Rural Egypt Research Articles

Changing Incidence of Uterine Cancer in Rural Egypt: Possible Impact of Nutritional and Epidemiologic Transitions.

PURPOSEUterine cancer is a top-ranking women’s cancer worldwide, with wide incidence variations across countries and by rural and urban areas. Hormonal exposures and access to health care vary between rural and urban areas, globally. Egypt has an overall low incidence of uterine cancer but variable rural and urban lifestyles. Are there changes in the incidence of uterine cancer in rural and urban areas in middle-income countries such as Egypt? No previous studies have addressed this question from a well-characterized and validated population-based cancer registry resource in middle-income countries. The aim of this study was to explore the differences in clinical and demographic characteristics of uterine cancer over the period of 1999 to 2010 in rural and urban Gharbiah province, Egypt.METHODSData were abstracted for all 660 patients with uterine cancer included in the Gharbiah Population-based Cancer Registry. Clinical variables included tumor location, histopathologic diagnosis, stage, grade, and treatment. Demographic variables included age, rural or urban residence, parity, and occupation. Crude and age-adjusted incidence rates (IRs) and rate ratios by rural or urban residence were calculated.RESULTSNo significant differences were observed in most clinical and demographic characteristics between rural and urban patients. The age standardized IR (ASR) was 2.5 times higher in urban than in rural areas (6.9 and 2.8 per 100,000 in urban and rural areas, respectively). The rate ratio showed that the IR in urban areas was 2.46 times the rate in rural areas.CONCLUSIONThis study showed that the disease IR in rural areas has increased in the past decade but is still low compared with the incidence in urban areas in Egypt, which did not show a significant increase in incidence. Nutritional transitions, obesity, and epidemiologic and lifestyle changes toward Westernization may have led to IRs increasing more in rural than in urban areas in Egypt. This pattern of increasing incidence in Egypt, which used to have a low incidence of uterine cancer, may appear in other middle-income countries that experience emerging nutritional and epidemiologic transitions. The rate of uterine cancer in urban areas in Gharbiah is almost similar to the corresponding rates globally. However, the rate in rural areas in this population has increased over the past decade but is still lower than the corresponding global rates. Future studies should examine the etiologic factors related to increasing rates in rural areas and quantify the improvement in rural case finding.

COMPARATIVE ECONOMIC STUDY OF CONSUMPTIVE EXPENDITURE ON FRUIT IN EGYPT

fruit's groups are considered one of the main food groups due to the numerous benefits for human health. The current research seeks to find answers regarding the impacts of changes in the prices and per capita income on Egyptian consumers. Accordingly, the research aims to study the main factors affecting expenditure on fruit's groups and measuring elasticities of expenditure on fruit's groups to assess its importance to consumers. Results showed that annual per capita expenditure on fruit's groups accounted for 6.8% and 6.4% of the average annual expenditure on food and drinks at the country level in 2010/2011 and 2014/2015, respectively. Results also showed variances in average per capita expenditure on fruit's group between expenditure categories. It was also found that per capita average expenditure on fruit's groups' group declines as family size increases, where variances exist between different family sizes in terms of per capita average expenditure on fruit's groups. In addition, results showed clear variances between expenditure on fruit's groups by household heads with different levels of education in rural Egypt compared to urban Egypt during 2010/2011 and 2014/2015. It was found that differences in per capita average share of expenditure on fruit's groups group decline as household head's economic activity differs, and as area of residence of household head differs (rural and urban). Results indicated variances between expenditure on fruits' group in urban and rural Egypt as household head's level of education differs, and that per capita expenditure on fruit's group greatly changed between 2010/2011 and 2014/2015 according to household head's occupation. Finally, estimating elasticities of expenditure on fruits indicated that they are semi-necessary goods at the level of urban and rural Egypt in 2014/2015, while proved necessary goods in rural Egypt during 2010/2011. In the light of the achieved results, the research recommended dedicating more support to education, encouraging foreign investment to create job opportunities for the unemployed and to raise the standard of living for society individuals, and promoting media programs that aim to raiseawareness about the health benefits of eating proper quantities of fruits per day, especially in rural Egypt.

Prevalence and correlates of bullying and victimization among school students in rural Egypt

ObjectivesKnowledge on risk factors of bullying and victimization among school students is crucial for the implementation of preventive measures. This study was conducted to determine the prevalence and correlates of school bullying and victimization and their association with behavioral disorders among preparatory and secondary school students in rural Egypt.Study designCross-sectionalMethodsA total of 476 students from two mixed public schools in rural Egypt (one preparatory and one secondary) were enrolled. A pretested self-administered questionnaire was used to collect sociodemographic characteristics and correlates of bullying and victimization including personal and social, family, school, and community factors. Frequency of bullying and victimization was measured using the short version aggression and victimization scale. The Strengths and Difficulties Questionnaire (SDQ) was used for screening behavioral problems.ResultsPrevalence of bullying behavior was high (77.8%) among the studied group, of those 9.5% were unique bullies, 10.5% were unique victims, and 57.8% were bully-victims. On multivariate logistic regression analysis, failure in previous scholastic years (OR = 11.1, 95% CI 1.1–101.4, P = 0.033), witnessing family members using weapons (OR = 6.1, 95% CI 1.1–34.0, P = 0.038), male gender (OR = 2.3, 95% CI 1.1–5.0, P = 0.027), and mothers’ education (university or higher) (OR = 0.1, 95% CI 0.02–0.7, P = 0.017) remained the significant predictors for bullying. However, only having a drug addict friend (OR 2.5, 95% CI 1.1–5.4, P = 0.025) was the significant predictor for victimization. The independent predictors for being bully-victims in order of importance were exposure to physical violence in the street (OR = 5.1, 95% CI 1.2–22.7, P = 0.031), male gender (OR = 3.2, 95% CI 1.8–5.6, P < 0.001), witnessing fights (OR = 3.1, 95% CI 1.7–5.7, P < 0.001) and insulting words (OR = 2.5, 95% CI 1.3–4.7, P = 0.007) among family members, exposure to insulting words in the street (OR = 2.1, 95% CI 1.2–3.7, P = 0.010), watching violent movies (OR = 2.0, 95% CI 1.2–3.4, P = 0.008), and younger age (OR = 0.7, 95% CI 0.6–0.8, P < 0.001).The self-reported SDQ revealed that the conduct problems scale scored significantly higher among bully-victims (2.8 ± 1.7 vs. 2.3 ± 1.6, P = 0.004).ConclusionsPrevalence of bullying behavior was high among rural adolescent school students. Establishment of a bullying prevention committee at school including all school personnel for addressing different factors associated with bullying behavior is recommended. Further follow-up and psychiatric assessment of students for predicting those prone to behavioral abnormalities are also recommended.

LIFE QUALITY AND ITS RELATIONSHIP WITH FERTILITY OF EGYPTIAN WOMEN IN THE VIEW OF PSYCHOLOGICAL FACTORS FIELD STUDY ON DIFFERENT SOCIAL PLACES

The purpose of this study is to determine the relationship between female fertility and certain variables in rural and urban areas. The aim of this study is to determine the differences between rural and urban on the health status of women. This study belongs to the pattern of descriptive studies in order to measure the relationship between two variables, A dependent variable is the fertility of women in the light of some psychological factors. The present study is based on the following methods: a quality of life measure by the researcher, a measure of psychological factors affecting the fertility of women by the researcher. The sample of the study was in a simple random sample. The sample size was in the Upper Upper Egypt (128) and the Upper Egypt (152). A simple random sample (119) was selected in rural Upper Egypt and a simple random sample was (138) single in Upper Upper Egypt. The results of the study confirmed that there was a statistically significant relationship at a significant level (0.05) between fertility The main recommendations of the study were to introduce the concepts of women's health mainly in education decisions in terms of the negative effects of the environment on human behavior in general, and women in particular.

