written infection control manual and only 14.3 % reported that infection control policies and procedures are updated yearly. Only 32.5 % of studied healthcare workers (HCWs) were not aware by the availability of a needle injury clinic. Only 28.6 % of the members of IC committee reported that pre-placement screening of HCWs for baseline blood tests for HBV, HCV, or HIV was conducted; however, periodic screening for these infections was not conducted as reported by all of the members. Among the members of IC committee, 57.1 % recorded availability of post-exposure evaluation. Only 42.8 % of the members of IC committee reported ensuring HCWs' confidentiality when reporting their exposure incidents. Both exposure management policies and practices were not aligning with the national guidelines.

Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area

BACKGROUND/OBJECTIVES

Scabies is a major global public health issue that might affect people from all socioeconomic levels. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions. Scabies often spreads among schoolchildren quite rapidly, owing to their close contact and overcrowding within the schools. However, limited information is available about its risk factors and the socioeconomic correlates among schoolchildren in Egypt. This study aimed to assess the prevalence of scabies and its risk factors among primary schoolchildren in Kafr El-Sheikh administrative area, Egypt.

METHODS

This cross-sectional descriptive study was performed on primary schoolchildren in urban and rural areas of Kafr El-Sheikh administrative area. A predesigned questionnaire was used for data collection from the randomly selected 2,104 children, and clinical dermatological examination was done for them.

RESULTS

Out of 2,104 children studied, there were 92 cases of scabies with a prevalence of 4.4%. The prevalence of scabies infestation in male students was 3.9%, while it was 4.8% in females, with no statistical significance. The results showed significant variations in the risk of scabies infestation by factors such as residence, paternal education and occupation, maternal education, sleeping with others, having animals at home, dealing with animals outside the house, type of building for living, family history of itchy rash, and sharing clothes with others.

CONCLUSION

In our community, scabies is still an important health problem affecting schoolchildren, especially in rural areas. It is characterized by a complex web of causation, particularly poor living conditions and low level of parents' education.

Looking beyond legality: understanding the context of female sex workers in greater Cairo, Egypt

Data on demographic, social and behavioural characteristics of female sex workers in greater Cairo are very scarce. A cross-sectional study was conducted with 431 randomly selected sex workers after mapping of sites where they gather. Data collection was performed by direct interviewing using a questionnaire sheet covering sociodemographic data and sexual history with paying and non-paying partners. More than one half of participants (52.7%) were aged < 30 years. Only 39.3% were exclusively working as sex workers while the rest had other jobs beside sex work. Almost 70% were responsible for deperidants. The age of first selling sex was < 15 years for 4.7% of the women and 15-25 years for 58.7%. Unwanted pregnancies were experienced by 36.2% and 34.8% had had an abortion. Many participants had ever been arrested by the police (71.2%). The study has provided some useful background data for further studies in this very sensitive area of research.

HIV infection and related risk behaviours among female sex workers in greater Cairo, Egypt

Although illegal in Egypt, prostitution exists. The prevalence of HIV infection among female sex workers (FSWs) in Cairo is not precisely known. This cross-sectional study investigated the high-risk behaviour for HIV infection and HIV prevalence among FSWs in greater Cairo. A total of 431 FSWs were interviewed about their sexual history with paid and unpaid partners, condom use and risky behaviour for HIV infection; all were tested for HIV. Use of alcohol and drugs was reported by 39.9% and 49.0% of the women respectively; 37.6% only used such substances while with a client. Male condoms were known by 72.6% but their use in the previous month was low (32.8%) and only 22.4% had used one with their last client. The main reasons for not using condoms were not thinking of it (40.6%) and client refusal (20.5%). All the women tested negative for HIV infection. The high-risk behaviour of many FSWs necessitates intervention programmes to reduce their risk of HIV infection.

Evaluation of HIV voluntary counselling and testing services in Egypt. Part 2: service providers' satisfaction

Voluntary counselling and testing (VCT) services are major components of HIV prevention and treatment efforts. A study in Egypt aimed to determine the satisfaction of service providers at VCTs to identify strengths and weaknesses in the service. Direct interviews with all 50 VCT team members and focus group discussions with 16 counsellors showed that the majority believed that they had received enough training (90%), but still 66% wanted further training. Only 50% reported receiving sufficient incentives. Problems that were highlighted included absence of a fixed job description, lack ofadministrative support, unclear working rules and regulations and lack of proper community awareness. Counsellors expressed the need for improving working environment to ensure privacy and confidentiality.

