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BACKGROUND: This hospital-based cross-sectional study aims to investigate the epidemiologic and clinical characteristics of rotavirus group A (RVA) infection among children with acute gastroenteritis and to detect the most common G and P genotypes in Egypt. METHODS: A total of 92 stool samples were collected from children under five who were diagnosed with acute gastroenteritis. RVA in stool samples was identified using ELISA and nested RT-PCR. Common G and P genotypes were identified utilizing multiplex nested RT-PCR assays. RESULTS: RVA was detected at a rate of 24% (22 /92) using ELISA and 26.1% (24 /92) using VP6 nested RT-PCR. The ELISA test demonstrated diagnostic sensitivity, specificity, and accuracy of 91.7%, 100%, and 97.8%, respectively. G3 was the most prevalent G type (37.5%), followed by G1 (12.5%), whereas the most commonly detected P type were P[8] (41.7%) and P[6] (8.2%). RVA-positive samples were significantly associated with younger aged children (p = 0.026), and bottle-fed (p = 0.033) children. In addition, RVA-positive samples were more common during cooler seasons (p = 0.0001). Children with rotaviral gastroenteritis had significantly more frequent episodes of diarrhea (10.87 ± 3.63 times/day) and vomiting (8.79 ± 3.57 times/day) per day (p = 0.013 and p = 0.011, respectively). Moreover, they had a more severe Vesikari clinical score (p = 0.049). CONCLUSION: RVA is a prevalent cause of acute gastroenteritis among Egyptian children in our locality. The discovery of various RVA genotypes in the local population, as well as the identification of common G and P untypeable strains, highlights the significance of implementing the rotavirus vaccine in Egyptian national immunization programs accompanied by continuous monitoring of strains.
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Fezes , Gastroenterite , Genótipo , Infecções por Rotavirus , Rotavirus , Humanos , Gastroenterite/virologia , Gastroenterite/epidemiologia , Egito/epidemiologia , Estudos Transversais , Rotavirus/genética , Rotavirus/isolamento & purificação , Rotavirus/classificação , Infecções por Rotavirus/virologia , Infecções por Rotavirus/epidemiologia , Lactente , Pré-Escolar , Feminino , Masculino , Fezes/virologia , Ensaio de Imunoadsorção Enzimática , Hospitais , Prevalência , Recém-Nascido , Sensibilidade e Especificidade , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
BACKGROUND: Endothelial dysfunction is an integral pathophysiologic mechanism in sickle cell disease (SCD), and can lead to many complications. Sleep-disordered breathing (SDB) is a SCD complication with diverse incidence and pathophysiology. This study aimed to determine the prevalence of SDB in children with SCD and to assess its relation to endothelial dysfunction. METHODS: Sixty children with SCD and 60 healthy controls were enrolled. The levels of TNF-α, IL-6, and IL-17A were evaluated in the entire cohort using enzyme-linked immunosorbent assay (ELISA) kits. Polysomnography (PSG) was performed for all SCD patients after completion of the Pediatric Sleep Questionnaire (PSQ). RESULTS: TNF-α, IL-6, and IL-17A levels were significantly greater in children with SCD than in controls (p-values < 0.001, < 0.001, and 0.006, respectively). The PSQ revealed symptoms suggestive of SDB in 50 children with SCD (83.3%), and PSG revealed obstructive sleep apnea (OSA) in 44 children with SCD (73.3%); 22 patients had mild OSA, and 22 had moderate-to-severe OSA according to the apnea-hypopnea index (AHI). TNF-α was significantly greater in SCD children who reported heavy or loud breathing, trouble breathing or struggle to breathe, and difficulty waking up in the morning (p-values = 0.002, 0.002, and 0.031, respectively). The IL-6 levels were significantly greater in SCD children who stopped growing normally (p-value = 0.002). The levels of IL-6 and IL-17A were significantly greater in SCD children with morning headaches (p-values = 0.007 and 0.004, respectively). CONCLUSION: Children with SCD showed a high prevalence of SDB with significantly elevated levels of markers of endothelial function, highlighting the interplay of SDB and endothelial dysfunction in SCD.
