Tobacco use and associated factors among school students in Dubai, 2010: intervention study

Tobacco smoking is an emerging problem among adolescents in the United Arab Emirates (UAE). This study aimed to measure the prevalence of current tobacco use and its associated factors among school students in Dubai Emirate and to determine the impact of an intervention programme on knowledge and attitudes towards tobacco use. A school-based intervention programme was carried out among 2457 students aged 10-20 years and data were collected with a self-administered questionnaire. Of the students, 14.6% were tobacco users, mostly cigarettes (11.2%) and waterpipes (2.2%). The most common self-reported reasons for smoking were for the experience (29.4%), for stress relief (22.5%) and because their peers smoked (21.9%). Stepwise logistic regression analysis showed that the predictors of tobacco use were: male, higher age, UAE national, higher school level, government school, low knowledge about tobacco and family history of smoking. There were significant improvements in knowledge and attitudes scores after the health education intervention programme.

Ovarian cancer in Alexandria from 1988 to 1997: trends and survival

The trend of incidence of ovarian cancer was studied, the 5-year survival rate calculated and prognostic factors for survival determined. Data were collected from the Alexandria Cancer Registry and medical records in various hospitals. A total of 358 cases of ovarian cancer were diagnosed from 1988 to 1997. A significant increasing trend in incidence of ovarian cancer from 1.23/100 000 in 1988 to 3.16/100 000 in 1997 was found. The overall 5-year survival rate was 46%. The 5-year survival rates for tumour stages I to IV were 85%, 71%, 41% and 22% respectively, which was statistically significant. Survival rates with poorly differentiated tumours were significantly worse than with moderate or well differentiated tumours

Ovarian cancer in Alexandria from 1988 to 1997: trends and survival

The trend of incidence of ovarian cancer was studied, the 5-year survival rate calculated and prognostic factors for survival determined. Data were collected from the Alexandria Cancer Registry and medical records in various hospitals. A total of 358 cases of ovarian cancer were diagnosed from 1988 to 1997. A significant increasing trend in incidence of ovarian cancer from 1.23/100,000 in 1988 to 3.16/100,000 in 1997 was found. The overall 5-year survival rate was 46%. The 5-year survival rates for tumour stages I to IV were 85%, 71%, 41% and 22% respectively, which was statistically significant. Survival rates with poorly differentiated tumours were significantly worse than with moderate or well differentiated tumours.

Probability of contraceptive continuation and its determinants

Probability of contraceptive continuation and factors associated with discontinuation were assessed in a retrospective study of women’s records in Alexandria. Contraceptive continuation rates were 88/100, 75/100 and 56/100 women at 6, 12 and 24 months respectively. Reasons for discontinuation included side-effects and health concerns [30.4%], accidental pregnancy and personal reasons [6.4%]and desire for pregnancy [5.4%]. Women who were older and who had several children were most likely to continue contraceptive use. Three significant predictors of discontinuation were side-effects and health concerns, age of the woman and contraceptive method. Women should be fully informed of the contraceptive methods available and their side-effects, and counselling programmes should be offered, particularly during the first 2 years of use

Probability of contraceptive continuation and its determinants

Probability of contraceptive continuation and factors associated with discontinuation were assessed in a retrospective study of women's records in Alexandria. Contraceptive continuation rates were 88/100, 75/100 and 56/100 women at 6, 12 and 24 months respectively. Reasons for discontinuation included side-effects and health concerns (30.4%), accidental pregnancy and personal reasons (6.4%) and desire for pregnancy (5.4%). Women who were older and who had several children were most likely to continue contraceptive use. Three significant predictors of discontinuation were side-effects and health concerns, age of the woman and contraceptive method. Women should be fully informed of the contraceptive methods available and their side-effects, and counselling programmes should be offered, particularly during the first 2 years of use.

Categorical analysis of factors affecting needs and demands for removable dentures among Alexandria Dental Research Center clientele

An accurate assessment of dental needs is important to public health planners. With this information, it is possible to assess future treatment needs and demands for services including those for removable dentures. The present work aimed to estimate the magnitude and types of needs, and demands for partial or complete removable dentures, to study some factors that may affect the identified needs and demands for removable dentures, in addition to studying the factors that may affect satisfaction with the dentures. The present study was conducted in "Alexandria Dental Research Center". Data were collected by means of interview questionnaire, followed by dental examination of all patients attending the center for the sake of removable dental restorations for a period of 6 months. A further follow up over a period of three months was undertaken to the 330 cases recorded. About one third of the cases demanded partial and/or complete dentures and were above 60 years old. The first purpose for construction of new dentures was mastication, followed by cosmetics. Only one quarter of cases decided to have delayed immediate dentures. Diabetics and those having chronic diseases showed more demand for complete dentures. The most discriminating variable between the demand for different dentures was the missing in the lower anterior teeth followed by missing in the upper both anterior and posterior and then missing in the upper anterior teeth. Satisfaction score increased with advance of age, among males, among those for complete dentures, and those who had had previous dentures. Stepwise logistic regression revealed that the best predictor for overall satisfaction was the history of having previous dentures. Results of the present study, suggest that early screening and treatment of diabetic patients, gathering detailed information by means of a questionnaire before new dentures fabrication may be an important tool for the dentist in predicting and consequently enhancing patient satisfaction with the dentures. Health education should stress on the value of restoring missing teeth and all available options around this.

Measurement of KAP concerning hepatitis B among secondary school students in Alexandria

Hepatitis B infection is a serious health problem throughout the world. Success in the prevention of this disease with its fatal consequences depends to a large extent on the adolescents' level of knowledge and their awareness about it. As well as their attitude and different risk behavior they might practice at this age. The aim of the present study was to assess the secondary school students' level of knowledge about hepatitis B and to record their perceptions, attitudes and practices towards it. Also to identify their health locus of control towards the disease. The studied sample included 643 students of both sexes representing different senior levels in one educational sector in Alexandria. The used technique was self-administered questionnaire. Results revealed that (55.2%) of the studied sample had fair level of knowledge about hepatitis B Girls had more negative attitude towards the disease than boys. About one half of the students (50.4%) were not vaccinated against the disease. Also, the majority of students had internal health locus of control regarding hepatitis B. It is recommended to integrate knowledge about hepatitis B within formal and informal school programs. Community campaigns for vaccinating the adolescents against the disease should be carried out.

Assessment of health and nutritional status of infants in relation to breast feeding practices in Karmouz area, Alexandria

Infants are most precious part of nation's life. Infant health is a reflection of the health of the mother and it gives an indication of the health of the adult population of the future. The present work was designed to study the health and nutritional status of infants in Karmouz area in Alexandria as well as the effect of breast feeding practices on the health status of infants. Accordingly, a house to house survey was conducted through cluster sampling technique. The total sample amounted to 396 mothers and 409 infants. Data were collected about infants health status and their feeding practices. Weight and length were measured for all infants. Stool samples were collected and examined. The results revealed that 55.3% of infants had acute respiratory tract infections (ARI); 16.4% had bronchitis and 4.9% had pneumonia, 44% of the infants suffered from diarrhea, 13.2% were infected with parasites, Gardia lamblia was the most commonly found parasite (9.0%). High proportion of infants was found to be stunted (22.7%), 8.6% were wasted and 7.6% were underweight, 40.3% of mothers were in partial practice level. Infants below six months of age who received solid foods at three months or less had a significantly higher percentage of diarrhea (70.6%) compared to 51.5% among those of late weaning (four months or later). The diarrhea was significantly more common among infants aged 12 - < 18 months with about two times of risk relative to those aged < 6 months. A significantly higher risk of diarrhea was found for infants of bottle--or complementary feeding (OR = 2.05, 2.07 respectively, model X2 = 9.71, P < 0.01), in addition the protective effect of breast feeding persisted after adjustment of confounders by multiple logistic regression. High proportion of mothers (63.8%) continued to breast-feed their babies during diarrheal episodes. On the other hand breast-feeding was not significantly protective against the acute respiratory tract infection. Stunting of the infants increases rapidly with age from 12.6% among infants under six months to 30.4% among those aged from 9 - < 12 months. The percentage of stunted infants varied greatly by education of the mothers, it was doubled from 14.7% among those of mothers of high level of education to 28.9% of non educated mothers with a significant high risk of 2.31 times. The repeated attacks of diarrhea throughout the two years of life was still significantly associated with stunting even after adjustment of confounders by multiple logistic regression;, those with three attacks or more had about three times of risk relative to those without the disease (OR = 2.56, 95% CL = 1.12-5.81, model X2 = 19.03, P < 0.01). Health education program should be emphasized to all mothers to improve their knowledge and practice about breast-feeding and its importance in prevention of diarrhea.

Self-efficacy for dietary behaviour concerning heart disease among Alexandria school pupils

A study of 1134 preparatory-school pupils was conducted to measure children’s self-efficacy for selecting healthy food for the heart, to examine the relationship between self-efficacy and self-reported usual food consumption and to estimate test-retest reliability. Results revealed an acceptable estimate of internal consistency of dietary self-efficacy [Cronbach alpha = 0.76]. Over half the students exhibited a moderate level of self-efficacy and 42% a high level. Test-retest reliability of the scale was good [r = 0.65, Cronbach alpha = 0.79]. Usual food choice was the first best predictor of dietary self-efficacy [r = 0.44], followed by sex [boys had higher self-efficacy than girls] and then knowledge [r = 0.37]. The three factors contributed to explain 25% of the variance

Hepatitis B and C virus infections among patients with gingivitis and adult periodontitis: seroprevalence and public health importance

The aim of the present case control study was to identify seroprevalence of hepatitis B and C virus (HBV and HCV) infections among one hundred cases with periodontal disease (71% gingivitis and 29% adult periodontitis) and one hundred controls with healthy gingiva matdhed for age and sex. Moreover, it aimed to detect hepatitis markers in saliva samples corresponding to the positive sera. Different risk factors associated with hepatitis infection and detectability rate of hepatitis markers were also studied.

METHODOLOGY

enzyme linked immunosorbent assay (ELISA) technique was used to detect the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti HBc), e antigen (eAg) and antibody to hepatitis C virus (anti HCV) both in serum and saliva samples. HCV RNA was detected by polymerase chain reaction (PCR) technique. Oral examination was performed for assessment of simplified Oral Hygiene Index (OHI-S), Papillary Bleeding Index (PBI), probing pocket depth and loss of fibre attachment.

RESULTS

cases with periodontal disease showed higher percentages of hepatitis exposure (hepex; anti HCV and/or anti HBc) and significantly higher anti HCV seropositivity than the controls (26% and 13% versus 22% and 8%, respectively). No difference in HBsAg carrier rate nor in anti HBc seropositivity was elicited. Furthermore, cases with periodontal disease showed higher detectability rate of HBsAg, anti HBc, anti HCV or both anti HCV and/or anti HBc in whole unstimulated saliva than the controls (100% vs 66.7%, 50% vs 23.5%, 23.1% vs 0.0% and 42.3% vs 18.2%, respectively). Stepwise logistic regression delineated two significant factors associated with the risk of hepatitis exposure, the first predictor was the rural residence and the second one was the history of blood transfusion (OR=3.10, 2.94, respectively). Periodontal disease, severity of bleeding and bad oral hygiene were associated with the risk of hepatitis infection and with the detectability of hepatitis markers in the whole saliva.

Assessment of students' knowledge, attitude and practice concerning cancer and its prevention. Part I

Cancer is a serious public health issue, but it is increasingly regarded as preventable. The present study was conducted to assess students' knowledge, attitude and practice about cancer. A questionnaire was developed by the researchers and completed by 896 secondary school students from the middle zone of Alexandria Governorate. Females had a significantly higher awareness than males as regards the relationship between not eating vegetables and fruits, environmental effects, exposure to irradiation or to the sun for long periods and the hazards of getting cancer. Third grade students were significantly more knowledgeable than the other two grades (H=11.43, p<0.01). Only 4.5% of the participants had satisfactory levels of knowledge. Students in general expressed strong fear of cancer. Females were more worried than males either about themselves getting cancer or about others having it. More than 50% of the females liked to be friendly with children having cancer as compared to 37% of males. Only 12.3% of the students had a positive attitude towards cancer prevention. Males tended to consume healthier foods than females. Furthermore, 57% of the students demonstrated good practice. School education on cancer is extremely needed for these adolescents in order to correct misconceptions, provide accurate information and to develop a positive attitude towards cancer.

Improving students' knowledge, attitude and practice towards cancer prevention through a health education program. Part II

A health education program for cancer risk reduction was conducted among 649 students out of 896 for whom Knowledge, Attitude and Practice (KAP) had been obtained at the initial study. Three hundred and sixteen students acted as the intervented group and three hundred and thirty three were the control group. There was a great improvement in the percentage of correct knowledge answers in the majority of the questions from pre to post tests especially for the questions about the effect of excessive use of fatty foods (76.3%) and excessive use of salty foods (68.0%) on the occurrence of cancer. After the program, at least 87% or more of the students recognized the hazards of risky food, 86.1% knew that mothers who do not breast feed their infants have a greater chance of getting cancer breast, 51.3% responded correctly to the question about the effect of oral contraceptive pills after 40 years. More than 86% recognized the serious effect of prolonged exposure to the sun. A significant shift toward positive attitude was found especially with the item "I am very afraid to know that I have cancer, so I avoid going to the physician" (76.9%). It was found that 94% of the students agreed that there is a relation between the type of food and cancer. The students showed significant increases in median practice scores from pre to post tests and the larger gain associated with participants in the program (9.97%). The majority of the students reported increases in their daily consumption of fruits, cereals, leafy vegetables and salad. These significant changes in KAP scores from pre to post tests were noticed for both sexes, different social classes and different educational grades.

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.