AN ECONOMIC STUDY OF GEOGRAPHIC DISPARITIES OF FOOD PRICES AND INFLATION IN EGYPT

With the full recognition that the problem of inflation in Egypt is due mainly to factors related to the recent economic policy, while others are related to structural reasons, that ignited the flames of inflation led by monopolies prevailing in the commodity market. The problem is the rise in food and drink prices (FCPI) in particular. The problem is further compounded by the increase in poverty in Egypt, which rose to 31.8% in October 2017. The most serious is the increase of extreme poverty rate of 5.8% of the population is mainly due to rising food prices. The research is concerned with the analysis of general price index and the food price index in four regions, namely, rural upper Egypt, urban upper Egypt, rural lower Egypt, and urban lower Egypt. The research compare between the evolution of consumer price indices in two period, the first period cover, 22 months before the adoption of the floating exchange rate policy and second period cover 15 months after the adoption from November 2016 of the new policy and it. The main of the research are summarized in the following points: 1- Increase the general index of prices and number. 2- A marked increase in the indices in the geographical areas in the countryside from the urban during two periods. 3- There is a significant effect of the time component on the increase in the price index during two periods of study, which was more evident in the float period. 4- The food price index had a clear effect on the increase in the general price index in the regions. 5- The conditions of the increase in the monthly inflation rates in the pre-flotation period in the Egyptian geographical regions, although there was a decrease in the floating period over time, in the floating period. 6- High urban inflation rates for rural areas, despite their rise.

Female genital mutilation: current awareness, believes and future intention in rural Egypt

BackgroundFemale genital cutting, also termed female genital mutilation (FGM), is a damaging practice with no health benefits for girls or women, and is considered to be a violation of children’s rights.MethodsA cross-sectional, community-based study using interview administered questionnaire to explore knowledge and attitude of people living in a rural area in Minia. Systematic random sampling was used to interview 618 males and females above the age of 18 in the period from September to November 2016.ResultsFGM was performed on 76.6% of females, complications occurred in 35.6% of them. Females demonstrated a higher level of knowledge than males. Nearly 56% of respondents believed that this practice should continue. Females were more supportive of the continuation of FGM than men (60.3% vs. 47.9%). The attitude that FGM is a good practice, knowledge level, women’s status and religion were significantly associated with women’s willingness to subject their daughters to FGM in the future. Attitude was the only significant predictor associated with men’s willingness to subject their daughters to FGM.ConclusionThe strong correlation between social pressure and intentions to carry out FGM means that FGM practice will continue to be embraced among future generations unless policies are put in place to eradicate this practice through empowering females by education and reasonable income.

EMPLOYING ELEMENTS OF THE EGYPTIAN RURAL HERITAGE TO ENRICH CONTEMPORARY ORNAMENTAL DESIGN

For the artist, the visual heritage of rural Egypt represents a rich source of inspiration that supports the societal culture with itsspecial visual insights. But recently, with the technological and living developments, the features of the Egyptian countryside beganto change, as it lost many of its features that distinguished it from the city, Therefore there was a deficiency in the student'sfamiliarity with the artistic heritage of its rural heritage. From here, this study was conducted to educate students about its ruralheritage and urge them to design their own vision in contemporary decorative paintings whose elements are inspired by theaesthetics of this heritage , through: 1 - Presenting distinctive scenes from the Egyptian rural heritage. 2- Presenting some artisticworks that dealt with the Egyptian countryside. 3- Conducting a student experiment to derive aesthetics values in rural scenes byusing principles of design.

Longitudinal determinants of married women’s autonomy in Egypt

This article explores determinants of women’s autonomy in Egypt around the beginning of the ‘Arab Spring’ in 2011. We show that women’s autonomy over time is a product not only of their individual characteristics, but also of the household and community environment in which they live. Using the 2006 and 2012 Egyptian Labor Market Panel Survey (ELMPS) and multilevel models, results demonstrate that women’s autonomy changes over time. There are large and consistent variations in women’s autonomy by household region of residence and wealth. For example, women in the rural and urban Upper Egypt region are less autonomous than women in the Cairo region, and women in wealthier households are less autonomous compared to the poorest households. Programs aiming to increase women’s autonomy focus exclusively or primarily on women’s own characteristics. These results indicate that strategies to improve women’s autonomy should be mindful of the multiple dimensions of autonomy and have a programmatic focus on changing household and social environments.