Evaluation of HIV voluntary counselling and testing services in Egypt. Part 1: client satisfaction

HIV voluntary counselling and testing (VCT) services were launched in Egypt in 2005. A study of all functioning VCT centres in Egypt (7 mobile and 9 fixed) aimed to determine the profile of clients and their level of satisfaction to identify strengths and weaknesses in the service. In direct interviews with a sample of 928 clients, the main motive for seeking VCT was risky sexual behaviour (34.2%). More females than males sought services because of partners' risky sexual behaviour. More than 90% of the clients were satisfied with the counselling service. Only 41.4% were willing to discuss the test results with their partners. Male sex, higher education level and attendance at fixed VCT centres were associated with higher satisfaction.

Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt

A study in Egypt determined the prevalence of hepatitis B and C virus infections among barbers (n = 308) and their clients (n = 308) in Gharbia governorate, and assessed knowledge, attitude and practices during hair-cutting and shaving. HBsAg was detected among 4.2% of barbers and 3.9% of clients (more urban than rural). Anti-HC antibodies were detected in 12.3% of barbers and 12.7% of clients. HCV-RNA prevalence was 9.1% among both barbers and clients (more rural than urban). Knowledge was high among the majority of participants and good practices during shaving and hair-cutting were observed for the majority of barbers. Barbers appeared to have no job-related risk of acquiring viral hepatitis.

Needs assessment and coping strategies of persons infected with HIV in Egypt

The aims of this study were to identify the psychosocial and health care needs of persons living with HIV/AIDS and to determine their coping strategies. The study was conducted in 3 governorates of Egypt on 153 people infected with HIV. The data were collected using a structured questionnaire and in-depth interviews. The majority of the people had been forced to change the pattern of their sexual behaviour. Fear of stigmatization and feelings of anxiety, hopelessness and depression were frequently reported, resulting in a negative psychosocial impact on the infected person. Decreasing stigma and providing psycho-social support would help people living with HIV/AIDS to utilize effective ways of coping with the negative sequelae of the infection.

Knowledge, attitude and practices of Egyptian industrial and tourist workers towards HIV/AIDS

This study explored knowledge, attitudes and practices towards HIV/AIDS infection among 1256 Egyptian industrial and tourism workers aged 16-40 years. Compared with industrial workers, tourism workers had a significantly better perception of the magnitude of the HIV/AIDS problem worldwide as well as in Egypt and of the likelihood of the problem worsening. Knowledge of tourism workers was also significantly better about causative agent of AIDS and methods of transmission. Both groups had negative attitudes towards patients living with HIV/AIDS concerning their right to confidentiality and to work. Both groups had a positive attitude towards behaviour change for protection from HIV/AIDS, principally via avoidance of extramarital sexual relations and adherence to religious beliefs. Use of condoms as a way to avoid HIV/AIDS was reported by only 0.4% of workers.

Risk behaviours for HIV/AIDS infection among men who have sex with men in Cairo, Egypt

A sample of 73 men who have sex with men (MSM) in Cairo, Egypt, were screened for HIV infection and were interviewed to study their risk behaviours for HIV/AIDS. Most (65.8%) had initiated sexual activity before 15 years; 65.8% took both active and passive roles in sexual acts. The frequency of sexual acts was < 1 per week for 73.3% of those aged 25+ years, but > 1 daily for 25.9% of those aged < 25 years. Heterosexual relations were reported by 73.3% of the older age group, while 70.7% of the younger age group were exclusively MSM. Condoms were always used by only 19.2% of the sample.

Risk perception and precautions taken by health care workers for HIV infection in haemodialysis units in Egypt

A cross-sectional study was made in 32 haemodialysis units in the the Nile delta, Egypt to evaluate knowledge and practices towards risk of HIV infection by 317 health care workers. Exposure to needle-stick injury was reported by 48.6% in the previous year. Significantly more workers in government units than in private units had good knowledge of bloodborne infections, universal blood precautions and safe disposal of contaminated items, and recognized asymptomatic HIV patients as a risk. Previous training, but not years of experience, influenced knowledge. Despite good knowledge, the performance of health workers was poor for universal blood precautions, and was worse in private haemodialysis units.