Abstract Background Egypt has made progress in delaying age at marriage, but child marriage continues to be practiced in many places across the country. This study investigates the impacts of child marriage on the health and wellbeing of girls residing in urban Egypt using a multi-method approach. Methods The quantitative component leveraged data from the 2014 Egypt Demographic and Health Survey and focused on (1) reproductive health, (2) maternal health and (3) social outcomes among a subsample of ever-married urban women ages 20–24 (N = 1041). Simple and multivariable logistic regressions were used to estimate prevalence odds ratios and 95% confidence intervals for associations between child marriage and the three sets of outcomes. The qualitative component drew from 11 focus groups, 23 in-depth interviews, and 13 key informant interviews conducted in three urban sites in Egypt. The data was thematically analyzed using a combination of inductive and deductive coding. Results The prevalence of marriage under age 18 was 13.22%. Child marriage was significantly associated with ever use of contraception (Adjusted Odds Ratio (AOR) 2.95 95% CI 1.67–5.19), multiple births (AOR 12.93 95% CI 5.45–30.72), rapid repeat childbirth (AOR 2.20 95% CI 1.34–3.63), and pregnancy termination (AOR 1.89 95% CI 1.11–3.23). Many of these associations disappeared after adjusting for marriage duration. Girls married under age 18 had larger spousal age gaps (AOR 2.06; 95% CI 1.24–3.41) and higher odds of FGM (AOR 2.14; 95% CI 1.11–4.13). They were significantly more likely to report receiving no ANC care (AOR 0.39; 95% CI 0.19–0.80), and less likely to deliver through C-section (AOR: 0.53; 95% CI 0.34–0.83). Consequences emerging from the qualitative data centered around five themes: (1) Access to and use of sexual and reproductive health services; (2) exposure to FGM; (3) marriage and birth registration; (4) marital relations; and (5) relationship with in-laws. Conclusion Findings provide important insights into the practice of child marriage in urban areas in Egypt and illustrate a range of adverse consequences associated with the practice.
Shatha Elnakib, May Elsallab, Maha Abdel Wanis et al.
A cross-sectional descriptive design study was conducted in the pediatric hospital in Al-Hasahisa-Algazera state -Sudan, to ascertain the prevalence of stunting in children under five years old. There are 100 patients in the samples (46 girls and 54 males). The questionnaire used to collect the study's primary data includes questions about participant content, sociodemographics, housing status, health, and nutrition. To estimate the patient's percentage of stunting, anthropometric measures, including height/length for age and mid-upper arm circumference (MUAC), were also obtained. The data showed that most of the children were raised in nuclear homes. A significant correlation (P value <0.05) was seen between stunting and mother education. The parents' educational attainment showed that a sizable percentage of fathers (52%) and mothers (45%) were illiterate. According to the findings, 82% of mothers were housewives, and 75% of fathers were employed. This finding demonstrated a significant (P value 0.004) relationship between income level and stunting, with weak income (22%), moderate-income (78%), and no income level. Furthermore, 36% of completed breastfeeders and 37% of non-completers showed a highly significant (P value 0.003) correlation between breastfeeding and stunting. During the course of the study, diarrheal diseases affected 68% of the children, while anemia (27%), malaria (52%), parasitic infections (17%), and chest infections (69%)were the most common conditions. 39% of the kids had severe malnutrition, and 18% had moderate malnutrition. The bulk of them, 78%, were stunted, with the remaining 19% mild, 11% moderate, and 48% severely stunted. According to the report, 35% of stunted children were female, and 43% of stunted children were male.
