Journal of High Institute of Public Health http://jhiph.alexu.edu.eg/index.php/jhiph <p class="Default">JHIPH is an open access<strong>&nbsp;<a title="license" href="http://jhiph.alexu.edu.eg/index.php/jhiph/$$$call$$$/api/file/file-api/download-library-file?libraryFileId=1" target="_blank" rel="noopener">[CC BY-NC-ND 4.0 license]</a></strong><a title="license" href="http://jhiph.alexu.edu.eg/index.php/jhiph/$$$call$$$/api/file/file-api/download-library-file?libraryFileId=1" target="_blank" rel="noopener">,</a> peer reviewed journal, indexed on&nbsp;<strong><a href="https://scholar.google.com/">Google Scholar</a>, <a href="http://srv4.eulc.edu.eg/eulc_v5/libraries/start.aspx?ScopeID=1.&amp;">Egyptian Universities Libraries Consortium </a></strong>and<strong> <a href="http://www.who.int/library/databases/emro/en/">WHO Index Medicus of Eastern Mediterranean Region</a>&nbsp;</strong>and hosted by <a href="http://hiph.alexu.edu.eg" target="_blank" rel="noopener"><strong>High Institute of Public Health</strong></a>, <a href="http://www.alexu.edu.eg" target="_blank" rel="noopener"><strong>Alexandria University</strong></a> since 1970. Previously was Bull High Inst Public Health.</p> <p>JHIPH publishes original and review articles, case reports and case series covering all areas of public health. It has a broad scope encompassing epidemiology, prevention and control of communicable and non-communicable diseases, primary family care, nutrition, environmental health, management of health systems and services, occupational medicine and industrial hygiene, health education and health promotion.</p> <p>It has a very proficient and diverse editorial board that reflects the scope of public health. They are concerned with the quality, and authenticity of research papers and other contributions in public health areas, thrive to place the journal among the top public health journals, to expand its international outreach by an online submission system and to increase its impact factor.&nbsp;</p> High Institute of Public Health en-US Journal of High Institute of Public Health 2357-0601 <p><a title="license" href="http://jhiph.alexu.edu.eg/index.php/jhiph/$$$call$$$/api/file/file-api/download-library-file?libraryFileId=1" target="_blank" rel="noopener"><strong>Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License [CC BY-NC-ND 4.0] </strong>&nbsp;</a></p> <p>By exercising the Licensed Rights, You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International Public License.&nbsp;<strong>&nbsp;</strong>This License does not reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License. You must give <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/">appropriate credit</a> to the Licensed Material. You may do so by providing a URI or hyperlink to a resource that includes the required information Or by citing and referencing to research articles by scientific referencing styles. You may not use the material for <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/">commercial purposes</a>. If you <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/">remix, transform, or build upon</a> the material, you may not distribute the modified material. You may not apply legal terms or <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/">technological measures</a> that legally restrict others from doing anything the license permits.&nbsp;</p> Artificial Sweeteners Consumption among Alexandria University Students, Egypt http://jhiph.alexu.edu.eg/index.php/jhiph/article/view/417 <h4><strong>Background: The consumption of artificial sweeteners has increased in many countries worldwide. In the Arab world, there is little data about consumption pattern of artificial sweeteners especially among university students for their own eating practices and behaviors.</strong></h4><h4><strong>Objective(s): This study aimed to identify the rate of artificial sweetener consumption among Alexandria University students, and to determine its levels in relation to acceptable daily intake (ADI) set by Food and Drug Administration (FDA).</strong></h4><h4><strong>Methods: A cross-sectional study was carried out including 400 Alexandria University students of both sexes. The studied sample was equally allocated and randomly selected from four faculties. Data on demographic characteristics, medical history, dietary pattern, and pattern of artificial sweeteners usage were collected from each participant.</strong></h4><h4><strong>Results: The consumption of artificial sweeteners was reported by 31% of Alexandria University students. The most commonly consumed types of artificial sweeteners were Sucralose (0.59±0.2 mg/kg body weight/day) followed by Aspartame (0.03±0.01 mg/kg body weight/day). Daily levels of consumed artificial sweeteners in relation to ADI levels were 11.86±4.2% for Sucralose and 0.05±0.02% for Aspartame.