[IN THE MARGIN OF A RARE WORK OF G EBERS: ANATOMIC TERMINOLOGY IN PAPYRUSES OF PHARONIC EGYPT. STUDIES AND RESEARCH ON MEDICINE AND BIOLOGY OF ANCIENT EGYPT. I].
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Biology↗
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[History of sterility in ancient times. I. Sterility in Egypt. Diagnostic recipes for sterility and pregnancy in ancient Egypt].
Egyptians were the first to develop recipes in order to predict sterility and to diagnose an early pregnancy. These recipes was reused by Hippocrate and still employed until the XVIIIth century.
Egypt, Ancient↗
[Egypt--everything is different here. Report on a visit to a mission hospital in Egypt].
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Egypt↗
Cancer mortality in Menofeia, Egypt: comparison with US mortality rates.
OBJECTIVES: In developing countries where cancer registries are unavailable, mortality statistics from death certification may be a practical source of cancer statistics. We aimed at describing the cancer mortality in Egypt and comparing it to that in the US. METHODS: We used the mandatory and routinely available mortality records of Menofeia province in the Nile Delta region of Egypt, which is typical of the rest of Egypt. We determined cancer mortality rates, and compared them with the Surveillance, Epidemiology, and End Results (SEER) mortality rates of the US. RESULTS: Bladder and liver cancers were the two most common causes of cancer mortality in Menofeia, Egypt. When adjusted for age the Egyptian rates were much higher than the US rates (9.5/100,000 and 8.4/100,000 for bladder and liver cancer, respectively, compared with 2.3/100,000 and 2.5/100,000 for the same cancers from SEER data). We also observed that age-specific rates for early-onset colorectal cancer under age 40 and premenopausal breast cancer were higher in Egypt than in the US. CONCLUSION: This study confirms our earlier observations about the higher proportion of early-onset colorectal cancer in Egypt, and opens the door for future studies to investigate familial clustering of cancer in Egypt.
Adolescent↗
Cost-effectiveness of different treatment strategies for tuberculosis in Egypt and Syria.
SETTING: The National Tuberculosis Programmes in Egypt and Syria. OBJECTIVES: To calculate the costs and effectiveness of alternative ways of implementing TB control in Egypt and Syria, in order to illustrate the factors influencing the cost-effectiveness of TB treatment in middle-income countries. DESIGN: We compared the costs and cure rates in Egypt and Syria of the World Health Organization recommended directly observed treatment, short-course (DOTS) strategy and alternative strategies. The study included costs both to the health services and to the patient. RESULTS: In Egypt and Syria, the cost-effectiveness of DOTS implemented through the primary health care (PHC) system was respectively $258 and $243 per patient cured. This compares to a cost per patient cured of $297 (Egypt) and $693 (Syria) for alternative strategies implemented through specialist clinics. In Egypt, when DOTS is implemented through specialist chest clinics it costs $585 per patient cured. Hospitalisation costs either $1490, $1621 or $1699 per patient cured, depending on treatment delivery in the continuation phase. CONCLUSION: This study demonstrates that the move towards DOTS integrated at the PHC level has substantially improved the effectiveness of TB treatment in Egypt and Syria, without substantially increasing costs. An analysis of the different costs and effectiveness of the variety of TB treatment strategies has enabled both National Tuberculosis Programmes to expand DOTS and implement it in a way that takes into account limited resources and local health systems.
Antitubercular Agents↗
Brief communication: Y-chromosome haplotypes in Egypt.
We analyzed Y-chromosome haplotypes in the Nile River Valley in Egypt in 274 unrelated males, using the p49a,f TaqI polymorphism. These individuals were born in three regions along the river: in Alexandria (the Delta and Lower Egypt), in Upper Egypt, and in Lower Nubia. Fifteen different p49a,f TaqI haplotypes are present in Egypt, the three most common being haplotype V (39.4%), haplotype XI (18.9%), and haplotype IV (13.9%). Haplotype V is a characteristic Arab haplotype, with a northern geographic distribution in Egypt in the Nile River Valley. Haplotype IV, characteristic of sub-Saharan populations, shows a southern geographic distribution in Egypt.
Adult↗
Hepatitis B virus infection in upper and lower Egypt.
The relative prevalence of hepatitis B surface antigen (HBsAg), anti-HBs, and anti-hepatitis B virus core antigen (HBc), as markers of hepatitis B virus infection, among 1,866 apparently healthy residents of two Egyptian provinces representing Upper and Lower Egypt populations was determined using solid-phase radioimmunoassay (SPRIA). The prevalence rate of HBsAg in the Egyptian population was moderately high (10.1%); it was higher in the Upper Egypt (11.7%) than the Lower Egypt (8.0%) population and more frequent in young adults--especially those of Upper Egypt--and males than females in both populations. The prevalence of anti-HBs gradually increased with age; it was higher in the Lower Egypt (51.1%) than the Upper Egypt (41.7%) population, and it was higher in females than males. A remarkably high infection rate, as shown by the prevalence of anti-HBc, was found in both populations (88.0%), with minor variations depending on age, sex, and geographic area.
Adolescent↗
Traffic safety assessment and development of predictive models for accidents on rural roads in Egypt.
This paper starts by presenting a conceptualization of indicators, criteria and accidents' causes that can be used to describe traffic safety. The paper provides an assessment of traffic safety conditions for rural roads in Egypt. This is done through a three-step procedure. First, deaths per million vehicle kilometers are obtained and compared for Egypt, three other Arab countries and six of the G-7 countries. Egypt stands as having a significantly high rate of deaths per 100 million vehicle kilometers. This is followed by compiling available traffic and accident data for five main rural roads in Egypt over a 10-year period (1990-1999). These are used to compute and compare 13 traffic safety indicators for these roads. The third step for assessing traffic safety for rural roads in Egypt is concerned with presenting a detailed analysis of accident causes. The paper moves on to develop a number of statistical models that can be used in the prediction of the expected number of accidents, injuries, fatalities and casualties on the rural roads in Egypt. Time series data of traffic and accidents, over a 10 years period for the considered roads, is utilized in the calibration of these predictive models. Several functional forms are explored and tested in the calibration process. Before proceeding to the development of these models three ANOVA statistical tests are conducted to establish whether there are any significant differences in the data used for models' calibration as a result of differences among the considered five roads.
Accident Prevention↗
Biological and biochemical comparative studies on Schistosoma mansoni from two localities in Egypt where S. haematobium is endemic.
The changing pattern of Schistosoma mansoni and S. haematobium distribution in Egypt is generally attributed to ecological changes caused by the construction of the Aswan High Dam. Although S. mansoni was previously restricted to Lower Egypt, it is now found at certain foci in Upper Egypt. In areas of Lower Egypt where S. mansoni and S. haematobium are sympatric, S. mansoni eggs are shed almost exclusively in the stools of patients, whereas in Upper Egypt they are more frequently shed in the urine. In spite of this difference, the eggs and adult worms obtained from hamsters infected with S. mansoni strains from each of these areas proved to be morphologically identical. Protein patterns and isoenzyme profiles of male or female adult worms of each of the two isolates, obtained from infected hamsters, also proved virtually identical. In hamsters with mixed infections of S. mansoni and S. haematobium, some S. mansoni females cross-mated with S. haematobium males and they then developed ovaries and laid eggs which were typical of S. mansoni and which were excreted from the urinary bladder. In Upper Egypt, which is predominantly a S. haematobium area, patients with established infections may have a preponderance of S. haematobium males associated with S. mansoni females. These females may then migrate to the vesicular plexus and deposit S. mansoni eggs in the urinary bladder, to be shed subsequently in the urine. The observations appear to be better explained by the phenomenon of parthenogenesis than by the production of true genetic hybrids.
Animals↗
Incidence and socioeconomic determinants of abortion in rural Upper Egypt.
Because of a growing cultural and religious sensitivity and controversy over reproductive health issues, particularly abortion, this area remains relatively unexplored in Egypt. This study was conducted using a participatory approach to determine the morbidity and determinants of abortion in rural Upper Egypt. In all, 1025 women from six villages in Upper Egypt were included in the study. Information regarding the incidence of abortion, patterns of health care utilization and risk factors was obtained using a structured interview format. The local dialect was used in formulating questions and they were revised and amended by a panel of local leaders, interviewers and representatives of the study population. Interviewers were local educated (secondary or university level) female volunteers. Information about exposure to 17 risk factors was also collected and statistical analysis was done by estimating the odds ratio and applying a test of statistical significance. Then, a multivariate logistic regression model was applied to control for possible interactions and confounding effects. The results were that 40.6% (n=416) had aborted at least once; of them 24.6% (n=252) had aborted more than once and were designated as recurrent aborters. The lifetime prevalence of recurrent abortion was estimated to be 25% and nearly 21% of pregnancies were aborted. The incidence of abortion was estimated to be 265 per 1000 live birth. Only 21.9% (n=91) of women received medical care for the last abortion. The vast majority of women (92%, n=299) who did not seek medical help received help from traditional and domestic sources. These sources are midwife (59.9%, n=179), relative or neighbour (29.8%, n=89), and traditional practitioner (10.4%, n=31). The multivariate analysis revealed that the incidence of abortion is significantly associated with gravidity, consanguinity, and mother occupation, while recurrent abortion is associated with gravidity, consanguinity and woman's age at marriage. In conclusion, the morbidity of abortion is a serious public health problem in Egypt. Because the incidence rate is very high and because safe abortion is limited in Egypt, maternal mortality due to abortion is expected to be underestimated. Promotion of family planning is expected to have a significant impact on the incidence of abortion in Upper Egypt.
Abortion, Induced↗
Exponential spread of hepatitis C virus genotype 4a in Egypt.
Hepatitis C virus (HCV) infects >10% of the general population in Egypt, in which intravenous injection with an antimony compound for endemic schistosomiasis in the past has been implicated. To simulate the epidemic history of HCV in Egypt, sera were obtained from 3608 blood donors at 13 governorates in or surrounding the Nile valley during 1999. The prevalence of antibody to HCV (anti-HCV) and genotypes was determined in them, and the molecular evolutionary analysis based on the neutral theory was applied to HCV isolates of genotype 4a, which is outstandingly prevalent in Egypt and indigenous there. Of 3608 sera, 317 (8.8%) were positive for anti-HCV. The molecular evolutionary analysis on 47 HCV genotype 4a isolates of carriers from various districts in Egypt indicated that the spread of HCV-4a would have increased exponentially during the 1940s through 1980 when oral medications became available. In conclusion, the estimated spread time is consistent with the duration of intravenous antimony campaigns in Egypt.
Adult↗
Determinants of caesarean section in Egypt: evidence from the demographic and health survey.
This paper examines the impact of near birth complications and socio-demographic, healthcare and spatial characteristics of caesarean section in Egypt, using data on 4032 births from the 2000 Egypt Demographic and Health Survey. The hospital caesarean section rate was 22% in Egypt. Fever/vaginal discharge around delivery, birth weight, mother's age and education, birth order, residence and antenatal visits were important determinants of caesarean section. Variations by place of delivery were evident, although complications were more significant determinants of caesarean section in public settings and demographic characteristics were more important in private facilities. Unexpectedly, long labour and bleeding around delivery were not associated with caesarean section, particularly, in private hospitals. In view of the high and rising caesarean section rate in Egypt, monitoring the quality of maternity services in Egypt is imperative. An investigation of the forces sustaining the differential in determinants by place of delivery is needed.
Adolescent↗
The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt.
BACKGROUND: The population of Egypt has a heavy burden of liver disease, mostly due to chronic infection with hepatitis C virus (HCV). Overall prevalence of antibody to HCV in the general population is around 15-20%. The risk factor for HCV transmission that specifically sets Egypt apart from other countries is a personal history of parenteral antischistosomal therapy (PAT). A review of the Egyptian PAT mass-treatment campaigns, discontinued only in the 1980s, show a very high potential for transmission of blood-borne pathogens. We examine the relative importance of PAT in the spread of HCV in Egypt. METHODS: The degree of exposure to PAT by cohort was estimated from 1961-86 Ministry of Health data. A cohort-specific exposure index for PAT was calculated and compared with cohort-specific HCV prevalence rates in four regions. FINDINGS: HCV prevalence was calculated for 8499 Egyptians aged 10-50 years. A significant association between seroprevalence of antibodies to HCV and the exposure index (1.31 [95% CI 1.08-1.59]; p=0.007) was identified across four different regions. In all regions cohort-specific HCV prevalence was lowest in children and young adults than in older cohorts. These lower prevalence rates coincided with the gradual and final replacement of PAT with oral antischistosomal drugs at different points in time in the four regions. INTERPRETATION: The data suggest that PAT had a major role in the spread of HCV throughout Egypt. This intensive transmission established a large reservoir of chronic HCV infection, responsible for the high prevalence of HCV infection and current high rates of transmission. Egypt's mass campaigns of PAT may represent the world's largest iatrogenic transmission of blood-borne pathogens.
Adolescent↗
An ancient scourge: the end of dracunculiasis in Egypt.
This paper addresses the question of when guinea worm disease was last found in Egypt, and how written sources from the nineteenth and twentieth centuries which mention the disease should be evaluated. This enquiry is relevant to the global eradication campaign now in progress, and the need for countries in which dracunculiasis was once present to prepare a certification of eradication. Sudan, the country which has the largest number of cases today, is Egypt's southern neighbour. Because of the nature of the disease (in endemic areas it is most common among poor, rural people), it may not have come to the attention of urban-based health personnel. In the period before the details of the transmission cycle were known, the attitudes and mindsets of physicians and travellers also have to be taken into account in interpreting written reports of the disease. An examination of documentary sources from the nineteenth and twentieth centuries in European languages does not show any clear evidence for dracunculiasis transmission in Egypt during that period. Cases noted in Egypt, especially by the much quoted Dr Clot Bey in the 1820s, most likely originated beyond the borders of the country, in Sudan and, to a lesser extent, from endemic areas in the Middle East. However, many later commentators merely repeated what Clot Bey had written. A further difficulty is that some published reports which apparently concern dracunculiasis in Egypt, actually refer to cases in animals rather than humans.
Animals↗
"Breaking the bureaucracy": drug registration and neocolonial relations in Egypt.
According to the Egyptian Ministry of Health, the per capita use of prescription drugs in Egypt is amongst the highest in the world. Multinational pharmaceutical companies license their proprietary products for manufacture and sale in Egypt through their Egyptian subsidiaries. A Ministry of Health Committee reviews and approves for sale all drugs marketed in the country. Aside from being an extremely lucrative market itself, approval of a drug for sale and manufacture in Egypt also opens to the pharmaceutical companies other markets in the Arab world. The Egyptian drug approval process is thus both important for assuring the health of Egyptian nationals and a high-stakes activity for the pharmaceutical companies. This paper examines the social relations and interactions of multinational pharmaceutical representatives in Egypt with Egyptian researchers in relation to the Ministry of Health's drug approval process. From time-to-time events focus attention on the huge financial rewards reaped by multinational pharmaceutical companies from their activities in lesser developed countries. This attention not infrequently has revealed the "drugging of the Third World" as a result of actions by expatriate multinational pharmaceutical officials. Indigenous review procedures such as those established by the Egyptian Ministry of Health might guard against such external exploitation. This paper shows how in place of external exploitation, indigenous pharmaceutical company officials have manipulated local patterns of social interaction to construct a system of reciprocal obligations which may frustrate intended safeguards, and by reconstructing colonial institutional structures, creates a pattern of neocolonialism in Egypt.
Drug Approval↗
Overview of injection practices in two governorates in Egypt.