Unmet need for family planning among women in rural Egypt

Background: Although Egypt has a strong family planning program; the downward trend in the unmet need has been reversed recently. Thus the present study aimed to assess the magnitude of unmet need for family planning, its common reasons and the associated factors among women of reproductive age group.Methods: this is a community-based cross sectional household survey study conducted in Awish El-Hagar village, Mansoura, Egypt during the year 2015-2016. Using an interviewer questionnaire; 394 rural women in childbearing period were surveyed via a systematic random sampling technique with the help of the outreach community health workers affiliated to Awish El-Hagar family medicine center.Results: The overall prevalence rates of unmet need for family planning and contraceptive use were 11.2% and 69.5% respectively, while the total demand for family planning was 80.7%. Infrequent sex (27.3%), fear from the side effects (25%) and husband opposition (15.9%) were the most frequent reasons for non-use of family planning methods among unmet need women. Logistic regressions explored that risk factors for unmet need women were having husband disapproved family planning, having only girls, perception that having &gt;3 children to be ideal, working, having husband with the main family planning decision maker, with no past history of unintended pregnancy and having only boys.Conclusions: A considerable proportion of Egyptian women still have an unmet need for family planning that need to be addressed by more effective family planning and health education programs together with improving counseling strategies and enforcing the role of outreach workers.

Empowering Women Under Social Constraints: Evidence from a Field Intervention in Rural Egypt

Women in the MENA region are economically and socially disempowered. High youth unemployment rates together with discriminatory social norms drive them to limit their investment in human capital. We evaluate a large-scale intervention attempting to relax human capital constraints for women by offering vocational, business and life skills training in 30 villages in rural Egypt. Relative to women in the control villages, the intervention increased the likelihood of treated women engaging in income-generating activities, driven by an increase in self-employment. Treated women also became more likely to have future business aspirations. However, their intra-household decision-making and gender equality attitudes were not affected by the intervention. We show that these results mask heterogeneous effects in terms of background characteristics and initial levels of social empowerment. We find no evidence of positive spillover effects for the program within treated villages and, more importantly, no evidence of different pre-trends in employment between the treated and control groups prior to the intervention.

Optimizing Clinical Diagnosis and Antibiotic Prescribing for Common Respiratory Tract Infections, Fanara Family Health Center- Rural Egypt

Optimizing Clinical Diagnosis and Antibiotic Prescribing for Common Respiratory Tract Infections, Fanara Family Health Center- Rural Egypt

Hepatitis C Virus Exposure Rate among Health-care Workers in Rural Lower Egypt Governorates.

Studies on hepatitis C virus (HCV) in Egypt supported a strong role for various exposures in the health-care setting. In this study, we attempted to estimate the frequency of HCV exposure among Egyptian health-care workers (HCWs). Five hundred and sixty-four (564) HCWs were included in this study. Two hundred and fifty-eight (45.74%) were health-care providers and 306 (54.25%) were non-health-care providers. All HCWs completed both the study questionnaire and provided a blood sample for anti-HCV testing by third-generation enzyme-linked immunosorbent assay. Subsequently, anti-HCV-positive samples were tested for HCV RNA using nested polymerase chain reaction (PCR). The mean age of included HCWs was 33.0 ± 9.8 years; of them, 319 (56.56%) were males and 245 (43.44%) were females. The mean duration of health-care work was 9.3 ± 6.7 years. The frequency of antibody against hepatitis C virus (anti-HCV) among included HCWs was 8.7% (n = 49). Old age and prolonged duration of health-care work were significantly associated with anti-HCV seropositivity. Forty (81.63%) of 49 with anti-HCV-positive HCWs had positive hepatitis C viremia. The frequency of HCV RNA positivity increased with age. The frequency of eradicated past infection among nurses (36.85%) was markedly higher than that (6.7%) detected in non-health-care providers. High rate of HCV infection is detected in Egyptian HCWs in rural Lower Egypt governorates. Health-care providers seem to eradicate HCV infection more frequently than non-health-care providers. National screening and treatment of infected HCWs are recommended.

Hepatitis B in Egypt: A cross-sectional analysis of prevalence and risk factors for active infection from a nationwide survey.

