Association between blood lead levels and environmental exposure among Saudi schoolchildren in certain districts of Al-Madinah

Mohammed Adnan Zolaly1, Manal Ibrahim Hanafi2,3, Nashaat Shawky4, Khalid el-Harbi1, Ahmed M Mohamadin5,61Pediatric Department, 2Family and Community Medicine Department, Medical College, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia; 3Community Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 4Ophthalmology Department, Medical College, 5Chemistry for Health Sciences Department, Deanery of Academic Services, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia; 6Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Cairo, EgyptIntroduction: Both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries. When humans are exposed to high levels of lead, there is damage to almost all organs and organ systems (most importantly, the central nervous system, kidneys, and blood), which often culminates in death.Objective: To estimate the prevalence of blood lead levels (BLLs) and to identify the sources of environmental exposure and potential risk factors for elevated BLLs among Saudi schoolchildren.Methods: A cross-sectional survey was conducted from March to May 2010. The study population included 557 Saudi school students of both sexes. A multistage random sampling technique was used. Information about socioeconomic status, house and school construction, and parents' education and employment was collected using questionnaires. Lead was analyzed in a blood sample using an atomic absorption technique and hemoglobin was measured using a Sysmex hematological analyzer.Results: The mean BLL was 4.94 ± 3.38 µg/dL (range 0.45–26.3 µg/dL). A total of 19% had BLLs <1.0 µg/dL, 16% had BLLs <2.5 µg/dL, 15% had BLLs <5.0 µg/dL, 20% had BLLs <7.5 µg/dL, 25% had BLLs <10.0 µg/dL, and about 6% had BLLs >10.0 µg/dL. Analysis of odds by controlling all risk factors (adjusted odds ratio [OR]) that affect BLLs (≥10 µg/dL) indicated that using cosmetics (OR = 18.5, confidence interval [CI] = 14.4–19.8), putting colored toys in mouth (OR = 15.7, CI = 3.6–16.2), eating canned food (OR = 9.8, CI = 7.0–10.1), and using newspaper during food preparation (OR = 7.6, CI = 6.3–8.2) are risk factors. There were significant correlations between BLLs and family habits (r = 0.225, P = 0.000), personal habits (r = 0.321, P = 0.000), eating habits (r = 0.128, P = 0.002) and school building characteristics (r = 0.469, P = 0.000). There was a significant correlation between BLLs and anemia in age group 6 < 12 years (P = 0.000) and age group 12 to less than 18 years, among males (P = 0.000) and females (P = 0.041).Conclusion: The BLLs of children are affected by multiple factors. Female students have higher BLLs and lower hemoglobin concentration than males. The possible sources of lead exposure were use of toothpaste, use of kohl, putting colored toys in the mouth, use of both canned food and canned juice, use of lip gloss in females, and different methods of handling newspaper while preparing food.Keywords: blood, lead, exposure, cosmetics, schoolchildren, anemi

Effect of female genital mutilation on female sexual function, Alexandria, Egypt

Background: The global prevalence of female genital mutilation (FGM) ranges from 0.6% up to 98%. It has many health psychological impacts including abnormalities of female sexual function. Objectives: To study female genital mutilation and its effect on female sexual function, Alexandria, Egypt 2013. Methods: A case–control study was conducted on a convenient sample of 272 circumcised women with their 272 control from 4 randomly selected primary health care centers. Specially designed format (including data about socio-demographic characters, gynecological obstetric histories, and FGM act) and female sexual function index (a 19-item self-reported questionnaire for assessing the key dimensions of female sexual function) were used. Bivariate analysis was conducted to test significant differences between cases and control. Results: 73.9% of cases experienced dysmenorrhea (OR = 3.750), 43.4% had obstructed labor (OR = 1.745) and 27.6% got postpartum hemorrhage (OR = 2.855). 48.9% of FGM was performed by dayas or midwives, 91.2% performed at home, 49.6% of type I, and 87.9% experienced complications. Cases had lower mean sexual function. 52.6% of cases were convinced with FGM. Conclusion: FGM was a risk factor for dysmenorrhea, obstructed labor and postpartum hemorrhage. Cases had lower mean sexual function; moreover, half of them convinced with FGM practice and with its continuation

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically