Data on demographic, social and behavioural characteristics of female sex workers in greater Cairo are very scarce. A cross-sectional study was conducted with 431 randomly selected sex workers after mapping of sites where they gather. Data collection was performed by direct interviewing using a questionnaire sheet covering sociodemographic data and sexual history with paying and non-paying partners. More than one half of participants (52.7%) were aged < 30 years. Only 39.3% were exclusively working as sex workers while the rest had other jobs beside sex work. Almost 70% were responsible for deperidants. The age of first selling sex was < 15 years for 4.7% of the women and 15-25 years for 58.7%. Unwanted pregnancies were experienced by 36.2% and 34.8% had had an abortion. Many participants had ever been arrested by the police (71.2%). The study has provided some useful background data for further studies in this very sensitive area of research.

Intimate partner violence is common in rural areas of Ethiopia. The aim of this study was to assess the knowledge and prevalence of domestic violence among women in Kersa district of Oromia region and identify the types, perpetuators and triggers for violence. A community-based cross-sectional interview-based survey was conducted in 2008 on 858 women of reproductive age. Only 39.7% of women reported that they recognized that violence against women was a problem in their area. Ever experience of violence by an intimate partner was reported by 166 women (19.6%) and 70.3% of the perpetuators were husbands. Ever experience of domestic violence among women was significantly related to Amhara ethnicity and age group 30-49 years. Only 33 (19.9%) women who ever experienced violence had reported it to the legal authorities. Women's reasons for failing to report to the legal system were not wanting to expose the issue and not knowing where to go.

To evaluate the effect of prenatal counselling on compliance for health promotion and pregnancy outcomes we conducted an experimental randomized control study on a sample of 86 teenage pregnant women attending the maternal and child health centre in Elkhosos village, Egypt. Data were collected pre-counselling, post-counselling and after delivery. At the post test, women in the study (counselling) group showed statistically significantly greater knowledge and compliance of health promotion (P < 0.001) than women in the control group. In the study group, 90.7% were full term at labour compared with 41.9% in the control group; 88.4% of the women in the study group had normal vaginal delivery compared with 76.7% of those in the control group. The health condition in 90.7% of the study group neonates was classified as good compared with only 46.5% in the control group. Only 9.3% of the study group babies had low birth weight compared with 32.6% of the control group babies (P = 0.008).

Evidence- and consensus-based clinical practice guidelines for haemodialysis have recently been developed in Egypt. This study aimed to measure compliance with the guidelines in a sample of 16 government hospitals in Cairo and Giza governorates. Each haemodialysis unit was visited to assess the haemodialysis unit and patient care practices for all patients under dialysis at the time of the visit. The mean percentage compliance with haemodialysis guidelines among all study hospitals was 59.3% (SD 11.2%) overall. Within the 5 separate domains, compliance was: 58.8% (SD 12.4%) for personnel, 68.5% (SD 16.0%) for patient care practices, 61.3% (SD 15.4%) for infection prevention and control, 51.5% (SD 18.2%) for the facility and 56.5% (SD 7.1%) for documentation/ records. There were no statistically significant differences between Cairo and Giza governorates except for facility measures which were slightly better in Giza. Overall, compliance with the developed practice guidelines for haemodialysis in Egypt was not satisfactory and was not uniform across facilities.

Afghanistan has 2 tuberculosis surveillance systems, the National Tuberculosis Control Programme (NTP) and the Health Management Information System (HMIS). An evaluation of these surveillance systems in January/ February 2010 was done to identify their strengths and weaknesses and to formulate recommendations. Attributes of the programmes were evaluated using US Centers for Disease Control and Prevention guidelines. Usefulness and flexibility of the NTP system were good; stability, representativeness and data quality were average. Simplicity, acceptability and timeliness were poor. Reporting delays regularly exceeded 3 months. Positive predictive value and sensitivity were 11% and 70% respectively. The HMIS system was simple, acceptable and stable, with timely reporting. Reporting and feedback were good, as this system has strong government support. Flexibility, data quality and representativeness were average. Positive predictive value and sensitivity were 10% and 68% respectively. No outbreaks were detected by ther system. The NTP and HMIS surveillance systems are duplicative and neither covers the private sector.

Hepatitis C is a health problem worldwide. The World Health Organization estimates that 3% of world's population is infected with hepatitis C virus (HCV). In haemodialysis patients, the prevalence reaches 80% in some countries. In Morocco, HCV prevalence is 32% according to the Moroccan register of dialysis. The natural history of hepatitis C infection in chronic haemodialysis patients is characterized by a silent evolution. There are different methods to diagnose HCV and they are becoming increasingly sensitive. There are indirect tests for antibodies to HCV: these are reproducible but false negatives are common and there is direct testing of viral RNA: this is more sensitive but not always available and is more expensive. The use of these tests has been categorized through new recommendations from learned societies. However, the evaluation of liver disease is still controversial and liver biopsy remains the gold standard. This paper reviews the approaches for diagnosing and evaluating hepatitis C in haemodialysis patients.

Milk, in addition to its undeniable nutritional and immunological benefits, is an important element for the development of the infant. Warnings, sometimes exaggerated, may prevent the mother and child from enjoying the benefits of both breastfeeding and appropriate medication. This approach is justified by the total absence of investigations on the excretion of drugs in breast milk during clinical trials. The actual risk was evaluated by several classifications; an estimate of the passage of drugs into milk and estimation of infant exposure to the drug are possible and can provide a reliable indicator to better judge the risk to the infant. Generally we are faced with two different situations: a new treatment during lactation or maintenance treatment already prescribed during pregnancy. If treatment needs to be prescribed for a long period of breastfeeding, a strategic approach is required.

The role of inflammatory cytokines in the pathophysiology of beta-thalassaemia is still unclear. In this study production levels of interleukins (IL)-12 and IL-13 were measured by commercial ELISA in culture supernatants of mitogen-stimulated peripheral blood mononuclear cells-from 30 non-splenectomized beta-thalassaemia cases with iron overload and 20 age- and sex-matched healthy individuals. IL-12 levels were significantly lower among cases compared with controls (91.4 pg/mL versus 154.6 pg/mL), while IL-13 levels were significantly higher (42.5 pg/mL versus 5.7 pg/mL). There was a significant negative correlation between IL-12 and lL-13 levels among beta-thalassaemia cases (r= -0.42). Patients with beta-thalassaemia alone had higher IL-12 levels than beta-thalassaemia patients who were seropositive for chronic hepatitis B or C virus infection (140 pg/mL versus 50 pg/mL); IL-13 levels were slightly lower (65 pg/mL versus 67 pg/mL). An imbalance in the IL-12/IL-13 axis may be relevant to the pathophysiology of beta-thalassaemia.

The diagnosis of diabetes mellitus by the available criteria is controversial and relies heavily on fasting glucose results. This cross-sectional study in 2010-2011 aimed to measure the frequency of impaired glucose tolerance and diabetes mellitus in 127 subjects having fasting blood glucose < 7.0 mmol/L and to measure the agreement between different standard diagnostic criteria. Subjects presenting to a laboratory for analysis of fasting blood glucose for excluding diabetes mellitus underwent a 2-hour 75 g oral glucose challenge. A total of 40.6% of subjects with fasting blood glucose from 5.6-6.0 mmol/L had abnormal glucose regulation on the basis ofthe gold standard glucose challenge. Agreement between American Diabetes Association and World Health Organization diagnostic criteria was only fair (kappa = 0.32). Abnormalities of glucose metabolism including impaired glucose tolerance and diabetes mellitus can exist at fasting blood glucose results < 6.1 mmol/L (110 mg/dL).

Depression is projected to be the leading cause of disease burden in older populations by the year 2020. The aim of this study was to assess the prevalence depression among a group of elders in Alexandria, Egypt and compare the characteristic of elders in 3 different settings. A descriptive, cross-sectional study was carried out among 100 people aged 60+ years in a government elderly home, an internal medicine ward in Alexandria Main University Hospital and a slum area in Alexandria. Based on the Geriatric Depression Scale (short form) the highest prevalence of scores that were suggestive or indicative of depression was among elders who were hospitalized (79.0%), had ophthalmic diseases (85.7%) or tumours (80.0%), had 2+ chronic morbidities (64.9%), were taking 4+ medications daily (83,3%), were more physically dependent and had 2+ hospital admissions in the last 3 years (90.9%). Modifiable factors that impact on depression need to be considered in developing interventions for improving mood states in the elderly.