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Anemia Falciforme , Endotélio Vascular , Interleucina-6 , Polissonografia , Síndromes da Apneia do Sono , Fator de Necrose Tumoral alfa , Humanos , Anemia Falciforme/complicações , Anemia Falciforme/fisiopatologia , Masculino , Feminino , Criança , Síndromes da Apneia do Sono/fisiopatologia , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/complicações , Egito/epidemiologia , Interleucina-6/sangue , Fator de Necrose Tumoral alfa/sangue , Estudos de Casos e Controles , Endotélio Vascular/fisiopatologia , Interleucina-17/sangue , Prevalência , Adolescente , Biomarcadores/sangue , Estudos TransversaisRESUMO
Fasciolosis is a zoonotic neglected parasitic disease that affects a variety of hosts, resulting in substantial economic losses. The epidemiological information about fasciolosis in water buffaloes in Egypt is very scarce. Hence, the present study aimed to determine the seroprevalence of F. hepatica in water buffaloes using commercial ELISA kits in three governorates at north of Egypt and to estimate the associated risk factors for F. hepatica infection. The total seroprevalence of F. hepatica in buffaloes was 15.4% (63/410), with a higher seroprevalence in Kafr Elsheikh governorates 17.9% (25/140) than in other areas. Fasciolosis was more likely in older buffaloes (OR = 3.4, 95%CI:1.5-7.8), throughout the winter season (OR = 5.3, 95%CI:1.9-14.7). Moreover, the absence of prophylactic treatment (OR = 2.3, 95%CI:1.2-4.2) increased the risk of F. hepatica infection in buffaloes, particularly in animals suffered from diarrhea (OR = 3.8, 95%CI:1.4-10.6). The present study confirmed the prevalence of F. hepatica in water buffaloes in north of Egypt. Consequently, the implementation of preventive and control for the parasite and its intermediate host are very necessary to decrease the economic losses and public health hazard.
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Búfalos , Fasciola hepatica , Fasciolíase , Animais , Búfalos/parasitologia , Egito/epidemiologia , Fasciolíase/veterinária , Fasciolíase/epidemiologia , Estudos Soroepidemiológicos , Fatores de Risco , Fasciola hepatica/isolamento & purificação , Feminino , Masculino , Ensaio de Imunoadsorção Enzimática/veterinária , Prevalência , Anticorpos Anti-Helmínticos/sangueRESUMO
Vaccines, like the Corona Virus Disease-2019 (COVID-19) vaccines, can control diseases, but vaccine hesitancy reduces their use. It is important to assess the intention to use COVID-19 vaccines boosters and the determinants of this intention to help in developing programs to promote the uptake of boosters. An online survey collected data from adults in Egypt between March and June 2022 using a questionnaire that assessed demographic characteristics, and constructs of the Theory of Planned Behaviour (TPB) and the Health Belief Model (HBM). The survey was uploaded to SurveyMonkey and the links were posted on social media platforms. Binary regression analysis was used and the dependent variable was intention to use boosters of COVID-19 vaccines. The independent variables were indicators of the HBM including perceived susceptibility to COVID-19 infection (medical history) and possibility of disease prevention (awareness of the availability of types of COVID-19 vaccines); and indicators of the TPB including attitude toward COVID-19 vaccines (that they are harmful, that they may lead to death and confidence in locally and foreign manufactured vaccines), perceived norms (the percentage of vaccinated persons in one's circle) and perceived control over booster uptake (presence of government mandates for COVID-19 vaccination). The confounders were sociodemographic factors (age, sex, education, and place of residence). Complete responses were available from 1113 out of 1401 participants (79.4%), with mean (SD) age = 25 (9.5) years, of whom, 66.7% (n = 742) were females and 68.6% (n = 764) were university students. About 39.4% and 31.2% indicated that they would get or would definitely get the booster dose of the COVID-19 vaccines. In multiple regression, intention to use a booster dose was significantly related to not agreeing (AOR = 4.87, P < 0.001) or not agreeing at all (AOR = 8.46, P = 0.001) that vaccines are harmful and to having no confidence (AOR = 0.21, P < 0.001) or no confidence at all (AOR = 0.14, P < 0.001) in foreign-manufactured vaccines. Most university-educated Egyptians in the study intended to take the COVID-19 vaccine booster dose and this intention was associated with attitude toward the harm of the vaccine and confidence in foreign-manufactured vaccines. Awareness campaigns are needed to counteract misinformation and promote booster dose uptake.
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Vacinas contra COVID-19 , COVID-19 , Intenção , Humanos , Egito/epidemiologia , Feminino , Masculino , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/imunologia , Adulto , COVID-19/prevenção & controle , COVID-19/epidemiologia , Inquéritos e Questionários , Adulto Jovem , Imunização Secundária , Vacinação/psicologia , Pessoa de Meia-Idade , SARS-CoV-2/imunologia , Modelo de Crenças de Saúde , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricos , Adolescente , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3-14.6) and IgM with a 95% CI (3.5-8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.
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Doadores de Sangue , Infecções Sexualmente Transmissíveis , Toxoplasma , Toxoplasmose , Humanos , Egito/epidemiologia , Masculino , Toxoplasma/imunologia , Feminino , Toxoplasmose/epidemiologia , Toxoplasmose/parasitologia , Adulto , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/parasitologia , Estudos Transversais , Estudos Soroepidemiológicos , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem , Anticorpos Antiprotozoários/sangue , Prevalência , Adolescente , Sífilis/epidemiologia , Sífilis/sangueRESUMO
Caring for patients in the intensive care unit (ICU) creates competing priorities of interventions for nurses and other health care providers. Oral care might be prioritized lower; however, its neglect may lead to sequelae such as extended time in the ICU, nosocomial diseases most notably ventilator-associated pneumonia (VAP), or oral problems. Safe patient care depends on effective and efficient oral care. The aim of this study was to lower the incidence of VAP and maintain oral health through implementing an "oral care bundle" for mechanically ventilated (MV) patients. Using a quasi-experimental design, we divided 82 adult MV patients in the ICUs of a university-based hospital in Egypt into a control group (n = 41) that received the standard of care and a bundle group (n = 41) that received an "oral care bundle." The results of the study reported a significantly lower incidence of VAP in the intervention group (P = .015). It can be concluded that there is a significant relationship between receiving an oral care bundle and improved oral health and a reduction in the VAP rate among MV patients. This highlights the need to incorporate the oral care bundle in the daily nursing care for MV patients.
