High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Detection of Campylobacter in Chicken Parts by Conventional Methods and Polymerase Chain Reaction with Identification of Antibiotic Resistance Profile73814925810.21608/jhiph.2019.49258ENNajah R.El-WadaweDepartment of Microbiology, High Institute of Public Health, Alexandria University, EgyptEman A.OmranDepartment of Microbiology, High Institute of Public Health, Alexandria University, EgyptWalaa A.HazzahDepartment of Microbiology, High Institute of Public Health, Alexandria University, EgyptWafaa M.K.BakrDepartment of Microbiology, High Institute of Public Health, Alexandria University, EgyptJournal Article20190923<strong>Background & Objective(s): </strong>Campylobacteriosis is a zoonotic, food-borne bacterial disease caused by Campylobacter spp. The most common pathogenic species are Campylobacter jejuni (C. jejuni) and C. coli. Multiple reservoirs harbor Campylobacter but chicken are considered the most common. Different chicken parts can harbour Campylobacter, particularly the intestine while chicken breasts usually have minimal counts. Antibiotics are used as feed as well as for therapeutic purposes in animals, and thus antimicrobial resistance of some Campylobacter isolates to common antibiotics is an issue of public health importance. The aim of this study was to detect C. jejuni and C. coli in chicken using conventional methods (culture followed by biochemical tests) and PCR, with identification of antimicrobial resistance of isolates.
<strong>Methods:</strong> In the present study, Campylobacter was isolated from 100 different chicken parts (thigh, neck, intestine and wings) collected from 40 different chickens. Culture on charcoal cefoperazone deoxycholate agar (CCDA) was followed by biochemical confirmation of Campylobacter spp then by matrix-associated laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). Simultaneously, DNA of Campylobacter was detected from chicken broth by multiplex polymerase chain reaction (PCR). Both conventional and PCR methods were compared. Campylobacter colony count was determined for different chicken parts, and the antimicrobial resistance of isolates was identified.
<strong>Results: </strong>Out of the 100 examined chicken samples, 79 were presumptively positive on CCDA while only 15 isolates were MALDI-TOF confirmed (18.98%). All samples had Campylobacter counts exceeding 104 cfu/g. Colony counts ≥105 cfu/gm were encountered in 77.7% of PCR positive samples. Multiplex PCR had low sensitivity (60%) for detection of Campylobacter in chicken broth compared to confirmed cultures. Despite this drawback, PCR was advantageous over culture in detecting samples with mixed Campylobacter species. The intestine had the highest frequency (27.5%) of Campylobacter, with 72.7% of its samples yielding ≥105 cfu/g. C. jejuni responded better to erythromycin, ciprofloxacin and chloramphenicol (susceptibility= 100%, 80% and 80% respectively) while C. coli had a poorer susceptibility profile. Tetracycline and nalidixic acid had a poor antibacterial effect on both C. jejuni and C. coli.
<strong>Conclusion:</strong> The distribution of Campylobacter species varied according to chicken part, with the intestine having the highest counts. All chicken samples had Campylobacter counts more than 10 4 cfu/g. PCR had 60% sensitivity compared to culture, but was more superior in detecting mixed cultures. C. jejuni was more sensitive to erythromycin, ciprofloxacin and chloramphenicol antibiotics than C. coli.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Behavioral and Emotional Problems among Adolescent Students82894925910.21608/jhiph.2019.49259ENSafaa R.OsmanDepartment of Community Health Nursing, Faculty of Nursing, Assiut University, EgyptShaimaa A.KhalafDepartment of Community Health Nursing, Faculty of Nursing, Assiut University, EgyptMontaser S.OmarDepartment of Educational Psychology, Faculty of Education, Assiut University, EgyptTaghreed A.IsmailDepartment of Public Health and Community Medicine, Faculty of Medicine, Assiut University, EgyptJournal Article20190923<strong>Background & Objective(s): </strong>Emotional and behavioral problems among adolescents represent a considerable public health problem in developing countries. These problems are considered a source of stress for adolescents as well as their families, schools and community. Emotional health and well-being of young people have implications on their self-esteem, behavior, school attendance, educational achievement, social cohesion and future health and life chances. To estimate the prevalence of emotional and behavioral problems and to determine the association between these problems and socio-demographic variables among adolescent students in Assiut district.