Mutations in the pyridine nucleotide-disulfide oxide reductase domain-containing protein 1 (PYROXD1) gene are characteristically linked to early-onset congenital myofibrillar myopathy, typically presenting with generalized weakness, hypotonia, and respiratory insufficiency in infancy or early childhood.However, emerging evidence suggests phenotypic heterogeneity.We report the case of a 45-year-old Tunisian woman, born to non-consanguineous parents, who presented with a slowly progressive limb-girdle muscular dystrophy (LGMD) phenotype; her older brother, subsequently confirmed to carry the same homozygous variant, had a similar but more severe clinical history of proximal weakness.The patient's symptoms began at age 17 with running difficulties, progressing by age 35 to difficulty rising from a seated position and climbing stairs, and by age 45 to exertional dyspnea, dysphagia, and sleep-disordered breathing.Physical examination revealed a high-arched palate, scoliosis, joint hypermobility, limited ankle dorsiflexion, palatal weakness, and mild neck flexion weakness alongside a proximal-dominant limb-girdle pattern of weakness.Her brother showed a matching but more severe phenotype starting at age 12. Electrodiagnostic studies demonstrated normal nerve conduction and a nonirritable myopathy; serum creatine kinase was entirely normal, and pulmonary function testing revealed a restrictive ventilatory defect with mild obstructive sleep apnea on polysomnography.Clinical exome sequencing confirmed a pathogenic homozygous c.464A>G (p.Asn155Ser) mutation in the PYROXD1 gene in both affected siblings, with both parents confirmed as unaffected heterozygous carriers.This represents the first molecularly confirmed family with PYROXD1-related myopathy in Tunisia and North Africa, and only the second family identified across the African continent; a single unrelated Tunisian case harboring the same variant has also recently been reported.This case expands the known clinical spectrum of PYROXD1 variants to include adult-onset LGMD-like presentations with respiratory and bulbar involvement, emphasizes the diagnostic utility of recognizing associated dysmorphic features (scoliosis, high-arched palate, nasal speech, and joint hypermobility), and highlights the pivotal role of comprehensive genomic testing in atypical adult myopathies.
Abraham Alhatou, Omar Mohammed Alhatou, Mohammed Alhatou
Abstract This study assessed parental attitudes toward routine childhood vaccination in five Arab countries (Egypt, Jordan, Saudi Arabia, Syria, and Libya) and explored factors associated with vaccine hesitancy in the post-coronavirus disease 2019 (COVID-19) pandemic period. Using a cross-sectional design, 2095 parents or guardians of children aged ≤ 4 years were surveyed via online and face-to-face interviews. The Arabic version of the Parent Attitudes about Childhood Vaccines Scale was used to measure parental vaccine hesitancy. Overall, 18.8% of parents were classified as vaccine hesitant. In multivariable modified Poisson regression analysis, residing in Libya was associated with a significantly lower prevalence of vaccine hesitancy compared with Egypt (adjusted prevalence ratio (aPR): 0.14, 95% CI 0.07–0.28; p <0.001), whereas rural residence (aPR: 1.28, 95% CI 1.03–1.58; p = 0.024), unemployment (aPR: 1.26, 95% CI 1.01–1.56; p = 0.040), having a child born after the COVID-19 pandemic (aPR: 1.54, 95% CI 1.22–1.94; p <0.001), family history of COVID-19-related death (aPR: 1.34, 95% CI 1.08–1.65; p = 0.007), lack of parental COVID-19 vaccination (aPR: 1.56, 95% CI 1.26–1.92; p <0.001), and lower confidence in vaccinations provided by the health system (aPR: 2.24, 95% CI 1.77–2.83; p < 0.001) were independently associated with higher parental vaccine hesitancy. Mediation analyses found no significant indirect associations through parental vaccine hesitancy on the relationships between education, country income, parental COVID-19 vaccination or infection history, and childhood vaccination. However, education, country income, and parental COVID-19 infection demonstrated significant direct effects on childhood vaccination status. These findings emphasize the importance of strengthening confidence in health systems and addressing socioeconomic disparities to reduce parental vaccine hesitancy and support childhood immunization programs in the post-pandemic era.
Ehab Elrewany, Ayat Diaa Eldeen Ashour, Hoda Ali Ahmed Shiba et al.