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Unidades de Terapia Intensiva , Saúde Bucal , Higiene Bucal , Pacotes de Assistência ao Paciente , Pneumonia Associada à Ventilação Mecânica , Respiração Artificial , Humanos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Masculino , Feminino , Egito/epidemiologia , Higiene Bucal/enfermagem , Respiração Artificial/efeitos adversos , Pessoa de Meia-Idade , Adulto , Incidência , Enfermagem de Cuidados CríticosRESUMO
BACKGROUND: Acinetobacter baumannii (A. baumannii) is a life-threatening and challenging pathogen. In addition, it accounts for numerous serious infections, particularly among immunocompromised patients. Resistance to nearly all clinically used antibiotics and their ability to spread this resistance is one of the most important concerns related to this bacterium. OBJECTIVES: This study describes different molecular mechanisms of two multidrug-resistant A. baumannii isolates obtained from endotracheal aspirates collected from the neonatal intensive care unit (NICU), Ain Shams University Hospital, Egypt. METHODS: Following the identification of two isolates, they were examined for susceptibility to antimicrobial agents. This was followed by multilocus sequence typing as well as whole-genome sequence (WGS). Additionally, a Pathosystems Resources Integration Center (PATRIC) analysis was performed. RESULTS: Two isolates, Ab119 and Ab123, exhibited resistance to all tested antibiotics except for tigecycline and colistin. The WGS analysis of antimicrobial resistance genes (AMR) indicated that both isolates shared beta-lactam, aminoglycoside, macrolides, and sulfonamide resistance genes. Furthermore, each strain revealed different resistance genes such as blaNDM-1, blaNDM-10, OXA-64, aph (3')-VI, Tet-B in Ab119 strain and blaOXA-68, blaPER-1, blaPER-7, Tet-39 in Ab123 strain. Multiple efflux pump genes were detected. Multilocus sequence typing indicated that both isolates belong to the same sequence type (ST931), which belongs to international clone (IC3). Both isolates exhibited the presence of multiple mobile genetic elements (MGEs), but no plasmid was detected in either of them. CONCLUSIONS: A low prevalence of the IC3 sequence type was identified among two A. baumannii isolates obtained from the NICU in Egypt, exhibiting a high resistance level. Healthcare workers must have knowledge regarding the prevalence of A. baumannii among different populations in order to administer suitable treatment, improve patient outcomes, and apply effective infection control practices.
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Infecções por Acinetobacter , Acinetobacter baumannii , Antibacterianos , Farmacorresistência Bacteriana Múltipla , Genoma Bacteriano , Unidades de Terapia Intensiva Neonatal , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Sequenciamento Completo do Genoma , Acinetobacter baumannii/genética , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Acinetobacter baumannii/classificação , Humanos , Egito/epidemiologia , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Acinetobacter/microbiologia , Infecções por Acinetobacter/epidemiologia , Antibacterianos/farmacologia , Estudos Prospectivos , Recém-Nascido , Genoma Bacteriano/genética , Estudos TransversaisRESUMO
Background: Canine monocytic ehrlichiosis (CME) is considered a multisystemic, life-threatening, rickettsial, and tick-borne disease that affects canine species and is caused by Ehrlichia canis (E. canis). Clinical signs of CME vary from asymptomatic to severe illness with three clinical phases. E. canis has the potential to infect humans. Aim: This study aimed to provide recent information as there is limited data about the disease in Egypt. Therefore, this work was conducted to study the molecular prevalence of E. canis and evaluate the corresponding risk factors, hematology, biochemistry, and molecular characterization of the genus Ehrlichia and E. canis species among Egyptian dogs. Methods: One hundred eighty dogs of both sexes from 3 months to 8 years from different breeds: stray and foreign breeds were examined for clinical signs in all seasons in two delta governorates: El-Dakahlia and El-Gharbia. Blood samples were collected from dogs for microscopic and haemato-biochemical analysis, and then molecular characterization of the genus Ehrlichia and species-specific E. canis was performed, followed by sequencing and phylogenetic analysis. Results: Out of 180 samples examined by polymerase chain reaction (PCR) assay, 42 (23.33%) were positive for the genus of Ehrlichia and the species-specific E. canis. Only twenty-four dogs (13.33%) were positive for PCR, infested with ticks, and showed fever, anemia, loss of body weight, pale mucous membrane of gum and conjunctiva, blindness, paralysis, hemoglobinuria, and Melena. The univariate logistic regression revealed that all variables, including age, season, tick infestation, hemorrhage from natural orifices, and ectoparasitic treatments per year, showed statistical significance (p ≤ 0.05), except breed and sex, which also did not exhibit any relation between CME infection in multivariate logistic regression. The presence of morulae inside leukocytes in 66 dogs out of the total examined 180 (36.67%), only 39 (59.1%) were positive for morulae and PCR-positive for E. canis. Dogs positive for E. canis suffered from anemia, severe thrombocytopenia, the absolute value of WBCs and their fractions, alanine aminotransferas (ALT), AST, ALKP, γ-GT, total. P, T.BIL, urea, globulin, and creatinine were significantly increased in dogs infected with E. canis when compared to those with negative PCR results, while the levels of albumin and A: G ratios were significantly decreased. Conclusion: The current study proves the existence of E. canis in El-Dakahlia and El-Gharbia governorates, and this is the first large-scale study concerning the epidemiological, clinicopathological examination, molecular characterization, sequencing, and phylogenetic analysis of reported from the center of the Delta of the Nile in Egypt.
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Doenças do Cão , Ehrlichia canis , Ehrlichiose , Animais , Cães , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Ehrlichia canis/isolamento & purificação , Ehrlichia canis/genética , Egito/epidemiologia , Ehrlichiose/veterinária , Ehrlichiose/epidemiologia , Ehrlichiose/microbiologia , Feminino , Masculino , Prevalência , Filogenia , Fatores de RiscoRESUMO
BACKGROUND: Ventilator-associated pneumonia (VAP) is a challenging nosocomial problem in low- and middle-income countries (LMICs) that face barriers to healthcare delivery and resource availability. This study aimed to examine the incidence and predictors of VAP in Egypt as an example of an LMIC while considering death as a competing event. METHODS: The study included patients aged ≥ 18 years who underwent mechanical ventilation (MV) in an intensive care unit (ICU) at a tertiary care, university hospital in Egypt between May 2020 and January 2023. We excluded patients who died or were transferred from the ICU within 48 h of admission. We determined the VAP incidence based on clinical suspicion, radiological findings, and positive lower respiratory tract microbiological cultures. The multivariate Fine-Gray subdistribution hazard model was used to examine the predictors of VAP while considering death as a competing event. RESULTS: Overall, 315 patients were included in this analysis. Sixty-two patients (19.7%) developed VAP (17.1 per 1000 ventilator days). The Fine-Gray subdistribution hazard model, after adjustment for potential confounders, revealed that emergency surgery (subdistribution hazard ratio [SHR]: 2.11, 95% confidence interval [CI]: 1.25-3.56), reintubation (SHR: 3.74, 95% CI: 2.23-6.28), blood transfusion (SHR: 2.23, 95% CI: 1.32-3.75), and increased duration of MV (SHR: 1.04, 95% CI: 1.03-1.06) were independent risk factors for VAP development. However, the new use of corticosteroids was not associated with VAP development (SHR: 0.94, 95% CI: 0.56-1.57). Klebsiella pneumoniae was the most common causative microorganism, followed by Pseudomonas aeruginosa. CONCLUSION: The incidence of VAP in Egypt was high, even in the ICU at a university hospital. Emergency surgery, reintubation, blood transfusion, and increased duration of MV were independently associated with VAP. Robust antimicrobial stewardship and infection control strategies are urgently needed in Egypt.
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Pneumonia Associada à Ventilação Mecânica , Humanos , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Egito/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Masculino , Feminino , Infecção Hospitalar/epidemiologia , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Fatores de Risco , Análise de Sobrevida , IncidênciaRESUMO
Tuberculosis is a global public health concern. Earlier reports suggested the emergence of high rates of drug resistant tuberculosis in Egypt. This study included 102 isolates of Mycobacterium tuberculosis collected from two reference laboratories in Cairo and Alexandria. All clinical isolates were sub-cultured on Löwenstein-Jensen medium and analyzed using both BD BACTEC MGIT 960 SIRE Kit and standard diffusion disk assays to identify the antibiotic sensitivity profile. Extracted genomic DNA was subjected to whole genome sequencing (WGS) using Illumina platform. Isolates that belong to lineage 4 represented > 80%, while lineage 3 represented only 11% of the isolates. The percentage of drug resistance for the streptomycin, isoniazid, rifampicin and ethambutol were 31.0, 17.2, 19.5 and 20.7, respectively. Nearly 47.1% of the isolates were sensitive to the four anti-tuberculous drugs, while only one isolate was resistant to all four drugs. In addition, several new and known mutations were identified by WGS. High rates of drug resistance and new mutations were identified in our isolates. Tuberculosis control measures should focus on the spread of mono (S, I, R, E)- and double (S, E)-drug resistant strains present at higher rates throughout the whole Nile Delta, Egypt.
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Antituberculosos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis , Tuberculose Resistente a Múltiplos Medicamentos , Sequenciamento Completo do Genoma , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Egito/epidemiologia , Humanos , Antituberculosos/farmacologia , Sequenciamento Completo do Genoma/métodos , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Mutação , Adulto , Genoma Bacteriano , Masculino , Feminino , Farmacorresistência Bacteriana/genética , Farmacorresistência Bacteriana Múltipla/genética , Isoniazida/farmacologia , Variação Genética , Pessoa de Meia-Idade , Estreptomicina/farmacologiaRESUMO
BACKGROUND: Though an association between cluster headache (CH) and smoking has been postulated, data from the Middle East region is scarce. AIM OF WORK: To study the relationship between smoking and CH clinical characteristics and responsiveness to therapy in Egypt. METHODOLOGY: This was a prospective cohort hospital-based study conducted on patients with episodic and chronic CH in a tertiary headache clinic in Egypt during the period between 2019 and 2023. Patients were consecutively recruited at the time of their presentation and were followed up for two weeks after initiation of prophylactic treatment and steroids (as transitional therapy). RESULTS: Of 172 patients with CH recruited, 144 (83.7%) were smokers. Twenty-eight patients (16.3%) had chronic CH. The mean age was 42.08 ± 10.93 (20-66) years, and 131 (76.2%) were males. Smokers had a significantly higher median number of cluster bouts in the past five years (3.0 (IQR2.0-4.0) versus 2.0 (IQR 1.0-2.0)) and worse HIT-6 scores [51.0 (44.0-59.75) versus 41.0 (38.0-41.75)] than non-smokers (p < 0.001). The number of cluster bouts in the past five years was positively correlated with the smoking index (r = 0.249 (p = 0.006) and the smoking duration (in years) (r = 0.392 (p < 0.001)). HIT-6 scores were significantly correlated with the age at smoking onset (r=-0.190, = 0.023), smoking index (r = 0.519, p < 0.001), smoking duration (r = 0.611, p < 0.001), and number of cigarettes consumed per day (r = 0.392, p < 0.001). CONCLUSION: Smoking is significantly correlated with the daily frequency of CH attacks, the frequency of CH bouts in the past five years, and the HIT-6 scores among our cohort.
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Cefaleia Histamínica , Fumar , Humanos , Cefaleia Histamínica/epidemiologia , Cefaleia Histamínica/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Fumar/epidemiologia , Fumar/efeitos adversos , Estudos Prospectivos , Idoso , Adulto Jovem , Resultado do Tratamento , Egito/epidemiologia , Estudos de CoortesRESUMO
The diagnosis of familial Mediterranean fever (FMF) is primarily based on clinical standards. The purpose of this study was to investigate the relevance of Mediterranean fever (MEFV) genetic testing in the diagnosis of FMF as well as to identify the most frequent variant alleles and their relationship to clinical symptoms in Egyptian patients. Egyptian patients with a clinical suspicion of having FMF were studied in order to determine MEFV genotypes. Each patient was meticulously evaluated through an extensive collection of their medical history, a thorough clinical examination, and a series of laboratory tests, encompassing CBC, ESR, and CRP measurements. The MEFV variant screening procedure included the use of reverse dot blot hybridization. The average age of our patients when they were given a diagnosis was 22.8 ± 1.404 years old. The predominant clinical manifestations identified were abdominal pain, fever, and arthralgia. Molecular interrogation of the MEFV gene unveiled that a significant proportion of the cohort, constituting 72 individuals (60%), displayed heterozygosity, whereas a smaller fraction, comprising 12 subjects (10%), demonstrated homozygosity and an equivalent number (10%) exhibited compound heterozygosity. Pertaining to the distribution of allele variants, E148Q emerged as the most prevalent, succeeded by M694I, accounting for 12.5% of the cases, and M680I (G/A), representing 10.41%. This notable prevalence of heterozygous genotypes among the Egyptian demographic, preliminarily identified as potential FMF cases, underscores the imperative for molecular diagnostics to enhance the precision of FMF identification.
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Febre Familiar do Mediterrâneo , Pirina , Humanos , Febre Familiar do Mediterrâneo/genética , Febre Familiar do Mediterrâneo/diagnóstico , Pirina/genética , Feminino , Masculino , Adulto Jovem , Adulto , Alelos , Egito/epidemiologia , Polimorfismo Genético , Genótipo , Heterozigoto , Frequência do Gene/genética , AdolescenteRESUMO
INTRODUCTION: Healthcare providers should be well prepared to fight the COVID-19 pandemic and protect their patients and themselves as frontline workers. The aim of this study was to assess oncologists' and health care workers (HCWs) knowledge, attitude, and practice in response to the COVID-19 pandemic and its impact on them. MATERIAL AND METHODS: This cross-sectional study was conducted among Egyptian oncologists and HCWs in the oncology department at Suez Canal University Hospitals, Egypt. Participants were reached through a Google Form questionnaire. The questionnaire was shared on social media (Facebook, Twitter, and WhatsApp) over four months, from June 1st to September 30, 2022. All physicians and HCWs in the oncology department were invited to participate in the survey. Researchers intended to enroll all physicians and HCWs within the study period. RESULTS: Out of the 110 participants included in the study, there was a female predominance, and the majority were oncology nurses and clinical oncologists. Knowledge with significant participants' characteristics showed that knowledge significantly varied by age. The level of knowledge was significantly higher among participants between 30 and 40 years old (OR = 5.111; 95% CI, 1.202-21.738; P = 0.027). 65.5% of the participants had poor knowledge, with a mean ± SD of 4.9 ± 1.4. About 43.6% of the participants experienced more burnout than before the COVID-19 pandemic, with a negative emotional impact. 63.7% reported a negative financial impact due to the pandemic. 62.7% had support from their family, even though their job increases their risk of infection. 7.3% only reported a positive impact regarding their friend's relationship. CONCLUSION: COVID-19 pandemic has a negative impact on oncologists' personal and professional lives. Interventions should be implemented to lessen the negative impact and better prepare oncologists to handle future crises with greater efficiency and resilience.
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COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Oncologistas , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Masculino , Adulto , Estudos Transversais , Oncologistas/psicologia , Inquéritos e Questionários , Egito/epidemiologia , Pessoal de Saúde/psicologia , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , PandemiasRESUMO
BACKGROUND: Systemic Lupus Erythematosus (SLE) patients are more likely than the general population to suffer from thyroid illness. The major goal was to assess the thyroid dysfunctions due to immunological factors in Egyptian SLE children and how they are related to the course and severity of the illness. METHODS: Fifty children and adolescents with SLE are included in this cross-sectional observational study. Every patient underwent a thorough physical examination and a comprehensive history taking. An enzyme-linked immunosorbent assay (ELISA) approach was used to evaluate the thyroid profile, anti-thyroglobulin (Anti-TG), and anti-thyroid peroxidase (anti-TPO) antibodies. RESULTS: Of the 50 patients, the female: male ratio (F: M = 7:1) was 44 females and 6 males (12%). They were between the ages of 5 and 17. Out of the patients, thirty-two (64%) had thyroid dysfunctions, 19 (38%) had euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none had hyperthyroidism. Of the 50 patients, one (2%) had increased anti-TPO, whereas all other patients had normal anti-TG levels. A statistically significant negative correlation (p-value 0.007) was seen between the disease duration and free thyroxine (FT4). Furthermore, a significant negative correlation (p-values 0.015 and 0.028) was found when comparing the disease duration with thyroid antibodies (anti-TG and anti-TPO). CONCLUSION: In Juvenile Systemic Lupus Erythematosus (JSLE), thyroid dysfunctions can be identified. The disease duration but not its activity was significantly correlated with thyroid antibodies. For children with JSLE, thyroid function testing should be done on a regular basis. It is preferable to carry out additional thyroid antibody tests when necessary.
Assuntos
Lúpus Eritematoso Sistêmico , Humanos , Feminino , Masculino , Criança , Estudos Transversais , Adolescente , Lúpus Eritematoso Sistêmico/complicações , Pré-Escolar , Egito/epidemiologia , Testes de Função Tireóidea , Tireoidite Autoimune/complicações , Tireoidite Autoimune/diagnóstico , Tireoidite Autoimune/epidemiologia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/imunologia , Autoanticorpos/sangue , Ensaio de Imunoadsorção Enzimática , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The emergence of mucormycosis as a life-threatening fungal infection after the coronavirus disease of 2019 (COVID-19) is a major concern and challenge, but there is limited information on the risk factors for mortality in patients. METHODS: We conducted a prospective cohort study from May 2021 to April 2022 to determine the in-hospital outcomes of post-COVID-19 mucormycosis during the intensive care unit (ICU) stay. The sample of the study was collected as consecutive sampling using all accessible patients in the study period. The Statistical Package for Social Sciences (SPSS), version 25 (IBM, Chicago, Illinois, USA) was used for statistical analysis. RESULTS: Among 150 patients with post-COVID-19 mucormycosis, the majority had a primary sinus infection (86.0 %), while 11.3 % had both sinus and ocular infections, and 2.7 % had sinus and cutaneous infections. Around 21 % (n = 31) of patients deceased after staying in the ICU for a median (range) of 45.0 (10.0-145.0) days. The majority of the patients who deceased had pneumonia patches on computed tomography (CT) (90.3 %) while none of the patients who were discharged had pneumonia patches (p < 0.001). The deceased group had higher rates of pulmonary embolism (93.5 %) compared to the surviving groups (21.8 %). In a multivariate Cox regression analysis, the risk of death was higher in older patients above 60 years old (hazard ratio (95 %CI): 6.7 (1.73-15.81)), increase among patient with history of steroid administration (hazard ratio (95 %CI): 5.70 (1.23-10.91)), who had facial cutaneous infection with mucormycosis (hazard ratio (95 %CI): 8.76 (1.78-25.18)), patients with uncontrolled diabetes (hazard ratio (95 %CI): 10.76 (1.78, 65.18)), and total leukocytic count (TLC>10 ×103 mcL) (hazard ratio (95 %CI): 10.03 (3.29-30.61)). CONCLUSIONS: Identifying high-risk patients especially old diabetic patients with corticosteroid administration and detecting their deterioration quickly is crucial in reducing post-COVID-19 mucormycosis mortality rates, and these factors must be considered when developing treatment and quarantine strategies.
Assuntos
COVID-19 , Unidades de Terapia Intensiva , Mucormicose , Centros de Atenção Terciária , Humanos , COVID-19/mortalidade , COVID-19/complicações , Masculino , Mucormicose/mortalidade , Mucormicose/epidemiologia , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Adulto , Centros de Atenção Terciária/estatística & dados numéricos , Fatores de Risco , Unidades de Terapia Intensiva/estatística & dados numéricos , Egito/epidemiologia , Idoso , SARS-CoV-2 , Cuidados Críticos/estatística & dados numéricos , Adulto Jovem , Mortalidade HospitalarRESUMO
BACKGROUND: Thrombophilias are characterized by excessive venous and arterial thrombosis at regular or unusual sites. It may result from inherited, acquired, or a combination. Hereditary thrombophilia (HT) is detected in 30-40% of patients with thromboembolism. Venous/arterial thrombosis is considered a multifactorial disorder, some patients may have more than one risk factor which may be transient or permanent. OBJECTIVES: Assess the clinical characteristics of patients with unprovoked thromboembolic events and the role of inherited thrombophilia as a causative or additive risk factor. METHODS: 210 consecutive adult patients with unprovoked thromboembolic events were reviewed in hematology units at three tertiary Egyptian centers between September 2022 and September 2023. The diagnosis of thromboembolic events was confirmed by clinical and radiological findings. Laboratory screening for thrombophilia-associated. RESULTS: Among our patients, 53(25.2%) patients presented with isolated DVT, followed by portal vein thrombosis, 32(15.2%) had a pulmonary embolism, and sagittal sinus thrombosis was developed in 23(10.9%) patients. CONCLUSION: Younger people who experience spontaneous thromboembolism run the chance of having hereditary thrombophilia; the more mutations discovered, the higher the risk of thrombosis; the lower leg and deep vein thrombosis were the most common sites. Lastly, MTHFR C677T was the most common polymorphism in Egyptians, detected in almost half of the cases.
Assuntos
Trombofilia , Tromboembolia Venosa , Humanos , Trombofilia/genética , Feminino , Egito/epidemiologia , Masculino , Adulto , Tromboembolia Venosa/genética , Tromboembolia Venosa/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Predisposição Genética para Doença , Mutação/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Embolia Pulmonar/genética , Embolia Pulmonar/epidemiologia , Adulto Jovem , Idoso , População do Norte da ÁfricaRESUMO
Ticks and tick-borne pathogens pose a great threat to human and animal health. The present study aimed to determine the prevalence of ticks that infest camels and investigate the presence of tick-borne pathogens in the blood of camels, associated ticks, and surrounding rodents as reservoirs. From 100 inspected camels, from different localities in the Giza governorate, 1000 ixodid ticks were collected; these ticks belonged to three genera: Hyalomma, Amblyomma, and Rhipicephalus. The genus Hyalomma was represented by four species, Hyalomma dromedarii was the most prevalent species (55.4%), followed by Hyalomma excavatum (22%), Hyalomma impeltatum (11.6%) and Hyalomma rufipes (2.8%). The genus Amblyomma was represented by two species, Amblyomma gemma (2.8%) and Amblyomma marmoreum (2.7%), while the genus Rhipicephalus was represented by only one species, Rhipicephalus pulchellus (2.7%). Ticks, camel blood, and rodents (total number 100 brown rats) are screened for tick-borne pathogens (Borrelia burgdorferi, Borrelia miyamotoi, Babesia sp., and Coxiella burnetii) using PCR. Camel blood was found to be infected with Borrelia burgdorferi (66.6%), Borrelia miyamotoi (55%), and Babesia sp. (11.6%). Coxiella burnetii DNA was detected in all the collected ticks but was not detected in the blood of camels or rodents. Borrelia miyamotoi was detected in 12.5% of H. impeltatum, 55% of Camels, and 6% of the rodents, which may indicate a proposed risk of dispersal of B. miyamotoi, the agent of tick-borne relapsing fever.
