Screening for Antepartum Anxiety & Depression & Their Association with Domestic Violence among Egyptian Pregnant Women

Greater attention has been paid recently to prenatal mental disorders and their association with exposure to domestic violence (DV) as both have serious reproductive consequences.

The aim of this study was to screen for anxiety and/or depression among pregnant women, as well as identify the frequency and association of exposure to DV.

This cross-sectional study was conducted in 2013 and included a systematic random sample of 376 pregnant women attending the antenatal care outpatient clinic at the largest university hospital in Egypt. Participants were interviewed using a structured questionnaire including three components: sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale questionnaire (HADS), and the Hurt, Insulted, Threaten, Scream (HITS) inventory for screening for DV.

Women who expressed simultaneous anxiety and depressive manifestations accounted for 63%, whereas 11.4% and 10.4% of them expressed only anxiety and only depression, respectively. Exposure to DV was detected in 30.6% of all participants, of whom 25.2% were physically hit by their husbands often to most of the time. Simultaneous anxiety and depression was independently associated with lifetime exposure to DV (odds ratio=3.27, 95% confidence interval: 1.28-8.34, P=0.013), whereas having a university-graduated husband was a protective factor from DV (odds ratio=0.22, 95% confidence interval: 0.64-0.75, P=0.01).

Symptoms of anxiety and depression were highly reported among this sample of pregnant Egyptian women and were significantly associated with exposure to intimate partner violence. Screening of pregnant women for mental disorders associated with exposure to DV with provision of supportive mental health services, as well as interventions to reduce exposure to DV, should be considered for integration into antenatal care services.

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By:  Abdelhai R1, Mosleh H.

• 1Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Giza, Egypt. 

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Viral Transmission Risk Factors in an Egyptian Population with High Hepatitis C Prevalence

Egypt has the world’s highest prevalence of infection with hepatitis C virus (HCV), which is a major cause of hepatocellular carcinoma. The high HCV prevalence is largely attributed to the parenteral antischistosomal therapy (PAT) campaigns conducted from the 1950s through the 1980s; however, the primary modes of transmission in the post-PAT period are not well known. In this study we examined the associations between HCV prevalence and exposures to risk factors, including PAT, in a high HCV prevalence population.

Using a cross-sectional design, we examined the associations between demographic characteristics and risk factors for HCV transmission and HCV positivity prevalence among a sample of Egyptian residents. Data were collected through an interview-administered survey, and the association estimates were determined using χ² and logistic regression.

The highest HCV positivity prevalence was observed in cohorts born before 1960, and declined precipitously thereafter; whereas the proportion of subjects reporting PAT remained relatively stable. Being male, having a rural residence, and having received PAT were all associated with HCV positivity; however, PAT alone could not account for the high prevalence of HCV.

In Egypt, PAT and other transmission factors yet to be identified, as well as cohorts born before the 1960s and infected with HCV, are most likely the main contributors to the current HCV endemic.

Below:  Comparison between the number and percent of subjects who received parenteral antischistosomal therapy (PAT) and the number and percent of those who were HCV positive (HCV Pos) for either HCV anti-bodies and/or RNA in each of the age group

Full article at: http://goo.gl/veBEIt

By: Mary Kate Mohlman¹, Doa’a A. Saleh², Sameera Ezzat³, Mohamed Abdel-Hamid⁴, Brent Korba¹, Kirti Shetty¹, Sania Amr⁵ and Christopher A. Loffredo^1*

¹Lombardi Cancer Center, Georgetown University, 3970 Reservoir Rd, Washington 20057, DC, USA

²Cairo University, Cairo, Egypt

³Menoufiya University, Shibin El Kom, Egypt

⁴Minia University, Minia, Egypt

⁵University of Maryland School of Medicine, Baltimore, MD, USA

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Qualitative Interviews with Non-National Tuberculosis Patients in Cairo, Egypt: Understanding the Financial & Social Cost of Treatment Adherence

Limited data are available about the challenges of non-national TB patients undergoing long-term treatment courses in an urban setting. This study aimed to understand the financial and social cost of adherence of non-national TB patients in Cairo, Egypt as a means to inform the development of context-specific interventions to support treatment adherence. 

In 2011, 22 in-depth interviews were conducted with TB patients from Sudan, Ethiopia, Eritrea, Somalia and Djibouti to obtain qualitative data. Analysis was based on thematic analysis that aimed to identify recurrent themes and codes from the narratives. 

The study identified a number of factors that influence TB treatment adherence. Uncertain financial status due to limited or no employment was frequently discussed in interviews, which resulted in fear of not being able to support family, loss of pride, dependence on family and friends, fear of losing housing, food insecurity and limited food options. Respondents also feared infecting other household members and longed for opportunities to discuss their illness and treatment experiences with other individuals but their social networks were often limited. TB-related stigma was driven by shame and blame of infection. Respondents also believed stigma was based on their foreign origin. Stigma manifested in distancing and exclusion in various ways, resulting in isolation, psychological distress and reluctance to disclose TB status to others. Poverty-related factors and social context with a special focus on stigma should be considered when developing strategies for supporting long-term treatment courses for non-national patients in Cairo and other similar urban settings.

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By:  Lohiniva AL1, Mokhtar A2, Azer A3, Elmoghazy E4, Kamal E5, Benkirane M1, Dueger E1,6.

• 1Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No 3, Cairo, Egypt.
• 2National Tuberculosis Program, Ministry of Health in Egypt, Cairo, Egypt.
• 3United Nations High Commissioner for Refugees, 7th District, Egypt.
• 4Cairo Association Against Smoking, Tuberculosis and Lung diseases, Cairo, Egypt.
• 5Refugee Egypt, Cairo, Egypt.
• 6Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 

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