OBJECTIVE: To describe the extent and characteristics of injection use and injection providers in Egypt, given that unsafe injections are associated with blood-borne pathogen transmission. METHODS: Household surveys of a population-based sample of residents in the Nile Delta and in Upper Egypt; focus group discussions and in-depth interviews with community target groups, formal and informal medical providers. RESULTS: Of 4197 persons interviewed, 26.2% reported receiving an injection in the past 3 months. Of these, 77% reported it was for therapeutic indications. The age-sex specific prevalence of injections was highest among children 0-2 years of age and among older adults. Women were more likely to report having an injection than men, particularly at the age above 20 years. Overall, respondents reported receiving on average 4.2 injections per year, indicating that up to 281 million injections are provided per year in Egypt. Injection administrators were public and private sector physicians, pharmacists, barbers, doctor assistants, housekeepers, relatives and friends. Injection prescribers were mostly private and public sector physicians. Of the 1101 respondents who received an injection in the past 3 months, 92 (8.4%) reported that the provider did not use a syringe taken from a closed sealed packet. CONCLUSION: The frequency of therapeutic injection use is high in Egypt and may contribute to blood-borne pathogen transmission. The Ministry of Health and Population (MOHP) is developing interventions targeted towards promotion of injection safety and reduction of injection overuse on community basis as part of a comprehensive strategy to prevent blood-borne pathogen transmission in Egypt.
Adolescent↗
Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India.
Although studies have documented the associations between Intimate Partner Violence (IPV) and mental health, few have been done in developing countries. In this study, the association between IPV and mental health in women from different developing countries was established. Women, 15 to 49 years old with at least one child 18 years old or younger, were randomly selected from communities in Chile, Egypt, India, and the Philippines (N = 3974). The Self Report questionnaire (SRQ) was used to assess mental health. Women with a score on the SRQ of 8 or more, or who reported ever attempting suicide, were classified as having poor mental health. Physical IPV was defined as being slapped, hit, kicked, beaten or threatened by a male partner during the past year. Psychological violence included being insulted or belittled, threatened or abandoned. Between 22.5% (in Egypt) to 41% (in Chile) of participating women reported a score of eight or more on the SRQ. High score on the SRQ were significantly associated with current physical and psychological IPV in the samples from all participating countries except Chile. Twelve percent of women in Chile, 2.6%, in Egypt, 7.5% in India and 1.6% in the Philippines reported attempting suicide. Suicide attempts were also associated with current physical IPV in the Philippines, Egypt, and India, and with psychological violence in Egypt and India. IPV is significant risk factor for poor mental health in these developing countries. Efforts to reduce IPV should be considered as part of a mental health program.
Adolescent↗
Iodine deficiency disorders among school children in upper Egypt: an epidemiologic study.
Iodine deficiency disorders (IDD) are the world's single most significant cause of preventable brain damage and mental retardation. Data regarding IDD in upper Egypt are scarce and even lacking. The aim of the present work was to study the prevalence of IDD and some potential risk factors in upper Egypt. Using a two-stage cluster sampling technique, 6750 school children aged 8-10 years were screened for IDD through clinical examination of the thyroid gland and determination of urinary iodine, from three governorates in upper Egypt, namely Al-Minya (population of 3.3 million), Assyut (population of 2.9 million), and Suhag (population of 3.1 million). Iodine was determined in samples of soil and drinking water. Overall, the prevalence rate of goitre was 34.6 per cent. The median urinary iodine level for children with goitre was 5.04 micrograms/dl compared to 14.81 micrograms/dl among children free of goitre. Multiple logistic regression analysis showed that certain groups of school children were much more likely to develop goitre. They included females (OR = 3.07, 95 per cent CI = 2.78-3.39), children in households where drinking water had an iodine content of less than 0.5 microgram/100 ml (OR = 3.44, 95 per cent CI = 3.09-3.89), and children living in places where soil content of iodine was less than 0.2 microgram/100 g (OR = 2.67, 95 per cent CI = 2.30-3.10). We conclude that IDD is a severe public health problem in upper Egypt. The present situation in upper Egypt necessitates an urgent intervention programme.
Chi-Square Distribution↗