Assuntos
Camelus , Reservatórios de Doenças , Ixodidae , Animais , Camelus/parasitologia , Reservatórios de Doenças/veterinária , Reservatórios de Doenças/microbiologia , Ixodidae/microbiologia , Doenças Transmitidas por Carrapatos/veterinária , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/parasitologia , Roedores/parasitologia , Infestações por Carrapato/veterinária , Infestações por Carrapato/epidemiologia , Infestações por Carrapato/parasitologia , Egito/epidemiologia , FemininoRESUMO
Acute lymphoblastic leukemia (ALL), a leading cause of childhood cancer, targets immune system B and T cells. While understanding its causes is crucial, predicting susceptibility holds immense power for early diagnosis and intervention. This study explored the potential of interleukin 10 (IL-10), a key immune regulator, as a predictive tool in Egyptian children. Investigating 100 ALL patients and 100 healthy controls, we analyzed the IL10 gene polymorphism (-1082 A/G) and serum levels. Strikingly, both the G allele and higher serum IL-10 levels were significantly associated with increased ALL risk (p < 0.05, OR > 1). Moreover, IL-10 emerged as a remarkably accurate predictor, boasting an AUC of 0.995, with a sensitivity of 97% and specificity of 96%. These findings unveil the potential of IL-10 as a powerful predictive tool for pediatric ALL in the studied Egyptian population. Identifying individuals with the GG/AG haplotype and elevated IL-10 levels could enable early intervention and potentially improve outcomes. While further validation in larger and more diverse populations is needed, this study paves the way for personalized risk assessment and potentially revolutionizes how we combat this childhood killer.
Assuntos
Predisposição Genética para Doença , Interleucina-10 , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Interleucina-10/genética , Interleucina-10/sangue , Masculino , Feminino , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Criança , Medição de Risco/métodos , Pré-Escolar , Egito/epidemiologia , Polimorfismo de Nucleotídeo Único , Estudos de Casos e Controles , Lactente , Alelos , Adolescente , Genótipo , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/sangueRESUMO
BACKGROUND: Central venous catheters (CVCs) are the major risk factors for neonatal thrombosis that might negatively affect morbidity and mortality in neonates. The aim of the present work was to estimate the incidence of CVC-linked thrombosis, among neonates in the NICU of Alexandria University Maternity Hospital, Egypt, over 1year, and to determine its possible risk factors. METHODS: This observational cohort study involved 134 newborn infants born from July 2020 to July 2021with CVCs insertion during their hospital stay. Patients who had congenital anomalies, had thrombosis unrelated to the implantation of CVCs or died before 7 days of catheter placement were excluded from the analysis. The 134 neonates who met the study's eligibility requirements had 142 CVCs inserted. Serial ultrasound and Doppler scans on site of venous insertion of catheters were performed. RESULTS: Seventeen patients with catheter's thrombosis (12%) were found during the placement of 142 catheters or 1615 CVCs' days, resulting in an overall rate of 10.5 thrombotic events per 1000 catheters' days. We constructed a logistic regression model to identify risk factors behind CVC-linked thrombosis. In univariate analysis, femoral central venous lines (CVLs), catheter dwell-time, sepsis, packed red cells (PRBCs) transfusions and low platelet count were risk factors for CVC-linked thrombosis. Nevertheless, only PRBCs transfusion was significant in the multivariate analysis, with OR and 95% confidence level 5.768 (1.013-32.836). CONCLUSION: Many factors should be considered in prediction of patients at risk of thrombosis including sepsis, femoral line insertion, low platelet count and PRBCs-transfusions. In our analysis, PRBCs-transfusion through peripheral intravenous lines (PIVs) was the strongest factor associated with CVC-linked thrombosis.
Assuntos
Cateterismo Venoso Central , Humanos , Recém-Nascido , Feminino , Masculino , Fatores de Risco , Egito/epidemiologia , Cateterismo Venoso Central/efeitos adversos , Incidência , Trombose/etiologia , Trombose/epidemiologia , Cateteres Venosos Centrais/efeitos adversos , Estudos de Coortes , Unidades de Terapia Intensiva NeonatalRESUMO
BACKGROUND: Ewing sarcoma (ES) is the second most common primary malignant bone tumor in children and adolescents. Despite more intensive chemotherapy regimens and improved local control therapy, there is still a considerable rate of recurrent/progressive disease. METHODS: A retrospective study of 50 relapsed/progressive ES patients who were treated at the National Cancer Institute (NCI), Cairo University, during the period from 1st of January 2008 to the end of December 2018, to assess different prognostic variables and disease outcomes. RESULTS: Out of fifty eligible cases, 32 patients (64%) had disease recurrence, and 18 (36%) developed disease progression on treatment. The median follow-up period was 7.4 months. The median overall survival (OS) was 7.5 months, and the cumulative OS was 64% at 6 months and 32.6% at 1 year. The cumulative event-free survival (EFS) was 41.3% at 6 months and 22.3% at 1 year. Patients with disease recurrence had better OS and EFS than patients with disease progression (p = 0.019). Patients who underwent local control at relapse/progression had a significantly better outcome than patients who received chemotherapy only (p < 0.001). Recurrence > 2 years from initial diagnosis was the only independent predictor of better survival outcome. CONCLUSIONS: Patients with relapsing/progressive ES portended a poor outcome, with disease progression on treatment faring worse than relapse. Better outcome was observed in patients who experienced recurrence > 2 years after diagnosis, patients with disease recurrence rather than disease progression on treatment, and patients who underwent local control along with intensive chemotherapy.