Search PubMed⌕ Search

Biomedical subjects

M H Hussein

Publications and source records attributed to M H Hussein.

At least 19 recordsLinked to original sources
PubMed2000

Epidemiology 1, 2, 3: origins, objectives, organization, and implementation.

This supplement is a report on the Epidemiology 1, 2, 3 (EPI 1, 2, 3) investigation, its origins, evolution, and findings that were carried out over a period beginning in 1990 and ending in 1994 in Egypt. The large scope and size of the study, the largest to date on schistosomiasis in Egypt, was a rationale for publishing a supplement to document EPI 1, 2, 3 methods and results collectively in sufficient detail to serve as a reference for planning, designing, and analyzing future epidemiologic studies and evaluation of schistosomiasis control in Egypt. The 3 objectives of EPI 1, 2, 3 were to 1) determine the changing patterns of Schistosoma haematobium and S. mansoni, 2) investigate factors contributing to differences between villages in the Nile Delta, Middle Egypt, and Upper Egypt, and 3) investigate risk factors for morbidity. The objectives were addressed using standardized techniques, stool and urine examinations, clinical examinations (including abdominal ultrasound), and questionnaires on a selected sample of the populations of selected villages in 9 governorates in Egypt.

Egypt↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: patterns of Schistosoma mansoni infection and morbidity in Kafer El-Sheikh.

This is a descriptive report of the Epidemiology 1, 2, 3 project in Egypt that made use of large probability sampling methods. These results focus on Schistosoma mansoni infection in the northern Nile Delta governorate of Kafr El Sheikh. A probability sample of 18,777 persons, representing the rural population of the entire governorate, was drawn. The sample was designed not to exclude villages based on location or presence of health care facilities and to include representation of the smaller ezbas or hamlets. The objective was to obtain detailed estimates on age- and sex-specific patterns of S. mansoni infection, and to provide a baseline for prospective studies. Stool specimens were examined by the Kato method. The estimated mean +/- SE prevalence of S. mansoni infection in the rural population was 39.3 +/- 3.3% in 44 villages and ezbas after weighing for the effects of the sample design. The estimated mean +/- SE geometric mean egg count per gram of stool (GMEC) was 72.9 +/- 7.3. Prevalence and GMEC varied considerably by village and ezba, with ezbas having a significantly higher prevalence. Villages and ezba-specific prevalence was strongly associated with GMEC (r2 = 0.61, P < 0.001). The prevalence of S. mansoni infection increased by age to 55.4 +/- 3.2% at age 16 without a significant change in the adult ages. There were no gender differences until age 6, after which males were consistently higher until middle age, when the differences converged. The age- and sex-specific pattern of GMEC varied widely; however, when the GMEC data were collapsed into 5-year age groups, the GMEC peaked at 81.5 +/- 12.1 eggs/g in the 10-14-year-old age group. These estimates provide the basis for evaluating control measures for reducing prevalence, intensity of infection, and transmission.

Adolescent↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: Assiut governorate.

In the Assiut, Egypt Epidemiology 1, 2, 3 investigation, a sample of 14,204 persons in 10 villages, 31 ezbas (satellite communities), and 2,286 households was drawn from a rural population of 1,598,607. Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 5.2 +/- 0.5 (+/- SE). This varied considerably by village and ezba, ranging from 1.5% to 20.9%, with ezbas having a slightly higher overall prevalence than villages. The overall estimated geometric mean egg count was 6.6 +/- 0.5 eggs per 10 ml of urine and was consistently low throughout the communities. Infection with S. haematobium was associated with age (peak prevalence of 10.6 +/- 1.5% in 15-19-year-old age group) males, children playing in the canals, a history of blood in the urine, and reagent strip positivity for hematuria and proteinuria. The prevalence of either hepatomegaly or splenomegaly detected by physical examination was low (4.0% and 1.5%, respectively). The prevalence of hepatomegaly determined by ultrasonography was substantially higher, 24.1%. The prevalence of periportal fibrosis (PPF) was 12.0%, but grade II or III PPF was present in less than 1%. Ultrasonography-determined hepatomegaly, in both the midclavicular line and the midsternal line, increased by age to more than 30%. Periportal fibrosis was more common in the age groups in which infection rates were the highest. At the village and ezba level of analysis, the prevalence of hepatomegaly, splenomegaly, and PPF tended to be higher in communities having the highest prevalence of infection with S. haematobium.

Adolescent↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: Gharbia Governorate.

Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 14,344 individuals from 1,952 households in 34 rural communities in Gharbia Governorate of Egypt to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp. A subset, every fifth household, of 1,973 subjects had physical and ultrasound examinations to investigate prevalence of and risk factors for morbidity. Community prevalence of Schistosoma mansoni ranged from 17.9% to 79.5% and averaged 37.7%. The geometric mean egg count (GMEC) was 78.9 eggs/gram of feces. The prevalence and intensity of infection was 40-50% and 70-100 eggs/gram of feces in those > or =10 years of age. Schistosoma haematobium was detected in 5 of the 34 communities. The maximum infection rate was 2.8% and mean GMEC in the five communities was 2.1/10 ml of urine. The overall prevalence of S. haematobium in the governorate was 0.3%. Risk factors for infection with S. mansoni were male gender, an age >10 years, living in smaller communities, exposures to canal water, prior therapy for schistosomiasis, or blood in the stool (in children only). Morbidity detected by physical examination or ultrasonography did not correlate with S. mansoni infection in individuals with the exception of periportal fibrosis (PPF, odds ratio [OR] = 1.25). Periportal fibrosis was detected in more than half of the subjects by ultrasonography; 5.3% had grade II lesions and 1.0% had the most severe grade III changes. Risk factors for morbidity as manifested by ultrasonographically detected PPF were similar to those for infection. Periportal fibrosis had a negative relationship with abdominal pain (OR = 0.45) and hepatomegaly detected by physical examination and ultrasonography (ORs = 0.72 and 0.68), but it was associated with splenomegaly (ORs = 4.14 and 3.55). The prevalence of PPF, hepatomegaly, and splenomegaly increased with age. There was no relationship between community burden of schistosomiasis mansoni and any measurements of morbidity with the exception of splenomegaly detected by physical examination (r = 0.40). Schistosoma mansoni has almost completely replaced S. haematobium in Gharbia, which has a high prevalence and moderate intensity of S. mansoni infection. Periportal fibrosis was detected by ultrasonography in more than half of the subjects, and 1 in 16 had grade II and III lesions. The only relationship between PPF and other morbidity findings was its positive relationship with splenomegaly and negative association with hepatomegaly. Hepatic morbidity is common in communities in Gharbia but the role of schistosomiasis mansoni in this is uncertain.

Adolescent↗
PubMed2000

Epidemiology 1, 2, 3: study and sample design.

Bad sample designs and selection bias have plagued studies on schistosomiasis, and as a result some believe that schistosomiasis is too focal, making it difficult to draw reliable samples. The Epidemiology 1, 2, 3 (EPI 1, 2, 3) sample design, although complex, demonstrates that sampling theory is readily applicable to epidemiologic studies of schistosomiasis. The EPI 1, 2, 3 sampling scheme was designed to achieve the smallest feasible standard errors given EPI 1, 2, 3 objectives and certain logistical constraints. The sample design is a multi-stage selection of villages (ezbas, which were stratified by size) and households within each of 9 purposely selected Egyptian governorates. Villages and households were systemically selected from census frames. The sampling of ezbas was especially difficult because of the lack of complete sampling frames and their wide variation in population size. Ultimately, ezbas were stratified by size and then randomly selected from each stratum. Sample sizes for villages and ezbas and individuals within ezbas were calculated based on EPI 1 and 2 objectives, respectively. No re-selection was made for non-respondents. A 20% subsample of the full sample was drawn for clinical and ultrasonographic examinations. The sample selected from individual governorates closely parallel the age structure of the 1986 census of the respective rural populations. Details of the study design and related methods are given below.

Egypt↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: Qena governorate.

Qena is the southernmost governorate of Egypt included in the Epidemiology 1, 2, 3 national study. A probability sample selected 17,822 individuals from 2,950 households in 34 ezbas and 10 villages from a total rural target population of 1,731,252 (based on the most recent 1986 census of the population by the Egyptian Central Agency for Public Mobilization And Statistics). Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, respectively, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 4.8 +/- 0.7% (+/-SE) and geometric mean egg count (GMEC) was 7.0 ova per 10 ml of urine. Considerable variation in prevalence was observed between the villages and ezbas, ranging from 0.0% to 20%, with the smaller ezbas having a slightly higher overall prevalence. The age- and sex-specific patterns of S. haematobium showed typical peak prevalence in early adolescence, with males having a higher prevalence than females. A history of hematuria was associated with current infection (odds ratio = 3.6, 95% confidence interval = 2.32-5.63). Hepatomegaly and splenomegaly determined by physical examination present in 7.9% and 3.0%, respectively. Ultrasonography-determined hepatomegaly of the left liver lobe was found in 10.1%. Ultrasonography-detected hepatomegaly in both the left and right lobes increased in prevalence from approximately 5% in children to 15-20% in adults. The prevalence of ultrasonography-detected splenomegaly increased slightly with age. Grade III periportal fibrosis was detected in only 2 individuals in the sample. Bladder wall lesions and obstructive uropathy were also very infrequent. Other associations with these measures are given. Most villages and ezbas had an S. mansoni prevalence of less than 1%. The exception was Nag'a El-Sheikh Hamad, where the prevalence was 10.3 +/- 0.5% (GMEC = 57.4 +/- 2.6). Two other communities also had a prevalence >1% (Ezbet Sarhan and Kom Heitin).

Adolescent↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: summary findings in nine governorates.

Health questionnaires and parasitologic examinations of urine and stool were evaluated from a stratified random sample of 89,180 individuals from 17,172 households in 251 rural communities in 9 governorates of Egypt to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp. in Egypt. A subset, every fifth household, or 18,600 subjects, had physical and ultrasound examinations to investigate the prevalence of and risk factors for morbidity. Prevalence of S. haematobium in 4 governorates in Upper Egypt in which it is endemic ranged from 4.8% to 13.7% and averaged 7.8%. The geometric mean egg count (GMEC) ranged from 7.0 to 10.0 ova/10 ml of urine and averaged 8.1. Age stratified prevalence of infection peaked at 15.7% in the 10-14-year-old age group and decreased to 3.5-5.5% in all groups more than 25 years of age. Age-stratified intensity of infection peaked at approximately 10.0 ova/10 ml of urine in the 5-14-year-old age groups and was about half that in all groups more than 25 years of age. Males had higher infection rates and ova counts than females in all age groups. Schistosoma mansoni was rare in Upper Egypt, being consequential in only Fayoum, which had a prevalence of 4.3% and an average intensity of infection of 44.0 ova/g of stool. Risk factors for S. haematobium infection were male gender, an age <21 years old, living in smaller communities, exposures to canal water; a history of, or treatment for, schistosomiasis, a history of burning micturition or blood in the urine, and reagent strip-detected hematuria or proteinuria. The more severe grades (II and III) of ultrasonography-detected periportal fibrosis (PPF) were rare (15 of 906) in these schistosomiasis haematobia-endemic governorates. Risk factors for morbidity (ultrasonography-detected urinary bladder wall lesions and/or obstructive uropathy) were similar to those for infection, with the exception that risk progressively increased with age. Subjects with active S. haematobium infections were 3 times as likely as those without active S. haematobium infections to have urinary tract morbidity. The prevalence of S. mansoni in 5 governorates in Lower Egypt, where it is endemic, ranged from 17.5% to 42.9% and averaged 36.4%. The GMEC ranged from 62.6 to 93.3 eggs/g of stool and averaged 81.3. Age-stratified prevalence of infection peaked at 48.3% in the 15-19-year-old age group, but averaged 35-45% in all groups more than 10 years of age. The intensity of infection was highest in the 10-14-year-old age group, and showed a range of 70-85 eggs/g of stool in those > or =5 years of age. Males had higher infection rates and ova counts than females in all age groups. Schistosoma haematobium was rare in these governorates; Ismailia (1.8%) had the highest infection rate. Risk factors for S. mansoni were male gender, an age >10 years old, living in smaller communities, exposures to canal water, a history of, or treatment for, schistosomiasis or blood in the stool, detection of splenomegaly by either physical examination or ultrasonography, and ultrasonography-detected PPF. The more severe grades (II and III) accounted for 463 (13.3%) of the 3,494 having ultrasonography-detected PPF. Risk factors for morbidity (ultrasonography-detected PPF) were similar to those for infection except that inhabitants of smaller communities were not at increased risk. Active S. mansoni infection increased the odds ratio (OR) of having PPF by 1.37. In comparison with others with normal-size livers, subjects having hepatic enlargement in either the midclavicular line or the midsternal line detected by physical examination or ultrasonography had a reduced risk (ORs = 0.64-0.72) of PPF. The prevalences of lesions detected by ultrasonography were 23.7% for enlargement of right lobe of the liver, 11.3% for enlargement of left hepatic lobe, 20.6% for splenomegaly, and 50.3% for PPF. Schistosoma mansoni has almost totally replaced S. haematobium in Lower E

Adolescent↗
PubMed1997

Determinants of infection with schistosomiasis haematobia using logistic regression.