<strong>Methods:</strong> A cross sectional study was conducted in randomly selected secondary schools (2 urban and 2 rural) in Assiut district, and 400 students were included in the study. Self-administered questionnaires were used to collect study data which included: personal data, socioeconomic status scale and self-reported version of Strengths and Difficulties Questionnaire (SDQ) (Arabic version) which included 25 items divided into 5 subscales (conduct problems, hyperactivity, emotional symptoms, peer problems and prosocial behavior)
<strong>Results: </strong>About 45 % of adolescents were identified with emotional and/or behavioral problems using the SDQ. These problems included conduct, emotional, peer problems, prosocial and hyperactivity difficulties (36.0%, 42.3%, 5.0%, 28.5% and 24.8% respectively). Emotional difficulties were significantly higher (p value= 0.02) among females (40.4%), while conduct difficulties were more prevalent among males (47.5%). The majority of students with emotional/ behavioral problems (90%) reported high negative impact of such problems that was significantly associated with female sex, rural residents, students of low socioeconomic level and whose mothers were housewives.
<strong>Conclusion:</strong> Screening secondary school adolescents in Assiut district revealed high prevalence of emotional and behavioral problems that was associated with perceived enormous negative impact. Further studies and intervention programs are greatly needed to address adolescent mental health needs.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Effect of an Educational Program on Food Safety Practices in Food Preparation and Handling Procedures in Governmental Hospitals of an Egyptian Governorate90964926110.21608/jhiph.2019.49261ENIman H.WahdanDepartment of Epidemiology, High Institute of Public Health, Alexandria University, EgyptZahira M.GadDepartment of Epidemiology, High Institute of Public Health, Alexandria University, EgyptIhab M.HabibDepartment of Nutrition, High Institute of Public Health, Alexandria University, Egypt.Osama A.ElshazlyVeterinarian, Ministry of Health and Population, Gharbia Governorate, EgyptJournal Article20190923<strong>Background & Objective(s): </strong>In hospitals, food borne diseases could be prevented if appropriate food safety measures are applied during food handling. The study aims to assess the food safety practices of food handlers in governmental hospitals of Gharbia Governorate and to design, implement and evaluate the effect of an intervention program on these practices. <br /> <strong>Methods:</strong> The study was conducted in all Ministry of Health and Population hospitals of Gharbia Governorate (n=17) among all food handlers (n=161) using a one group pre-test post-test intervention approach. Data were collected using an interviewing questionnaire and an observation checklist. A health education program was designed and implemented then practices of food handlers were reassessed using the same study tools.<br /> <strong>Results: </strong>Food handlers with scientific background related to nutrition and those working in general hospitals had higher significant odds of food handler practice score than relevant categories. Mutivariate logistic regression analysis shows that hospital type and scientific background were significant predictors for food hygiene practices score. Food handlers had more good and fair levels of practices post-intervention compared to pre-intervention. There were significant differences between both pre and post intervention practice scores.<br /> <strong>Conclusion:</strong> There is a significant effect of the intervention program on food safety practices of food handlers.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Impact of a Mass Media Campaign on Adults’ Knowledge and Attitudes towards Antibiotic Use971054926610.21608/jhiph.2019.49266ENNessrin A.El-NimrDepartment of Epidemiology, High Institute of Public Health, Alexandria University, Egypt0000-0003-1976-4847Hussien A.ElaswdiDepartment of Epidemiology and Community Medicine, Faculty of Medicine, University of Misurata, LibyaMohamed D.El-BorgyDepartment of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, EgyptSunny A.SallamDepartment of Epidemiology, High Institute of Public Health, Alexandria University, EgyptJournal Article20190923<strong>Background & Objective(s): </strong>Self-medication with antibiotics is a worldwide problem and a major driver of the emergence of antimicrobial resistance. The objectives were to estimate the frequency, describe pattern and identify possible determinants of self-medication with antibiotics among adults in Misurata and to evaluate the impact of a mass media campaign on their knowledge and attitude regarding self-medication with antibiotics.<br /> <strong>Methods:</strong> In the 1st phase, a cross sectional design was used and 277 adults accompanying patients attending the outpatient clinics of Misurata Central Hospital were interviewed using a predesigned structured questionnaire. Data about pattern of antibiotic use, knowledge and attitude was collected. In the 2nd phase, an intervention design (one group pretest post-test design) was used. A two months mass media campaign in the form of a radio program (one episode/week for eight weeks), a TV episode and written articles in Misurata University magazine about the correct use of antibiotics was launched and its effect was assessed after three months.<br /> <strong>Results: </strong>Among adults using antibiotics, 39.5% used it as self-medication. Several defects in the pattern of antibiotic use was noticed including the duration of use, indication, and course completion. Almost two thirds had poor knowledge about antibiotics, while the majority had neutral or positive attitudes. The mean knowledge and attitude scores regarding antibiotics had significantly increased after the mass media campaign (from 9.03± 3.02 to 18.1± 4.21 and from 23.17± 5.11 to 25.81± 4.83, respectively).<br /> <strong>Conclusion:</strong> The study highlighted the extent of inappropriate use of antibiotics and the potential effectiveness of using mass media campaigns in raising the public awareness about antibiotics.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Evaluation of Topical Antiseptics against Biofilm Formation of Staphylococcus Aureus and Pseudomonas Aeruginosa in Chronic Suppurative Otitis Media1061104926810.21608/jhiph.2019.49268ENEman A.OmranDepartment of Microbiology, High Institute of Public Health, Alexandria University, EgyptAmira E.K.AmineDepartment of Microbiology, High Institute of Public Health, Alexandria University, Egypt0000-0001-8260-0111Journal Article20190923<strong>Background & Objective(s): </strong>Chronic suppurative otitis media (CSOM) is a common chronic disease that is often difficult to treat. Biofilms have been demonstrated in bacteria causing CSOM infections contributing to its pathogenesis and resistance to treatment. Antiseptics have a nonspecific mode of action and this gives them the advantage of a broader spectrum of antibacterial activity and a lesser risk of resistance The present study aimed to compare the effect of three antiseptics; 4%boric acid, Lugol’s iodine and tetrasodium ethylenediaminetetraacetic acid t(EDTA) solutions against <em>Staphylococcus aureus</em> (<em>S. aureus</em>) and <em>Pseudomonas aeruginosa (P. aeruginosa)</em> and their biofilm forming ability.<br /> <strong>Methods:</strong> Bactericidal effect of antiseptics was examined using disk diffusion method on Müeller Hinton agar plates and the effect on biofilm formation was examined using biofilm-oriented antiseptics test.<br /> <strong>Results: </strong>The best antiseptic agent for planktonic cells of both bacterial species was Lugol’s iodine (mean±SD= 2.00±0.68), followed by tEDTA (mean±SD= 1.48±0.62) then boric acid (mean±SD= 0.20±0.47).The tested antiseptics had very close results when measuring the mean inhibition zones of S. aureus and <em>P. aeruginosa</em> isolates. All tested antiseptics reduced biofilm formation, but tEDTA was the most effective antiseptic in reducing the biofilm formation compared to Lugol’s iodine and boric acid (Mean OD= 0.055±0.012 <em>versus</em> 0.145±0.137 and 0.122±0.071 respectively, <em>p</em>< 0.001).<br /> <strong>Conclusion:</strong> Lugol’s iodine had a better bactericidal effect on isolates, while tEDTA had a better effect on biofilm formation. Further in vivo studies are needed regarding both their efficacy and ototoxic effects to assess their possible use as local treatment of CSOM patients.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Smoking Attributable Inpatient Healthcare Expenditure among Adults in Alexandria, Egypt1111164927010.21608/jhiph.2019.49270ENNessrin A.El-NimrDepartment of Epidemiology, High Institute of Public Health, Alexandria University, Egypt0000-0003-1976-4847Ashraf M.WahdanDepartment of Biostatistics, High Institute of Public Health, Alexandria University, EgyptIman M.WahdanDepartment of Epidemiology, High Institute of Public Health, Alexandria University, Egypt0000-0002-6624-0491Journal Article20190923<strong>Background & Objective(s): </strong>The growing burden of non-communicable diseases (NCDs) in developing countries has highlighted the importance of monitoring the economic cost of tobacco use. The aim of this work was to calculate the inpatient smoking-attributable health care expenditure (SAE) for cardiovascular diseases (CVDs) and chronic respiratory diseases (CRDs) among adults in Alexandria, Egypt.
<strong>Methods:</strong> A household survey was carried out in Alexandria, Egypt and included 1354 adults. To estimate one of the direct healthcare costs of smoking, namely the inpatient costs of treating smoking-related CVDs and CRDs, a predesigned structured interviewing questionnaire was used to collect data on smoking status, history of CVDs and CRDs, number of inpatient admissions and expenditure per inpatient hospitalization. Estimation of the SAE for CVDs and CRDs among ever smokers in Alexandria was carried out based on the World Health Organization (WHO) economics of tobacco toolkit.
<strong>Results: </strong>About 56% of adults were ever smokers. Ever smokers had 7.7 and 2.015 times more risk for CVDs and CRDs compared to never smokers. About 79% of CVDs and 36% of CRDs among ever smokers were attributed to smoking. The SAE on inpatient care for CVDs and CRDs among ever smokers in Alexandria was equivalent to US$ 257 million and 10.256 million annually, respectively.
<strong>Conclusion:</strong> The cost of inpatient SAE for CVDs and CRDs is enormous. Tobacco control is a very important element in achieving sustainable development goals. <strong> </strong>High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Perinatal Outcomes of Maternal Anemia in Alexandria, Egypt1171244927110.21608/jhiph.2019.49271ENNadia ElzeinyCommunity Medicine Department, Faculty of Medicine, Alexandria University, EgyptEman A.SultanCommunity Medicine Department, Faculty of Medicine, University of Alexandria, Egypt0000-0002-9801-0607Hend Y.ShetyaResident of Family Medicine, Ministry of Health, EgyptJournal Article20190923<strong>Background & Objective(s): </strong>Anaemia is considered the most frequent complication related to pregnancy. It is also the most common preventable cause of fetal and maternal mortality and morbidity. Despite the routine use of iron and folate supplementation for prevention of anaemia in Egypt, the prevalence of anaemia is still high This study was conducted to estimate the occurrence of anaemia and investigate the relationship between maternal anaemia and perinatal outcomes at Karmouz Family Health Unit in Alexandria.
<strong>Methods:</strong> The study involved 206 pregnant women in third trimester. It was conducted on two phases: First, a cross sectional study using an interviewing questionnaire to collect data about sociodemographic profile and drug history. Laboratory data was collected from records to estimate the occurrence of anaemia. Then, a prospective cohort study was carried out using a follow up sheet to assess perinatal outcomes of maternal anaemia.
<strong>Results: </strong>The results of our study show that the occurrence of anaemia among studied pregnant women was high (73.8%). Most of the women who did not regularly receive iron supplementation were anaemic. Maternal anaemia was shown to be significantly associated with preterm labor, low birth weight, congenital anomalies, small head sized babies and neonatal intensive care admission. Moreover, hemorrhage and infection were significantly encountered maternal complications.
<strong>Conclusion:</strong> Irregular intake of iron supplementation during pregnancy was significantly associated with anaemia. Moreover, maternal anaemia was significantly related to maternal and neonatal complications.High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060149220190801Prevalence, Indications and Determinants of Caesarean Delivery in Alexandria, Egypt1251324927210.21608/jhiph.2019.49272ENEman I.MobarakCommunity Medicine Department, Faculty of Medicine, Alexandria University, EgyptEman A.SultanCommunity Medicine Department, Faculty of Medicine, Alexandria University, Egypt0000-0002-9801-0607Journal Article20190923<strong>Background: </strong>Prevalence of Caesarean delivery (CD) is increasing worldwide including Egypt. Alexandria is one of the governorates recording the highest rates in Egypt. Identifying factors associated with CD is important to plan for reduction.<br /> <strong>Objective</strong>: To identify prevalence, indications and determinants of CD in Alexandria, Egypt.<br /> <strong>Methods:</strong> This cross sectional survey was carried out in Alexandria, Egypt between July and December 2017. Target population was ever-married fertile women aged 15-49 years. Only women having at least one child aged ≤ 5 years were included. Using the cluster sample survey, 900 eligible women were selected and subjected to an interview questionnaire for data collection. It included socio-demographic data, habits, reproductive history and medical profile.<br /> <strong>Results: </strong>Prevalence of CD in Alexandria (2017) was 70.4%. The reported leading causes for CD were previous CD (34.9%) and women request (12.1%). The significant socio-demographic factors associated with CD included educational level (<em>p</em>< 0.000) and residence (OR=2). Biomedical variables involved previous abortion (<em>p</em>= 0.005), previous complicated pregnancy (OR=1.6), frequent antenatal visits (OR=1.8), pre-/eclampsia (OR=1.8), previous CD (OR=2.2), assisted reproduction (OR=2.2), delivery age ≥35 (OR=2.2), preceding birth interval ≤ 2 (OR=2.2), parity ≥5 (OR=2.5), preterm labour (OR=2.6), delivery in private sector (OR=2.7), and multiple pregnancy (OR=5.7).<br /> <strong>Conclusion:</strong> The rate of CD in Alexandria is high. Predictors of CD are high parity, pre-/eclampsia, previous CD, short preceding birth interval, higher education, urban residence, frequent antenatal visits, and delivery in private sector. The study recommends women health education and developing guidelines with medical audit of CD practice.