Evaluation of the public health empowerment program in the Eastern Mediterranean region

Background

The Public Health Empowerment Program (PHEP) is a 3-month training program for frontline public health staff to improve surveillance quality and strengthen the early warning system capacities. Studies evaluating the program and its impact on the health systems in the Eastern Mediterranean Region (EMR) are lacking. Therefore, this study aimed to assess the level of PHEP graduates' engagement in field epidemiology activities, assess their perceived skills and capacity to perform these activities and assess the extent to which PHEP helped the graduates to perform field epidemiology activities.

Methods

A descriptive evaluation study was conducted based on levels 3 and 4 of Kirkpatrick's model for evaluating training programs to assess the change in graduates' behavior and the direct results of the program. Data were collected using two online surveys targeting PHEP graduates and programs' directors/ technical advisers.

Results

A total of 162 PHEP graduates and 8 directors/ technical advisers participated in the study. The majority of PHEP graduates reported that they are often involved in activities such as responding to disease outbreaks effectively (87.7%) and monitoring surveillance data collection (75.3%). High proportions of PHEP graduates rated their skills as good in performing most of field epidemiology activities. The majority of graduates reported that the PHEP helped them much in conducting, reviewing, and monitoring surveillance data collection (92%), responding effectively to public health events and disease outbreaks (91.4%), and communicating information effectively with agency staff and with the local community (85.2%).

Conclusion

PHEP appears to be an effective program for improving the public health workforce's skills and practices in epidemiological competencies in the EMR. PHEP strengthened the engagement of the graduates in most field epidemiology activities, especially during COVID-19.

Seroprevalence of hepatitis A among children of different socioeconomic status in Cairo

To determine seroprevalence of anti-hepatitis A virus (HAV) antibodies and potential risk factors for and age of contracting symptomatic hepatitis A infection among children of different socioeconomic status (SES) in Cairo, we carried out a cross-sectional study on 426 children aged 3-18 years from low SES areas and 142 from high SES areas. Seroprevalence was significantly higher with age. Seropositivity to anti-HAV antibodies was significantly higher among children of low and very low SES, 90%, compared to children of high SES, 50%. Water supply and sewage disposal were the most significant risk factors for HAV seropositivity in children of low SES. Children of high SES were more likely to be vulnerable to infection in adolescence than those of low SES.

Long-term immunity to hepatitis B among a sample of fully vaccinated children in Cairo, Egypt

We assessed the long-term immunity to hepatitis B among 242 Egyptian children aged 6-12 years who had received a full vaccination course in infancy, and investigated the factors associated with immunity. Only 39.4% of the children had protective (> or = 10 lU/L) hepatitis B surface antibody levels (HBsAb). This proportion decreased with age but the decrease was not statistically significant. The mean level of HBsAb decreased significantly with increasing age (P = 0.026). A significant negative correlation was found between current age and HBsAb levels (r = -0.31, P = 0.041). Age and weight-for-age were found to be significant predictors of non-protective HBsAb levels.

Effect of human dietary exposure levels of genistein during gestation and lactation on long-term reproductive development and sperm quality in mice

The objective of the present study was to determine the long-term reproductive effects of gestational and lactational exposure (0, 0.1, 0.5, 2.5 and 10 mg/kg/day) to genistein on male mice at levels comparable to or greater than human dietary exposures. Testicular growth, sperm count and motility, and sperm fertilizing ability in vitro was assessed in male offspring on postnatal days (PND) 105 and 315. Selected genes were also examined by real-time PCR to determine whether genistein caused changes in gene expression similar to those previously observed with diethylstilbestrol (DES). No significant treatment-related effects on male offspring body weight, anogenital distance, seminal vesicle weight or testis weight were observed. There were also no significant effects on sperm count, the percent of motile sperm or the number of motile sperm at any age. The in vitro fertilizing ability of epididymal sperm was increased significantly in the high-dose group approximately 17% (P < 0.001) on PND 105 and 315. The results indicate that developmental exposure of mice to genistein at human exposure levels does not induce adverse effects on sperm quality or changes in testicular gene expression similar to DES.