A population-based stratified random sample of 10,039 inhabitants of rural communities in Minya Governorate, Egypt, were evaluated for risk factors for Schistosoma haematobium infection using multivariate analysis. Data were obtained by personal interview recording demographics, information on exposure to canal water, history of infection, and other risk factors for infection and examining urine samples for S. haematobium ova. Logistic regression analysis was used to adjust for confounders while assessing the role of each risk factor for infection. Using logistic regression allowed detection of several confounders and interactions which influenced other independent variables. Differences in exposure patterns to canal water among age and gender subgroups explained only a small portion of the variation in infection rates, thus favoring the alternative explanation: development of age-acquired immunity. The association of age with reduced prevalence of S. haematobium was the only relationship increasing (odds ratio [OR] = 2.95-4.30) with logistic regression. Male gender was a risk factor for infection but did not increase with logistic regression (OR = 2.33-2.03). The protective effects of education, only noted in schoolage children (OR = 0.59-0.51), were believed to be due to a school-based screening and treatment program.

Adolescent↗
PubMed1996

Study of the risk factors for viral hepatitis C infection among Egyptians applying for work abroad.

The aim of this study was to identify the risk factors for viral hepatitis C infection among Egyptians. A cross-sectional study with case-control analysis was conducted including 5071 Egyptians applying to the Ministry of Health Laboratories for certification of freedom from viral hepatitis (B and C) to work abroad. A questionnaire designed to cover the most important known and suspected risk factors was filled out by physicians interviewers before blood drawing and after proper orientation of the purpose of the study. The overall seropositivity among the whole sample for HCV was 31.5% and was significantly lower among females (13.2%) than among males (34%). A consistent increase of seropositivity for HCV antibodies with age (in males and females and in urban and rural areas) was observed with a peak level of 54.9% in all individuals for the age group 45-49 years (significant trend p < 0.0001). A significant increase of seropositivity (p < 0.005) above 25 years of age (35.7%) than below this age 12.8%) was observed on examination of HCV distribution in 5-year age group. Married individuals have a significant higher seropositivity for HCV than non-married (38.2% and 20.9% respectively OR = 2.3, 95% CL 2.1-2.7). Individuals living in rural areas had significantly more HCV seropositivity than those living in urban areas (OR = 1.7, 95% CL 1.5-2.0). Also, individuals living in Cairo and seashore governorates had significantly lower seropositivity (14.7% and 12.7% respectively) than those living in governorates in upper or lower Egypt (29.4% and 36.3% respectively). Medical procedures risk factors identified to be associated with significant higher HCV seropositivity included: past history of injections for bilharziasis, use of common syringes, dental extraction, injections for urography, blood transfusions and previous hospitalizations. Multivariate logistic analysis revealed that only age, male sex, marriage, rural residence, living in upper and lower Egypt, injections for bilharziasis and urography were significant in the final equation for the whole group. Blood transfusion was significant in the final regression analysis among females in urban living and hospitalization was significant among males in urban living and females in rural living. Further research is needed to elucidate those factors prevailing in rural areas and in upper and lower Egypt associated with increased risk for HCV infection.

Adolescent↗
PubMed1994

Wilms' tumor: long-term results from a single institution.

One-hundred-twelve children with pathological diagnosis of Wilms' tumor were treated during the period 1979-1989. They were postoperatively staged as follows: stage I, 25 patients; stage II, 27 patients; stage III, 48 patients; and stage IV, 9 patients. Three patients were preoperatively classified as stage V. The National Wilms' Tumor Study (NWTS) staging system was used. Except for Stage V patients, the treatment regimen consisted of nephrectomy followed by radiotherapy and/or chemotherapy according to stage of disease and pathology. Stage I, II, and III patients with favorable histology enjoyed 94 +/- 6%, 86 +/- 8%, and 71 +/- 8% 10-year actuarial survival, respectively. Stage IV patients and those in stages I, II, and III with unfavorable histology had a 10-year actuarial survival of 36 +/- 8%. Univariate analyses proved that NWTS stages affected the 10-year actuarial disease-free survival rates but not the overall survival rates. The histopathology significantly affected the disease-free survival and the overall survival rates both in the whole group of patients and in each stage when considered separately. The same histopathology also affected the incidence of development of distant relapse but not the local recurrence rate. On the other hand, massive tumor rupture at surgery increased the incidence of local relapse but not of distant metastasis and did not affect the overall survival rates. The presence of residuum after surgery had nearly the same effect as tumor rupture on the local recurrence. It also did not increase significantly the distant relapse incidence, but it affected significantly the overall survival. Retroperitoneal lymph node involvement had a similar effect. It increased the incidence of local relapse and decreased the 10-year overall survival rate but it had a borderline effect on development of distant metastasis (P = 0.06). The age at diagnosis had also a borderline effect on disease-free survival but it had not effect, of statistical significance, on the overall survival.

Actuarial Analysis↗
PubMed1994

Assessment of praziquantel therapy in treatment of Schistosoma mansoni infection.

The present study is the first report of the epidemiological survey carried out as a part of the Praziquantel resistance project which is one of the projects of Schistosomiasis Research Project (SRP) in Egypt. The results of the study, which has been carried out in 3 villages, revealed that praziquantel is effective as an antischistosomal drugs and reduced egg count significantly. However at the end of the study some cases remained infected in spite of the three treatment regimens. Several factors can be responsible, among them is the presence of resistance strains, which will only be elucidated in the subsequent steps of the project, when identification of resistant strains in experimental animals will be carried out.

Drug Resistance↗
PubMed1993

Nasopharyngeal carcinoma in children and adolescents successful role of retrieval therapy.

BACKGROUND: The nasopharyngeal carcinoma in children and adolescents usually presents in advanced locoregional stages. METHODS: Seventeen patients, below the age of 18 years, with the diagnosis of nasopharyngeal carcinoma were diagnosed and treated at the National Cancer Institute (NCI), Cairo, Egypt, during the period 1982-1987. These 17 patients were selected from 28 patients of the same age group to whom the diagnosis of nasopharyngeal malignancies were established. This diagnosis was confirmed morphologically and with immunostaining using antibodies against leucocyte common antigen (LCA), epithelial membrane antigen (EMA), cytokeratin and vimentin. RESULTS: Eighty two percent of our patients were in T3 + T4 and 94% had N 1-3 nodal status. The locoregional control was 94% with adequate conventional radiotherapy, while the distant metastasis rate was also high (81%). The 5-year actuarial survival rate was 47 +/- 11% and the survival worsened with the advancement in T stage. However, the present study did not show any influence of N stage on survival. The relatively high survival rate depended mainly upon successful retrieval therapy with radiochemotherapy. CONCLUSIONS: This emphasizes the role of combination chemotherapy in the treatment of relapsing nasopharyngeal carcinoma in young patients.

Adolescent↗
PubMed1989

Childhood non-Hodgkin's lymphoma in Egypt: preliminary results of treatment with a new ifosfamide-containing regimen.

Pediatric non-Hodgkin's lymphoma (NHL) constitutes 16% of pediatric malignancies reported to the National Cancer Institute (NCI) in Cairo. Since July 1985, we have treated 39 previously untreated pediatric NHL cases younger than 16 years of age (mean, 7.6 years) with a new protocol consisting of alternating cycles: regimen A comprised cyclophosphamide, high-dose ara-C, Adriamycin and vincristine; regimen B consisted of ifosfamide, methotrexate and VP16, with intrathecal methotrexate. Diagnoses included 20 abdominal masses, 16 peripheral lymphadenopathies and 6 bony lesions. Histopathology according to the working formulation revealed 21 cases of small non-cleaved lymphoma, 6 lymphoblastic, 5 large-cell and 7 unclassified diffuse lymphomas. Responses were complete in 31 cases (82%) and partial in 4 cases (10%), and no response was obtained in 4 cases (8%). Overall survival was 82% in limited disease and 60% in extensive disease at 28+ months. This short-term ifosfamide-containing regimen proved its efficacy, with results matching those of other regimens used in the United States and Europe.

Adolescent↗
PubMed1981

The impact of schistosomiasis on the pathology of bladder carcinoma.

In a series of 1095 Egyptian patients with carcinoma of the bladder treated by radical cystectomy, 902 cases (82.4%) contained schistosome eggs in the specimens, and 193 (17.6%) were egg-negative. The different tumor parameters were compared in these subgroups to explore any differences that could be related to schistosomal infestation. In egg-positive cases, the tumor developed at a younger age (46.7 years) than in egg-negative cases (53.2 years). Squamous cell carcinoma, commonly of low grade, predominated in the egg-positive group. No difference was observed in the frequency of tumor stages or lymph node metastases between the two subgroups. The limited tendency to distant spread in schistosomal bladder cancer, despite its advanced local stage, is accounted for by the high frequency of low grade tumors rather than the limiting effect of local schistosomal tissue reactions.

Adenocarcinoma↗