</strong></h4><h4><strong>Conclusion: Daily level of consumed artificial sweeteners by Alexandria University students was less than ADI set by the FDA. Further follow up studies are needed to investigate possible side effects of long term artificial sweeteners usage. Furthermore, large epidemiological studies must be carried out to investigate artificial sweeteners consumption pattern among different age groups.</strong></h4><h4><strong>Keywords: Aspartame, Sucralose, low calories sweeteners, university students. </strong></h4> Dalia I. Tayel Nermine A. Khamis Olfat A. Darwish ##submission.copyrightStatement## 2017-09-08 2017-09-08 47 1 1 7 Occurrence and Risk Factors of Low Birth Weight in Sana’a, Yemen http://jhiph.alexu.edu.eg/index.php/jhiph/article/view/419 <p><strong>Background:</strong> Low birth weight (LBW) remains prevalent and represents a public health problem in developing countries.</p><p><strong>Objective(s):</strong> The aim of present study was to estimate the occurrence and risk factors of low birth weight in Sanaa’, Yemen.</p><p><strong>Methods:</strong>  A case-control study was conducted at Al Kuwait University Hospital, Sana'a over a year. The study included all 181 women who delivered LBW single neonates ≥37 weeks of gestation. One hundred-eighty women who delivered babies ≥ 2500 g were taken as a control group. A questionnaire was prepared and included all maternal demographic and obstetric information. The maternal antenatal records were reviewed and birth weight was recorded. </p><p><strong>Results:</strong> The occurrence of LBW was 18%. The mean birth weight was 2215.8±162.5 g. The majority of mothers giving birth to LBW infants were in the age group 20 to less than 30 (73.5%), and about 60% were from rural areas and low socioeconomic level. Also, 79.6% of the mothers giving LBW infants were anemic, compared to only 16.1% of the control group; in addition 35.4% of them were chewing Khat, compared to only 20.6% of the control group, the differences were statistically significant. About 68% of LBW infants needed neonatal ICUs, 43% were delivered by caesarean section and 8.8% were still births. Maternal education significantly increased the mean birth weight by an average of 244 g for primary level, 270 g for secondary level and 348 g for university level when compared to non-educated mothers (P=0.001). It was also found that parity has significantly increasing effect on the mean birth weight among the group of LBW of plus 50 g for mothers with 3 parities when compared to  mothers with single parity (P= 0.05).</p><p><strong>Conclusion:</strong>  Maternal education was found as one of the determining factors significantly associated with increasing birth weight of neonates. Occurrence of low birth weight can be reduced by increasing the education level.</p><p><strong><em>Keywords:</em></strong> Low birth weight, occurrence, risk factors</p> Alia A. Shuaib Kaima A. Frass ##submission.copyrightStatement## 2017-09-08 2017-09-08 47 1 8 12 Application of Health Belief Model for Hygienic Behavior of Mothers of Hospitalized Children in Alexandria http://jhiph.alexu.edu.eg/index.php/jhiph/article/view/420 <h4>Background: Health Belief Model (HBM) explains different health behaviors, including hygienic practices, in light of different perceptions about health risks and related behaviors.</h4><p><strong>Objective(s): </strong>To assess mothers’ perceptions about childhood infections and hygienic behavior based on the constructs of the Health Belief Model.</p><p><strong>Methods: </strong>A convenient sample of 300 mothers admitted with their children at El Anfoushy paediatrics hospital was interviewed. Data was collected using an interviewing questionnaire investigating mothers’ knowledge, health beliefs, self-efficacy and practices regarding hygienic behavior. The total beliefs' score was graded as high if exceeded 75% of the maximum score or low if score is below 50%. Hygienic practices of a subsample of 100 mothers were assessed using a structured observational checklist covering data about the cleanliness of mother, child and area surrounding their hospital bed.</p><p><strong>Results: </strong>The mean age of the interviewed mothers was 26.18±3.99 years. About 40% of them had basic education and almost half of them were of middle socioeconomic standard.  The level of mothers’ knowledge about hygiene was fair in 47.7% and poor in 36% of the mothers. The majority of mothers showed a high level of perceived susceptibility (86.3%), severity (88.7%) and benefits (96.7%). Less than half of the mothers (44.3%) showed a high level of perceived barriers to adhering to hygienic behavior. Almost 60% of the sample showed a high level of self-efficacy. Reported level of mothers’ hygienic practices was high in 50.3% of the sample, while observation showed a high level of practice in only 11% and low practice level in 57% of the subsample. Multiple regression analysis showed a positive significant influence of  knowledge, self-efficacy, perceived susceptibility, severity and benefits on hygienic behavior of mothers. Perceived barriers had a significant negative influence on the studied behavior.</p><p><strong>Conclusion: </strong>The hygienic behavior of mothers is markedly influenced by their beliefs regarding the relation between health and hygiene as well as their beliefs regarding their ability to and cost of performing these behaviors.</p><p><strong><em>Keywords</em></strong><strong>: </strong>Health Belief Model, Perceptions, Susceptibility, Severity, Benefits, Barriers, Self-efficacy, Hygiene, Behavior.</p> Mofida M. Kamal Mohamed D. Elborgy Mona S.I. Wahba ##submission.copyrightStatement## 2017-09-08 2017-09-08 47 1 13 21 Doctor-Patient Communication, What is the Situation? An Intervention Study at a Selected Governmental Hospital in Sharkia Governorate http://jhiph.alexu.edu.eg/index.php/jhiph/article/view/421 <p><strong>Background:</strong> Good doctor-patient communication has multiple impacts as higher compliance, satisfaction for both patients and clinicians and decrease in malpractice.</p><p><strong>Objective(s):</strong> To assess physicians’ perception towards importance of effective doctor-patient communication, as well as to measure their actual practice and skills of communication according to the items of the Kalamazoo checklist before and after training program.</p><p><strong>Methods:</strong> An intervention study was carried out at outpatient clinics in a general hospital at Zagazig district. A randomly selected sample of 198 physicians was chosen. The phases of the study were: 1- Assessing the level of doctor patient communication practice using the Kalamazoo Checklist. 2- Assessing physicians’ perception towards effective communication, using a self-administered questionnaire. 3- Assessing the level of doctor patient communication practice after training program.</p><p><strong>Results:</strong> 46.5% of physicians highly perceived the importance of effective communication; with higher perception among females. The highest perceived items (more than 80%) were the effect of good communication on patients’ compliance, patients’ satisfaction and physicians’ satisfaction. The intervention program significantly improved the physicians’ communication skills.</p><p><strong>Conclusion:</strong> Less than half of the physicians highly perceived the importance of effective communication. Training can significantly impact communication skills.</p><p><strong><em>Keywords</em>: </strong>doctor-patient communication</p> Ghada M. Salem Amira E. Abdelsalam ##submission.copyrightStatement## 2017-09-08 2017-09-08 47 1 22 28 Evaluation of Different Diagnostic Approaches for Detection of Cryptosporidium in Stools of Diarrheic Children http://jhiph.alexu.edu.eg/index.php/jhiph/article/view/422 <p><strong>Background: </strong>Cryptosporidiosis is of utmost importance especially in vulnerable age groups in developing countries. Malnourished children are more susceptible to recurrent diarrheal episodes, which can lead to chronic nutritional and cognitive sequelae or even death.</p><p><strong>Objective(s): </strong>to evaluate four different diagnostic approaches for <em>Cryptosporidium</em> infection in stools of diarrheic children.</p><p><strong>Methods</strong><strong>: </strong>One hundred stool specimens were collected from diarrheic children in Alexandria University Children Hospital (El-Shatby). All samples were investigated by four techniques; directly by microscopic detection of <em>Cryptosporidium </em>oocysts using modified Ziehl-Neelsen (MZN) stain. Indirectly, through detection of coproantigen by enzyme linked immunosorbent assay (ELISA) and rapid strip test. <em>Cryptosporidium</em> DNA was detected by conventional polymerase chain reaction (PCR).</p><p><strong>Results: </strong>Using the four methods, 65% of examined children had <em>Cryptosporidium</em> infection, while <em>Cryptosporidium </em>oocysts were shown by MZN stain technique among 41%. However, by rapid strip test, ELISA, and PCR the percentages were 45%, 48%, and 59%, respectively. PCR elicited the highest diagnostic efficiency (64%) among the three diagnostic non-microscopic techniques when the MZN technique was used as the gold standard test. However, rapid strip test showed the least diagnostic efficiency (48%) when compared to PCR that was considered as the gold standard test. Meanwhile, ELISA was of moderate performance when compared to either PCR or to MZN technique used as gold standard test.</p><p><strong>Conclusion: </strong>PCR was more sensitive than rapid strip test and ELISA. It is time saving, but not cost effective. The rapid strip test could be considered as a complementary (additional) tool rather than a substitute for microscopic examination. It could be used for screening in cases of outbreaks of diarrhea for faster management of the problem.</p><strong><em>Keywords: </em></strong><em>Cryptosporidium</em>, PCR, ELISA, diarrheic children, diagnostic performance, rapid strip test Safaa M.M. Eassa Wael Felfel Sanaa A. Elmasry Azza H. Abdulfattah ##submission.copyrightStatement## 2017-09-08 2017-09-08 47 1 29 38