Impact of Nutritional Health Education on Knowledge and Practices of Mothers of Anemic Children in El Othmanyia Village – Egypt

BACKGROUND: In Egypt, more than one in four children suffers from some degree of anemia. AIM: This study was carried out to assess and improve the nutritional knowledge and risky nutritional habits of the mothers of anemic children aged 2–12 years old in El Othmanyia village. MATERIALS AND METHODS: An interventional study was conducted among anemic children aged 2–12 years old and their mothers in El Othmanyia village, Egypt. The study passed through three stages over 1 and ½ years; pre-interventional assessment of awareness (n = 350), educational interventions targeting anemic children and their mothers, and post-interventional evaluation of change in awareness and practice. RESULTS: The mean knowledge % score of mothers increased significantly after the intervention (82.2 ± 14.2 vs. 6.3 ± 5.8, respectively). Furthermore, the mean hemoglobin of the studied children increased significantly after the intervention (11.1 ± 0.7 vs. 10.5 ± 0.7). The percent of children with anemia decreased significantly from 100% to 40.3% after the intervention (p < 0.001). CONCLUSION: The knowledge and practices of mothers are moving in a desirable direction after the health education intervention. Hence, nutrition education is an appropriate, effective, and sustainable approach to combat iron deficiency anemia. Recommendations: A multiple interventional strategies between different ministries to set policies and guidelines that support the healthy nutritional behavior among children are recommended. &nbsp

Effect of Counteracting Lifestyle Barriers through Health Education in Egyptian Type 2 Diabetic Patients

BACKGROUND: Egypt is among the world top 10 countries in diabetes prevalence. It is the first country among the MENA region. Healthy lifestyle education and support help people with diabetes to improve health outcomes. Many physical and psychological barriers can hinder patients from following a healthy lifestyle. AIM: This study aimed to examine the effect of lifestyle modification educational sessions in helping Egyptian patients to overcome main barriers of diabetes self-management through improving nutritional behaviours, physical activity, medication compliance, and blood glucose monitoring. METHODS: A cohort study included 205 patients with type 2 diabetes. Baseline assessment of patients' lifestyle behaviours and barriers using personal diabetes questionnaire of Louisville University, with both anthropometric and blood glucose assessment. Interventional lifestyle health education was provided weekly through multiple integrated techniques, followed by a post-intervention assessment to evaluate the effect of the health education sessions. Statistical analysis was done to identify any statistically significant difference before and after the health education intervention. RESULTS: There was a significant improvement of the post-education mean scores of the studied behaviours when compared with the pre-education scores of the participants’ behaviours (p < 0.001). There was also a significant reduction in the barriers facing patients to diabetes self-management including nutritional barriers (P < 0.001), medication compliance barriers (P < 0.001) with a percent change (43%), physical activity barriers (p < 0.001), and blood glucose monitoring (p < 0.001) with a percent change (44%).There was a statistically significant positive correlation between improvement of medication compliance (P = 0.027), blood glucose monitoring(P = 0.045), and glycated haemoglobin of the study participants CONCLUSION: lifestyle modification education of type 2 diabetic patients can overcome the main barriers of following a healthy lifestyle and improve their anthropometric measures and blood glucose level

Stunting and its Determinants among Governmental Primary School Children in Egypt: A School-based Cross-sectional Study

BACKGROUND: In developing countries, stunting among children is a major public health concern. It affects all aspects of children’s lives; its effects are not constrained to physical wellbeing but reach out to mental, social, and spiritual wellbeing. AIM: The aim of this study is to determine the prevalence of stunting in some of the Egyptian governmental primary school children and its nutritional and socioeconomic determinants. METHODS: A cross-sectional observational study was conducted on primary school children aged 6–12 years. General demographic, socioeconomic, and anthropometric data, as well as dietary pattern, were collected. RESULTS: Out of 1740 children, 7.8% were stunted. Not eating eggs and dairy products had the most profound effect on stunting in children (p < 0.001). Not having meals on time, skipping breakfast, and having <3 meals per day were predictors of stunting (p = 0.003, p = 0.00, and p = 0.008, respectively). Mother’s education (p = 0.005) followed by family income (p = 0.007) was the most affecting social factors. CONCLUSION: There are many nutritional factors associated with stunting as skipping breakfast, not having meals on time, and having <3 meals per day. Scarcity in nutritive foods as eggs and dairy products and increased soft drink intake can lead to stunting. There are many enabling social factors for stunting as mother’s education and family income. However, the effects of these factors can be modified by health awareness

Vulnerability and Weaknesses of Eating Habits of Overweight School Children as an Entry Risk for COVID-19

