Development and validation of a French questionnaire that assesses knowledge, attitude, and practices toward Marburg diseases in sub-Saharan African countries

OBJECTIVES

Marburg virus, previously referred to as Marburg hemorrhagic fever, is a highly severe and frequently fatal illness that affects humans. This study aimed to develop and validate a French questionnaire to assess knowledge, attitude, and practice toward Marburg virus disease (FKAP-MVD).

STUDY DESIGN

An anonymous online survey was used, which was distributed through various platforms and emails. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal.

METHODS

To conduct the study, an anonymous online survey was used, which was distributed through various platforms such as Facebook, Twitter, WhatsApp, and emails. The survey was uploaded onto a Google form to facilitate data collection. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal.

RESULTS

Of the total sample of 510 participants, 60.0% were male, their mean age was 28.41 ± 6.32 years, 38.0% were married, 86.6% resided in urban areas and 64.1% had a university education. The questionnaire had good internal consistency; Cronbach's alpha was 0.87. The correlation between knowledge and attitude was 0.002, the correlation between knowledge and practice was 0.204, and the correlation between practice and attitude was relatively weak and negative at -0.060. This indicates the divergent validity of the questionnaire. The KMO value of 0.91 indicates a high level of adequacy, suggesting that the data are suitable for factor analysis. The Bartlett test of Sphericity yielded an approximate χ2 value of 4016.890 with 300 degrees of freedom and a P-value of 0.0001. The confirmatory factor analysis revealed 25 questions in three domains. The normed chi-square value is 1.224. The goodness of Fit Index (GFI) is 0.902, the Comparative Fit Index (CFI) is 0.982, the Root Mean Square Error of Approximation (RMSEA) is 0.033, and the Root Mean Square Residual (RMR) is 0.062. These values indicate a good fit of the model to the data.

CONCLUSIONS

In general, the developed questionnaire has significant potential to inform public health initiatives and interventions related to MVD.

Routine childhood immunization in Sub-Saharan Africa: addressing parental vaccine hesitancy

OBJECTIVES

Parental vaccine hesitancy (VH) is a major barrier to childhood vaccination. We aimed to identify the determinants of parental VH towards routine childhood immunization in 12 Sub-Saharan African countries.

STUDY DESIGN

A cross-sectional study was conducted from November 1 to December 15, 2022.

METHODS

Parents of children aged 19 months to 6 years and residing in the Sub-Saharan Africa were included. An anonymous online survey and face-to-face interviews were conducted. The Parent Attitude about Childhood Vaccine Scale was used to identify vaccine-hesitant parents. Multivariate regression and mediating analysis were performed.

RESULTS

Across the 5032 participants, 21.2% were hesitant towards routine childhood immunization. Urban residents (adjusted odds ratio [AOR] = 1.32, 95% confidence interval [CI]: 1.10-1.58), non-first-born children (AOR = 1.54, 95% CI: 1.19-1.98), and chronically ill children (AOR = 2.00, 95% CI: 1.69-2.37) increased the likelihood of parental VH. Mothers with higher education, attending at least one antenatal care (ANC) visit (AOR = 0.25, 95% CI: 0.19-0.32), and had a healthcare facility-based delivery (AOR = 0.55, 95% CI: 0.44-0.70) decreased the odds of parental VH. Parental VH mediated the effect of ANC and mothers' age on vaccination uptake. ANC increased the odds of vaccination uptake (odds ratio [OR] = 12.49, 95% CI: 9.68-16.13). Parental VH mediated the association between ANC and vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.12, 95% CI: 0.10-0.14). Each additional year of the mother's age decreased the odds of vaccination uptake (OR = 0.95, 95% CI: 0.95-0.96). The indirect effect of mother's age on vaccination through parental VH decreased the odds of vaccination uptake (OR = 0.45, 95% CI: 0.44-0.45). Parental VH continued to be a mediator of the combined effect of mother's age and ANC on vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.0017, 95% CI: 0.00166-0.00168).

CONCLUSIONS

Context-specific interventions are needed to address parental VH and improve vaccine acceptance and coverage.

Social Media Effect on Personal Self-Esteem Among the Population in Saudi Arabia

Background Self-esteem is a self-valuation; it is how people perceive their own worth and how valuable they believe they are to others. In this study, our primary objective was to explore the association between social media use and self-esteem among individuals who actively engage with social media platforms in Saudi Arabia. Method This study involved individuals aged 15 and above who are active social media users residing in Saudi Arabia. The data were collected through an anonymous online cross-sectional survey. Participants were recruited using snowball and convenience sampling method. A questionnaire was administered through Google Forms to collect data from participants. The questionnaire was structured into three sections, which included gathering social and demographic information, assessing personal usage patterns, and evaluating individual self-esteem levels using an Arabic valid version of the Rosenberg Self-Esteem Scale.  Results The survey included a total of 2,551 participants. Among them, 51.3% (n = 1,309) were female, 29% (n = 741) fell within the 21-25 age group, 95.7% (n = 2,441) were of Saudi nationality, and 51.6% (n = 1,316) were single. The social media platform most frequently used by participants was TikTok 98.5% (n = 2,512), followed by Facebook 95.7% (n = 2,441), Telegram 89.8% (n = 2,291), YouTube 72.2% (n = 1,942), WhatsApp 66.0% (n = 1,683), and finally, Snapchat 30.7% (n = 1,769). In total, 14.3% (n= 366) have low self-esteem, participants scored around 16.10 ± 1.80, ranging from 5 to 25. The following variables were significantly associated with self-esteem: female sex (83.88% vs 87.52%, X2 = 6.87, p = 0.009), nationality (X2 = 13.507, p < 0.001), marital status (X2 = 12.313, p = 0.006), region (X2 = 18.36, p = 0.001), using Tik Tok (X2 = 4.11, p = 0.043), the frequency of posting comments (X2 = 12.01, p = 0.017), comparing oneself to others (X2 = 27.94, p < 0.001), using social media because of weak personal communication (X2 = 6.56, p = 0.010), using social media to follow news (X2 = 6.89, p = 0.009), and the perceived effect of social media (X2 = 16.28, p < 0.001). Conclusions Our findings revealed that a minority of participants exhibited low self-esteem, and individuals from the Northern region were more likely to report such issues. Sociodemographic factors, including gender, nationality, and marital status, demonstrated associations with self-esteem. Additionally, the frequency of comments, TikTok usage, and peer comparison significantly influenced self-esteem levels.

Examining the Impact of Socioeconomic Factors and Lifestyle Habits on Obesity Prevalence Among Male and Female Adolescent Students in Asser, Saudi Arabia

Background Understanding the relationships between obesity and lifestyle factors is essential for the effective prevention and management of obesity in youth. This study aimed to investigate the association between sociodemographic factors, lifestyle elements such as physical activity and social stress, and the prevalence of overweight and obesity among Saudi adolescents in the Aseer region. Methodology From December 2022 to March 2023, we conducted a cross-sectional study using the multi-stage stratified random sampling technique. The study included Saudi male and female adolescents aged 12-19 years attending middle and high schools. Ordinal logistic regression was used to analyze the association between the ordinal dependent variable, classified into weight groups (normal, overweight, obese), and the independent variables. Results Of the total of 512 individuals, 90.4% were aged ≥18 years, 77.5% were males, and 76.8% were urban residents. Of the studied population, 33.6% were overweight, and 20.5% were obese. The prevalence of obesity and overweight was significantly higher among males compared to females (20.9% vs. 19.1% and 36.5% vs. 23.5%, respectively). Multivariate analysis revealed the following factors to be associated with obesity and overweight: female gender (2.31, 95% CI = 1.45-3.71), age 12-17 years (0.53, 95% CI = 0.28-0.97), place of delivery (Tanoma) (2.32, 95% CI = 1.13-4.75), family size of over eight members (0.43, 95% CI = 0.24-0.74), family monthly income of over 20,000 SAR (3.79, 95% CI = 1.38-11.35), being smokers (0.26, 95% CI = 1.31-2.93), experiencing social stress (1.96, 95% CI = 1.96-2.93), engagement in physical activity less than three times a week (0.49, 95% CI = 0.32-0.75), and engagement in physical activity more than three times a week (0.36, 95% CI = 0.22-0.58). Conclusions These findings emphasize the importance of addressing demographic, socioeconomic, and lifestyle factors in combating childhood and adolescent obesity through targeted interventions.

Knowledge, Attitude, and Practice of Diabetic Foot Ulcer Care in Asser Region: A Cross-Sectional Study

Background Foot problems continue to be the leading cause of hospital admissions among people with diabetes. The objective of this study was to explore and assess the knowledge and attitudes of individuals about diabetic foot ulcers in the Asser region, Saudi Arabia. Methodology An anonymous, online, cross-sectional survey was conducted. The questionnaire was distributed through commonly used social media platforms such as Instagram, Facebook, and Twitter. Results A total of 445 participants were included in this survey. Overall, 37.1% (165) were aged 18-25 years, 64.3% (286) were women, and 75.7% (337) had university-level education. A significant number of participants had relatives with diabetes (57.1%, 254), while a smaller percentage reported having diabetes themselves (7.3%, 33), and a substantial proportion were neither diabetic nor had a relative with diabetes (35.6%, (158). Nearly two-fifths of the participants (37.8%, 168) received information about diabetes and diabetic foot care from physicians, and 34.1% (152) of the participants accessed information online. There were significant differences between those who did not have diabetes mellitus (DM) and those who had DM or whose relatives were diabetic in responses to the following questions: "Do you think that diabetes may cause gangrene in the foot?" (50.9% (205) vs. 45.7% (32), p = 0.019), "Do you think that preventing diabetic foot ulcers is more important than treating diabetic foot ulcers?" (60.8% (228) vs. 46.9% (60), p = 0.002), and "Do you think it is important to constantly monitor diabetic foot wounds?" (63.1% (200) vs. 30.4% (17), p < 0.001). There was a statistically significant difference between groups in the practice of daily foot checks, washing feet, moisturizing feet, keeping feet away from hot and cold, and nail care (p < 0.001). Conclusions The participants in the study showed a lack of knowledge regarding diabetic foot care, indicating the potential for better outcomes through the implementation of enhanced health education programs.

Clinicopathologic Features of Breast Cancer in Egypt-Contemporary Profile and Future Needs: A Systematic Review and Meta-Analysis

PURPOSE

Breast cancer (BC) is the most common cancer among Egyptian females. No current national cancer database is available in Egypt to provide reliable data on the specific clinicopathologic features of BC in this population. Herein, we investigated the clinical profile of BC among Egyptian women.

METHODS

A systematic review of studies on BC published from inception until December 2021 was performed. We explored pooled estimated proportions of different stages of BC at presentation in Egypt and other clinicopathologic features including age, menopausal status, tumor (T) and lymph node (N) stages, and biological subtypes. Data analysis was performed using meta package (R).

RESULTS

Twenty-six studies were eligible for our systematic review and meta-analysis, including 31,172 BC cases. In 12 studies, including 15,067 patients with BC, the estimated mean age was 50.46 years (95% CI, 48.7 to 52.1; I2, 99%), with a pooled proportion of premenopausal/perimenopausal women of 57% (95% CI, 50 to 63; I2, 98%). Among 9,738 patients with BC, pooled proportions of stage I, II, III, and IV were 6% (95% CI, 4 to 8; I2, 90%), 37% (95% CI, 31 to 43; I2, 93%), 45% (95% CI, 42 to 49; I2, 78%), and 11% (95% CI, 9 to 15; I2, 87%), respectively. The pooled proportions of patients with T3 and T4 tumors were 21% (95% CI, 14 to 31; I2, 99%) and 8% (95% CI, 5 to 12; I2, 96%), respectively, while those with positive lymph nodes were 70% (95% CI, 59 to 79; I2, 99%).

CONCLUSION

Dominance of advanced stage and young age at diagnosis represented the two main features of BC among Egyptian women. Our data may serve to guide the policymakers in Egypt as well as other countries with lower resources to prioritize the diagnostic and therapeutic needs in this context.

Monkeypox (mpox) Outbreak: More queries posed as cases soar globally

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Translation and cultural adaptation of the WHO generic tuberculosis patient cost survey in an Egyptian context

Background: Tuberculosis (TB) represents a major health problem with a considerable proportion of patients subject to catastrophic health expenditure. This necessitates a valid tool for measuring TB-related expenditure for patients and their households so that appropriate measures can be enacted to lessen the financial burden. Aims: To translate and culturally validate the generic World Health Organization (WHO) tuberculosis patient cost survey in the Egyptian context. Methods: The instrument was translated and culturally adapted using forward translation, back translation, expert panel assessment, pretesting, cognitive interviewing, and appraisal by the developer. Results: A final Arabic version with modifications to 35 descriptors of the original tool was produced based on the results of expert committee meetings and cognitive interviews with patients. Twelve questions were modified, 13 response options were changed, 6 questions were added and 4 questions were removed. The pretesting of the tool demonstrated that the final version was a culturally sensitive tool to assess the costs incurred by TB patients in an Egyptian context. Conclusion: Policy-makers are encouraged to use this tool to assess the expenditure encountered by TB patients to set appropriate policies to reduce the patients’ financial burden.

Kupffer Cell Hyaline Globules in Children With Autoimmune Hepatitis

BACKGROUND

Hyaline globules (HGs) in the cytoplasm of Kupffer cells (KCs) have been appraised for being a typical feature of autoimmune hepatitis (AIH). This study aimed to determine how useful Kupffer cell hyaline globules (KCHGs) are in diagnosing AIH vs. other causes of pediatric chronic liver diseases (PCLDs).

MATERIALS AND METHODS

This retrospective study recruited 124 children; 58 with AIH, 50 with chronic hepatitis C virus (HCV) infection, and 16 with Wilson's disease (WD). Two pathologists retrieved paraffin blocks of liver biopsies and prepared new cut sections for Periodic acid-Schiff-Diastase (PAS-D) stain. They independently examined liver biopsies before starting treatment. Two pediatricians reviewed medical records for demographic, clinical, laboratory, and serological findings.

RESULTS

Females represented 48.6% of the studied children with a median age of 5.8 (4.9) years. Pathologists identified KCHGs in 67.24%, 12.5%, and 6.0% of AIH, WD, and HCV affected children respectively, P < 0.001. A significantly higher proportion of seropositive than seronegative AIH patients had KCHGs (77.5% vs. 50.0%), (P < 0.05). In multivariate analysis, KCHGs and prolonged prothrombin time were the only significant predictors that differentiate between AIH and the other studied PCLDs. The odds ratio of having AIH increased 68 times if KCHGs were seen. Among children with AIH, the presence of KCHGs was associated with higher median levels of direct bilirubin 2.2 (1.3) vs. 1.2 (2.2), and immunoglobulin G 3.2 (1.9) vs. 2.0 (1.7), (P < 0.05), but not to histopathological findings or hepatic fibrosis and activity.

CONCLUSIONS

KCHGs are key indicators that can differentiate between AIH and other PCLDs, and between seropositive and seronegative AIH.