Viral hepatitis is a major public health challenge in Egypt but little is known about the epidemiology of the hepatitis B virus (HBV) infection, its geographical distribution, or risk factors for infection in the Egyptian context. This study addresses this deficit using data from a nationally representative survey. Cross-sectional analysis of data gathered from men and women aged 15-59 in the Egypt Health Issues Survey (EHIS) 2015, including logistic regression to evaluate the contribution of different factors to risk of HBV infection. This was supplemented by spatial analysis of the distribution of acute or chronic HBV infection at governorate level, and the ecological relationship between HBV and HCV infections. Population HBV prevalence was 1.4% (95% confidence interval [CI] 1.2-1.6), with a HBV-HCV co-infection rate of 0.06%. Spatial analysis showed localisation of HBV infected individuals primarily to urban areas of Upper Egypt (in contrast to HCV for which prevalence is highest in rural Lower Egypt), and those in early middle age (Adjusted Odds Ratio [AOR] 3.32, 95% CI: 1.66-6.63). HBV positive status among other household members emerged as a powerful driver of infection risk in this analysis (AOR=10.75, 95% CI: 4.98-23.24). Spatial distribution of HBV infection in Egypt differs markedly from HCV and co-infection rates are low. Within-household transmissions appear to be particularly important in explaining the persistence of HBV infection in the general population. Prevention strategies should focus on urban Upper Egypt, and particularly those households with documented cases of infection.

A Study to Distinguish Between Wastewater Treatment Plants in Rural Egypt

Several wastewater treatment plants technologies have been set up in the Egyptian villages; however, the most efficient and economical technology hasn't been determined. This research aims to distinguish between the wastewater treatments plants which are used in rural Egypt to find out the best between them. The data about Centralized and Decentralized wastewater treatment plants which are used in rural Egypt using group of factors has been collected to distinguish between the characterizations of these plants by doing a questionnaire to evaluate the weight of these factors. The questionnaire has been given to experts to evaluate the factors for getting relative weights of them. Expert evaluated the factors according to his importance by choosing a mark from the lowest value one to the highest value ten. After receiving the results of the questionnaire from the experts, the data were processed to find out the best group of results of these plants. The largest percentage of Relative Weights of factors is Efficiency, followed by Costs, Average load removed, Specific surface area, Average flow and Average population. The best three centralized wastewater treatment plants were from the aerobic treatment.

Comparison of neurological health outcomes between two adolescent cohorts exposed to pesticides in Egypt.

Pesticide-exposed adolescents may have a higher risk of neurotoxic effects because of their developing brains and bodies. However, only a limited number of studies have addressed this risk among adolescents. The aim of this study was to compare neurological outcomes from two cohorts of Egyptian adolescents working as pesticide applicators. In 2005 and 2009, two cohorts of male adolescents working as pesticide applicators for the cotton crop were recruited from Menoufia Governorate, Egypt. The same application schedule and pesticides were used at both times, including both organophosphorus, and pyrethroid compounds. Participants in both cohorts completed three neurobehavioral tests, health and exposure questionnaires, and medical and neurological screening examinations. In addition, blood samples were collected to measure butyryl cholinesterase (BChE) activity. Pesticide applicators in both cohorts reported more neurological symptoms and signs than non-applicators, particularly among participants in the 2005 cohort (OR ranged from 1.18 to 15.3). Except for one test (Trail Making B), there were no significant differences between either applicators or non-applicators of both cohorts on the neurobehavioral outcome measures (p > 0.05). The 2005 cohort showed greater inhibition of serum BChE activity than the 2009 cohort (p < 0.05). In addition, participants with depressed BChE activity showed more symptoms and signs than others without BChE depression (p < 0.05). Our study is the first to examine the consistency of health outcomes associated with pesticide exposure across two cohorts tested at different times from the same geographical region in rural Egypt. This similar pattern of findings across the two cohorts provides strong evidence of the health impact of exposure of adolescents to pesticides.

Trends and Determinants of Contraceptive Use among Young (15 - 24 Year) Married Women : A Secondary Analysis Based on the 2008 and 2014 Egypt Demographic and Health Surveys

Background: young females in Egypt still face a number of challenges regarding their reproductive health (RH) despite efforts to enhance it. Importance of young women’s reproductive choices arises from the concept that early childbearing can impair their health and their productive participation in community. Aim: the paper aimed to explore the key determinant of the contraceptive (CC) use amongst young married females in Egypt using the 2008 and 2014 Egypt Demographic and Health Survey (EDHS) with a comprehensive look at the CC use changes occurred in the study period 2008-2014. Subjects and Methods: data from the 2008 and 2014 EDHS were secondary analyzed. Variables were selected to assess their effect on CC use. Multivariable regression analyses were performed. Odds ratio was computed. Results: overall contraceptive prevalence (CP) decreased from 53.7% in 2008 to 51.2% in 2014. Traditional methods were responsible for this decrease. Younger age, being from rural Upper Egypt, husband desire for more children, no visit to health facility were the most important risk factors for not using any CC method among Egyptian young married females in 2008. Added to these factors; low women autonomy, no exposure to family planning message, in the poster and women justifying husband violence in 2014. However, region lost its significance as a determinant in 2014. Conclusions: our results discovered the determinants that modulate the CC use behavior among Egyptian young married females.

The Use of Common Area k-Sample Test in Evaluating Targeting Methodologies: An Application to the Case of Egypt

This research utilizes a measure for evaluating targeting methodologies that is based on the common area under the kernel densities of per capita expenditure of different poverty groups. The proposed measure is incorporated with misclassification errors. It also compares some variables commonly used in targeting from a multidimensional perspective to show their overlap where standard statistical tests show them as significantly different. Such an integrated approach helps identify the complexity of model building thus providing a new tool in guiding social policies focusing on poverty alleviation. To demonstrate the added-value of the suggested measure, it is applied to a case study involving different methodologies to target poorest households in regions characterized with high prevalence of poverty in rural Upper Egypt. Results show that trials to classify the surveyed households using different models are faced with large overlap according to the proposed measure even when errors of under-coverage and/or leakage drop. Models built on the national-level of poor areas or on regional-level do not perform well on the level of these poor villages where geographical targeting would have been optimal.

Empowering Adolescent Girls in Socially Conservative Settings: Impacts and Lessons Learned from the Ishraq Program in Rural Upper Egypt.

In rural Upper Egypt, adolescence is a critical period in girls' transition to adulthood during which they are at risk for a number of negative outcomes, including restricted mobility and early marriage and childbearing. This study evaluates and presents lessons learned from Ishraq, an educational program that established safe spaces for out-of-school adolescent girls in rural Upper Egypt. Baseline and endline surveys were administered to all households containing an eligible girl in the program areas. We analyze the predictors of program enrollment and dropout and use difference-in-differences estimation to evaluate the impact of the program on participants as compared to non-participating eligible girls. Although we find positive impacts on literacy, attitudes toward sports, and reproductive health knowledge, little impact was found on broader indicators of empowerment, and no impact on the attitudes of participants' mothers or brothers. The experience of the Ishraq program highlights several key challenges facing safe spaces programs for adolescent girls, including targeting of a dispersed population with restricted mobility, reaching girls at a young age, achieving community-level attitudinal change, and the need for long-term follow-up of participants to measure behavioral change.

Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt

>80% of people chronically infected with hepatitis C virus (HCV) live in resource-limited countries, yet the excess mortality associated with HCV infection in these settings is poorly documented. Individuals were recruited from three villages in rural Egypt in 1997-2003 and their vital status was determined in 2008-2009. Mortality rates across the cohorts were compared according to HCV status: chronic HCV infection (anti-HCV antibody positive and HCV RNA positive), cleared HCV infection (anti-HCV antibody positive and HCV RNA negative) and never infected (anti-HCV antibody negative). Data related to cause of death was collected from a death registry in one village. Among 18,111 survey participants enrolled in 1997-2003, 9.1% had chronic HCV infection, 5.5% had cleared HCV infection, and 85.4% had never been infected. After a mean time to follow-up of 8.6years, vital status was obtained for 16,282 (89.9%) participants. When compared to those who had never been infected with HCV in the same age groups, mortality rate ratios (MRR) of males with chronic HCV infection aged <35, 35-44, and 45-54years were 2.35 (95% CI 1.00-5.49), 2.87 (1.46-5.63), and 2.22 (1.29-3.81), respectively. No difference in mortality rate was seen in older males or in females. The all-cause mortality rate attributable to chronic HCV infection was 5.7% (95% CI: 1.0-10.1%), while liver-related mortality was 45.5% (11.3-66.4%). Use of a highly potent new antiviral agent to treat all villagers with positive HCV RNA may reduce all-cause mortality rate by up to 5% and hepatic mortality by up to 40% in rural Egypt.

Iron Deficiency and Iron Deficiency Anemia in Adolescent Girls in Rural Upper Egypt

Iron Deficiency and Iron Deficiency Anemia in Adolescent Girls in Rural Upper Egypt