Do public health services in Egypt help young married women exercise their reproductive rights?

AbstractObjectiveTo assess supply and demand of family planning services from a reproductive rights perspective among young married women (YMW) in Egypt.MethodsData sources related to family planning included structured interviews with service providers (n=216); an inventory of equipment and supplies (n=40); exit interviews with YMW (n=147); and focus group discussions (n=12) with YMW, husbands, and mothers and/or mothers in law. YMW, husbands and mothers in law were not necessarily related.ResultsAlthough family planning services were readily available and affordable, YMW had limited access to information and services. Shortfalls were noted regarding respect for privacy, choice of family planning method, access to fertility services, and premarital counseling. Few YMW had sufficient autonomy to make informed reproductive decisions. Effective accountability mechanisms and processes for redress were also lacking.ConclusionImplementation of a rights-based approach and structural changes to family planning service delivery are recommended to empower YMW in Egypt to demand and exercise their reproductive rights

Breaking the silence: Learning about youth sexual and reproductive health in Egypt [Arabic]

This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the stage for the enormous work ahead in meeting young people’s needs for reliable sexual and reproductive health information and youth-friendly health services. It aims to shed light on these intimate and sensitive topics, encourage scientific debates, and highlight means of improving the sexual and reproductive health of young people in Egypt

The impact of metabolic syndrome on the clinical profile and tumor characteristics of endometrial carcinoma

Background: The objective is to study the influence of different components of metabolic syndrome on clinical behavior and tumor characteristics of endometrial cancer cases and to evaluate if metformin usage affects the stage and grade of endometrial cancer.Methods: 60 women attending the gynecological oncology clinic at El Shatby Maternity University Hospital, after being diagnosed as endometrial carcinoma, were recruited in the study. Serum samples were collected to detect insulin level and lipid profile, and then allocated into two groups according to metabolic syndrome existence. After the recommended surgery, and the routine histopathological diagnosis followed by histopathological chemilumeniscence technique to detect staining intensity, percentage of estrogen receptors ER, and score out of 8 according to Allred score.Results: Endometrial cancer EC patients with metabolic syndrome had a significantly higher age, higher FIGO stages, and higher grade compared to EC without metabolic syndrome (p˂0.05). There was no statically significant difference between both groups in estrogen receptors scoring. HDL was an important factor affecting grade of EC patients, as when HDL decreased by one mg/dl, the grade increased by 0.033% (P=0.030, OR=0.899, OR adjusted=0.826), Insulin level was found to be an important factor affecting stage as when insulin level increased by one Uiu/ml, the stage increased by1.091% (p=<0.001, OR=1.064, OR adjusted=1.091).Conclusions: Hyperinsulinemia was the most important factor affecting aggressiveness of the tumor as regards stage and risk group classification. Metformin failed to show a protective effect against endometrial cancer progression

Breaking the silence: Learning about youth sexual and reproductive health in Egypt

This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the stage for the enormous work ahead in meeting young people’s needs for reliable sexual and reproductive health information and youth-friendly health services. It aims to shed light on these intimate and sensitive topics, encourage scientific debates, and highlight means of improving the sexual and reproductive health of young people in Egypt

Sero-prevalence and risk factors associated with toxoplasma gondii infection among pregnant women in Alexandria, Egypt

Background: Toxoplasma gondii infection during pregnancy can result in fetal death, neonatal death or various congenital defects. This study aimed to estimate the seroprevalence of toxoplasma gondii infection using two different diagnostic tests, Enzyme-Linked Immunosorbent Assay (ELISA) versus Immunochromatographic assay (ICA) and to study the potential risk factors for acquiring infection in pregnant women attending antenatal care clinics in Alexandria, Egypt.Methods: A cross sectional study, conducted between May 2015 and June 2016. The study was done in antenatal care centers of most districts of Alexandria Governorate, Egypt. 382 pregnant women, of a gestational age between 8-40 weeks were included in the study and were given pretested structured questionnaire to assess risk factors, which included: demographic, socio-economic data, kitchen hygiene and behavioral variables. Blood samples were taken and sera were divided into two parts; the first part was examined for anti-T.gondii IgG and IgM antibodies using rapid diagnostic test RDT kit, the other part tested by ELISA.Results: The overall seroprevalence of T.gondii infection was (11.3%) detected by RDT, significantly increased to (57.9%) by ELISA test (X2= 5.3; p=0.001). RDT had the sensitivity of (15.8%), the specificity of (95%), PPV of (81.4%), NPV of (45.1%), with overall diagnostic efficiency of (49.2%). The association between T.gondii infection and the age of the pregnant women was found to be statistically significant (OR=2.84, 95%CI=1.251-6.455).Conclusions: The present study has documented a bad diagnostic performance of RDT in detection T.gondii in serum samples of infected pregnant women as compared to ELISA technique. Age is the only risk factor to be associated statistically with toxoplasma gondii infection

Serum IL 6 and umbilical artery Doppler indices in pre-eclamptic patients

Objectives: To study the changes in serum IL 6 levels in pre-eclamptic patients and to detect any correlation between these changes and changes in the umbilical artery Doppler velocimetry. Methods: In Shatby Hospital, 100 pregnant women, at or beyond 32 weeks were selected and divided into three groups: group A with severe pre-eclampsia, group B with mild pre-eclampsia, and group C with normal pregnancy as control. Measurement of maternal serum IL 6 using ELISA and umbilical artery Doppler velocimetry was done. Kruskal–Wallis, Mann–Whitney U tests, and Spearman’s rank correlation tests were used. Results: A statistical significant difference (p < 0.001) was found regarding serum IL-6 level. Using ROC curve for IL 6 levels, it is suggested that IL 6 of 0.82 ng/dl is a cutoff level to early diagnose mild pre-eclampsia (with sensitivity 87.5% and specificity 100%). A statistical significant correlation was found between maternal serum IL 6 levels and S/D ratio and RI in severe pre-eclamptic group (p < 0.05). Conclusion: Maternal serum IL 6 > 0.82 ng/dl can be implicated as an early laboratory diagnosis of mild pre-eclampsia. The significant correlation between maternal serum IL 6 levels and Doppler velocimetry supports both the immunologic and the systemic endothelial dysfunction theories of pre-eclampsia

The impact of metabolic syndrome on the clinical profile and tumor characteristics of endometrial carcinoma

Background: The objective is to study the influence of different components of metabolic syndrome on clinical behavior and tumor characteristics of endometrial cancer cases and to evaluate if metformin usage affects the stage and grade of endometrial cancer.Methods: 60 women attending the gynecological oncology clinic at El Shatby Maternity University Hospital, after being diagnosed as endometrial carcinoma, were recruited in the study. Serum samples were collected to detect insulin level and lipid profile, and then allocated into two groups according to metabolic syndrome existence. After the recommended surgery, and the routine histopathological diagnosis followed by histopathological chemilumeniscence technique to detect staining intensity, percentage of estrogen receptors ER, and score out of 8 according to Allred score.Results: Endometrial cancer EC patients with metabolic syndrome had a significantly higher age, higher FIGO stages, and higher grade compared to EC without metabolic syndrome (p˂0.05). There was no statically significant difference between both groups in estrogen receptors scoring. HDL was an important factor affecting grade of EC patients, as when HDL decreased by one mg/dl, the grade increased by 0.033% (P=0.030, OR=0.899, OR adjusted=0.826), Insulin level was found to be an important factor affecting stage as when insulin level increased by one Uiu/ml, the stage increased by1.091% (p=&lt;0.001, OR=1.064, OR adjusted=1.091).Conclusions: Hyperinsulinemia was the most important factor affecting aggressiveness of the tumor as regards stage and risk group classification. Metformin failed to show a protective effect against endometrial cancer progression

Sero-prevalence and risk factors associated with toxoplasma gondii infection among pregnant women in Alexandria, Egypt

Background: Toxoplasma gondii infection during pregnancy can result in fetal death, neonatal death or various congenital defects. This study aimed to estimate the seroprevalence of toxoplasma gondii infection using two different diagnostic tests, Enzyme-Linked Immunosorbent Assay (ELISA) versus Immunochromatographic assay (ICA) and to study the potential risk factors for acquiring infection in pregnant women attending antenatal care clinics in Alexandria, Egypt.Methods: A cross sectional study, conducted between May 2015 and June 2016. The study was done in antenatal care centers of most districts of Alexandria Governorate, Egypt. 382 pregnant women, of a gestational age between 8-40 weeks were included in the study and were given pretested structured questionnaire to assess risk factors, which included: demographic, socio-economic data, kitchen hygiene and behavioral variables. Blood samples were taken and sera were divided into two parts; the first part was examined for anti-T.gondii IgG and IgM antibodies using rapid diagnostic test RDT kit, the other part tested by ELISA.Results: The overall seroprevalence of T.gondii infection was (11.3%) detected by RDT, significantly increased to (57.9%) by ELISA test (X2= 5.3; p=0.001). RDT had the sensitivity of (15.8%), the specificity of (95%), PPV of (81.4%), NPV of (45.1%), with overall diagnostic efficiency of (49.2%). The association between T.gondii infection and the age of the pregnant women was found to be statistically significant (OR=2.84, 95%CI=1.251-6.455).Conclusions: The present study has documented a bad diagnostic performance of RDT in detection T.gondii in serum samples of infected pregnant women as compared to ELISA technique. Age is the only risk factor to be associated statistically with toxoplasma gondii infection