BACKGROUND: In developing countries, overweight among children becomes an alarming problem and a health concern. Obesity is a factor in disease severity of coronavirus disease (COVID-19) having the greatest impact on patients. AIM: The aim of this study was to determine the prevalence of overweight in some of the Egyptian governmental primary school children, its nutritional and socioeconomic determinants. Special focus was directed to identify the current dietary practices including risky nutritional habits of overweight children as a weak point leading to increasing their vulnerability to catching COVID-19 infection. METHODS: A cross-sectional observational study was conducted on primary school children aged 6–12 years. General demographic data, socioeconomic data, dietary pattern, intake of a diversity of nutrient-rich food versus calorie-dense food, and anthropometrical data were collected. RESULTS: Of 1600 child, there were 8% overweight who are considered at risk of COVID-19 infection. Considering the weekly share of the stomach, only one-third of the food consumed by overweight children is nutrient-rich, with high consumption of French fries and Candies (once per day among 95% and 78 % of overweight children, respectively). Moreover, 90% of them consume sugar-sweetened beverages (SSB) more than once per day. The majority of overweight children belonged to small, middle- income families, and had illiterate or read and write mothers. CONCLUSION: Overweight children eat narrow diversity of nutrient-rich food that includes vegetables, fruits, protein, and dairy products. They eat more calorie-dense foods, every day. The increase of family income increased the likelihood of having overweight children with a high intake of SSB, candies, and chips; consumption of snacks between meals and before sleep. Protective predictors against overweight were highly educated mothers, taking breakfast before school, having dinner, and taking meals on time. RECOMMENDATION: Nutritional behavioral education aiming at choosing nutritious and varied options of food that is effective for improving children’s nutritional status is the key to decreasing vulnerability toward COVID 19

The Hep-CORE policy score: A European hepatitis C national policy implementation ranking based on patient organization data.

BACKGROUND content: New hepatitis C virus (HCV) treatments spurred the World Health Organization (WHO) in 2016 to adopt a strategy to eliminate HCV as a public health threat by 2030. To achieve this, key policies must be implemented. In the absence of monitoring mechanisms, this study aims to assess the extent of policy implementation from the perspective of liver patient groups. - Label: METHODS content: "Thirty liver patient organisations, each representing a country, were surveyed in October 2018 to assess implementation of HCV policies in practice. Respondents received two sets of questions based on: 1) WHO recommendations; and 2) validated data sources verifying an existing policy in their country. Academic experts selected key variables from each set for inclusion into policy scores. The similarity scores were calculated for each set with a multiple joint correspondence analysis. Proxy reference countries were included as the baseline to contextualize results. We extracted scores for each country and standardized them from 0 to 10 (best)." - Label: RESULTS content: Twenty-five countries responded. For the score based on WHO recommendations, Bulgaria had the lowest score whereas five countries (Cyprus, Netherlands, Portugal, Slovenia, and Sweden) had the highest scores. For the verified policy score, a two-dimensional solution was identified; first dimension scores pertained to whether verified policies were in place and second dimension scores pertained to the proportion of verified policies in-place that were implemented. Spain, UK, and Sweden had high scores for both dimensions. - Label: CONCLUSIONS content: Patient groups reported that the European region is not on track to meet WHO 2030 HCV goals. More action should be taken to implement and monitor HCV policies

Determinants of Exclusive Breastfeeding in a Sample of Egyptian Infants

BACKGROUND: Breastfeeding is an optimum, healthy, and economical mode of feeding an infant. However, many preventable obstacles hinder exclusive breastfeeding in the first six months of life. AIM: We aimed to assess the social-, maternal- and infant-related factors disturbing exclusive breastfeeding in the first six months of life. METHODS: It is a retrospective study included 827 dyads of mothers and infants older than 6 months (411 exclusively breastfed, 311 artificially-fed and 105 mixed feds). Mothers were interviewed to obtain sociodemographic information, maternal medical history and perinatal history and a detailed history of infant feeding. RSULTS: Many factors were found to support the decision for artificial feeding rather than exclusive breastfeeding, including maternal age < 25 years (OR = 2.252), child birth order > 3rd (OR = 2.436), being a primi-para (OR = 1.878), single marital status (OR = 2.762), preterm infant (OR = 3.287) and complicated labor (OR = 1.841). Factors in favor of mixed feeding included cesarean section (OR = 2.004) and admission to the Neonatal Intensive Care Unit (OR = 1.925). CONCLUSIONS: Although it isn’t a community-based study and its results can’t be generalised, plans to improve health and development of children are preferable to include the following: health education and awareness programs about the importance of exclusive breastfeeding should be directed for young and first-time mothers. Improved antenatal care to reduce perinatal and neonatal problems; and training, monitoring, and supervising community health care workers to recognise labour complications and provide support and knowledge to lactating mothers

Potential Risk Factors of Developmental Cognitive Delay in the First Two Years of Life

BACKGROUND: The first two years of life constitute a critical period of rapid change. The events during this phase prepare the child for subsequent developmental competency.AIM: To determine the potential risk factors that affect an infant’s cognitive development in the first two years of life in a sample of Egyptian infantsSUBJECTS AND METHODS: A cross-sectional comparative study included 655 male and female infants. Their age ranged from 3 – 24 months. Bayley Scales of Infant and Toddler Development (Bayley III) were used for cognitive assessment. Perinatal and nutritional data were recorded. Levels of serum Zinc, Copper, Iron, vitamin B12 and complete blood count (CBC) were assessed in a subsample of 193 infants.RESULTS: Infants having below the average cognitive composite score (CCS) represented 38.47% of the whole sample. The risk of having a low average (CCS) was determined by multiple factors. Poor maternal education and low family income were the most significant social risk factors (OR = 2.19, p = 0.0003; OR = 1.64, p = 0.002 respectively). Prematurity and complicated labor represented significant perinatal risks (OR = 1.22, p = 0.005; OR = 2.39, p =0.001respectively). Bottle feeding versus breastfeeding in the first six months of life was the most significant nutritional predictor of low average (CCS) (OR = 1.79, p = 0.001). Infants with low average (CCS) had significantly lower levels of serum zinc and vitamin B12 than those with average scores. CONCLUSION: Multiple factors appear to interact affecting the early cognitive development of Egyptian infants. Prematurity, complicated labour, poor maternal education, low family income and micronutrient deficiency are the main risk factors. Studying these factors is of great value in directing governmental intervention efforts

The Interaction of Social, Physical and Nutritive Factors in Triggering Early Developmental Language Delay in a Sample of Egyptian Children

BACKGROUND: Language acquisition and child development during the early years of life depend on multiple interacting factors. AIM: To explore potential factors that can impact language development in 2 groups of Egyptian children, one with normal language development and the second with delayed development. Also, to explore to what extent can the involvement of impaired motor development potentiate the risk of developmental language delay. METHODS: This cross-sectional case-control study involved Egyptian children belonging to the middle socioeconomic class between 18 and 36 months of age. Children were classified according to their performance on language domain of Bayley Scales of Infant and Toddler Development (Bayley-III) into two groups, infants with the average or above score (control group) and those having below-average scores (cases). Motor development was assessed on the same scale. Factors affecting language development were tested, including socio-demographic, obstetric, and maternal medical factors in addition to Infant Feeding Practices. RESULTS: The independent factors lowering the language scores were early introduction of complementary food, low family income, history of delivery problems, pregnancy-related diseases of the mother, and maternal education. Impaired motor development appears as a further highly significant risk factor to the previously mentioned factors CONCLUSION: In Egyptian children, delayed language development is severely affected by the interaction of medical, social and nutritional factors. Providing adequate maternal health care during pregnancy and childbirth, regular developmental monitoring at each child visit, and screening for such risk factors, can reduce size of the problem and promote child’s social and psychological development

The Hep-CORE policy score: A European hepatitis C national policy implementation ranking based on patient organization data.

BACKGROUND: New hepatitis C virus (HCV) treatments spurred the World Health Organization (WHO) in 2016 to adopt a strategy to eliminate HCV as a public health threat by 2030. To achieve this, key policies must be implemented. In the absence of monitoring mechanisms, this study aims to assess the extent of policy implementation from the perspective of liver patient groups. METHODS: Thirty liver patient organisations, each representing a country, were surveyed in October 2018 to assess implementation of HCV policies in practice. Respondents received two sets of questions based on: 1) WHO recommendations; and 2) validated data sources verifying an existing policy in their country. Academic experts selected key variables from each set for inclusion into policy scores. The similarity scores were calculated for each set with a multiple joint correspondence analysis. Proxy reference countries were included as the baseline to contextualize results. We extracted scores for each country and standardized them from 0 to 10 (best). RESULTS: Twenty-five countries responded. For the score based on WHO recommendations, Bulgaria had the lowest score whereas five countries (Cyprus, Netherlands, Portugal, Slovenia, and Sweden) had the highest scores. For the verified policy score, a two-dimensional solution was identified; first dimension scores pertained to whether verified policies were in place and second dimension scores pertained to the proportion of verified policies in-place that were implemented. Spain, UK, and Sweden had high scores for both dimensions. CONCLUSIONS: Patient groups reported that the European region is not on track to meet WHO 2030 HCV goals. More action should be taken to implement and monitor HCV policies

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe