Background The early childhood period is considered the most important developmental phase in an individual's lifespan. However, it is not addressed in the Egyptian health system. We aimed to explore mothers' and healthcare providers' perceptions about early childhood development (ECD) and identify their needs to support ECD in Egypt. Methods Focus group discussions with 79 mothers of children younger than 2 years old from different socio‐economic backgrounds and residing in urban and rural areas and 26 primary healthcare providers were used to collect data. Emerging themes and subthemes were identified from the data analysis. Results Urban and rural mothers in Egypt of all educational levels are not well prepared to support their children's early development, especially the cognitive and emotional aspects. Limited sources of information about ECD, the large families of rural women and an absence of developmental health services and family support were the most important factors that led to a neglect of mother–child communication and stimulation. Conclusion Raising community awareness and training primary healthcare providers to counsel mothers about ECD are important prerequisites for supporting ECD in Egypt. Rural and first‐time mothers would be the most valuable starting point.

Background The early childhood period is considered the most important developmental phase in an individual's lifespan. However, it is not addressed in the Egyptian health system. We aimed to explore mothers' and healthcare providers' perceptions about early childhood development (ECD) and identify their needs to support ECD in Egypt. Methods Focus group discussions with 79 mothers of children younger than 2 years old from different socio‐economic backgrounds and residing in urban and rural areas and 26 primary healthcare providers were used to collect data. Emerging themes and subthemes were identified from the data analysis. Results Urban and rural mothers in Egypt of all educational levels are not well prepared to support their children's early development, especially the cognitive and emotional aspects. Limited sources of information about ECD, the large families of rural women and an absence of developmental health services and family support were the most important factors that led to a neglect of mother–child communication and stimulation. Conclusion Raising community awareness and training primary healthcare providers to counsel mothers about ECD are important prerequisites for supporting ECD in Egypt. Rural and first‐time mothers would be the most valuable starting point.

Objectives: To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. Methods: A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Results: Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Conclusion: Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use.

Objectives: To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. Methods: A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Results: Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Conclusion: Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use.

Objectives: to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. Methods: We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Results: Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Conclusion: Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pretravel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services.

Objectives: to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. Methods: We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Results: Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Conclusion: Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pretravel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services.

Background Bacteria and viruses have been implicated as a major cause of chronic obstructive pulmonary disease (COPD) exacerbations; however, the potential role of fungal colonization and infection is poorly understood. Objective The aim of this study was to assess the profile of pulmonary fungal infection among COPD patients with and without comorbidities to determine their prevalence, risk factors, and outcome among those patients. Patients and methods In this prospective cross-sectional analytic study, different samples (sputum, bronchoalveolar lavage, blood, and others) from 177 COPD patients at risk for pulmonary fungal infection were examined using mycological analysis (direct microscopy and culture). Bronchoalveolar lavage and blood samples were examined using the human 1,3-β-D-glucan and galactomannan ELISA tests. Results The prevalence of pulmonary fungal infection was significantly higher in COPD patients with comorbidities (77.8%) versus COPD patients without comorbidities (53.1%) (P0.001), with a predominance of Candida and Aspergillus spp. in both groups. Mechanical ventilation, corticosteroid therapy, ICU admission, and age were major risk factors for pulmonary fungal infection in COPD patients with comorbidities [P=0.012, odds ratio (ODR)=2.23; P=0.028, ODR=1.99; P=0.025, ODR=1.94; and P=0.034, ODR= 2.60; respectively]. COPD patients with comorbidities had significantly higher mortality rate (12.3%) compared with COPD patients without comorbidities (3.1%; P0.05). Blood galactomannan antigen was positive in 16 (19.7%) COPD patients with comorbidities versus seven (7.3%) in COPD patients without comorbidities (P0.05). Conclusion COPD patients with comorbidities had a higher prevalence of pulmonary fungal infection and higher mortality rate compared with COPD patients without comorbidities. Age, mechanical ventilation, corticosteroid therapy, and ICU admission were independent risk factors for pulmonary fungal infection in COPD patients with comorbidities.

Background Bacteria and viruses have been implicated as a major cause of chronic obstructive pulmonary disease (COPD) exacerbations; however, the potential role of fungal colonization and infection is poorly understood. Objective The aim of this study was to assess the profile of pulmonary fungal infection among COPD patients with and without comorbidities to determine their prevalence, risk factors, and outcome among those patients. Patients and methods In this prospective cross-sectional analytic study, different samples (sputum, bronchoalveolar lavage, blood, and others) from 177 COPD patients at risk for pulmonary fungal infection were examined using mycological analysis (direct microscopy and culture). Bronchoalveolar lavage and blood samples were examined using the human 1,3-β-D-glucan and galactomannan ELISA tests. Results The prevalence of pulmonary fungal infection was significantly higher in COPD patients with comorbidities (77.8%) versus COPD patients without comorbidities (53.1%) (P0.001), with a predominance of Candida and Aspergillus spp. in both groups. Mechanical ventilation, corticosteroid therapy, ICU admission, and age were major risk factors for pulmonary fungal infection in COPD patients with comorbidities [P=0.012, odds ratio (ODR)=2.23; P=0.028, ODR=1.99; P=0.025, ODR=1.94; and P=0.034, ODR= 2.60; respectively]. COPD patients with comorbidities had significantly higher mortality rate (12.3%) compared with COPD patients without comorbidities (3.1%; P0.05). Blood galactomannan antigen was positive in 16 (19.7%) COPD patients with comorbidities versus seven (7.3%) in COPD patients without comorbidities (P0.05). Conclusion COPD patients with comorbidities had a higher prevalence of pulmonary fungal infection and higher mortality rate compared with COPD patients without comorbidities. Age, mechanical ventilation, corticosteroid therapy, and ICU admission were independent risk factors for pulmonary fungal infection in COPD patients with comorbidities.

Background Bacteria and viruses have been implicated as a major cause of chronic obstructive pulmonary disease (COPD) exacerbations; however, the potential role of fungal colonization and infection is poorly understood. Objective The aim of this study was to assess the profile of pulmonary fungal infection among COPD patients with and without comorbidities to determine their prevalence, risk factors, and outcome among those patients. Patients and methods In this prospective cross-sectional analytic study, different samples (sputum, bronchoalveolar lavage, blood, and others) from 177 COPD patients at risk for pulmonary fungal infection were examined using mycological analysis (direct microscopy and culture). Bronchoalveolar lavage and blood samples were examined using the human 1,3-β-D-glucan and galactomannan ELISA tests. Results The prevalence of pulmonary fungal infection was significantly higher in COPD patients with comorbidities (77.8%) versus COPD patients without comorbidities (53.1%) (P0.001), with a predominance of Candida and Aspergillus spp. in both groups. Mechanical ventilation, corticosteroid therapy, ICU admission, and age were major risk factors for pulmonary fungal infection in COPD patients with comorbidities [P=0.012, odds ratio (ODR)=2.23; P=0.028, ODR=1.99; P=0.025, ODR=1.94; and P=0.034, ODR= 2.60; respectively]. COPD patients with comorbidities had significantly higher mortality rate (12.3%) compared with COPD patients without comorbidities (3.1%; P0.05). Blood galactomannan antigen was positive in 16 (19.7%) COPD patients with comorbidities versus seven (7.3%) in COPD patients without comorbidities (P0.05). Conclusion COPD patients with comorbidities had a higher prevalence of pulmonary fungal infection and higher mortality rate compared with COPD patients without comorbidities. Age, mechanical ventilation, corticosteroid therapy, and ICU admission were independent risk factors for pulmonary fungal infection in COPD patients with comorbidities.

Background Bacteria and viruses have been implicated as a major cause of chronic obstructive pulmonary disease (COPD) exacerbations; however, the potential role of fungal colonization and infection is poorly understood. Objective The aim of this study was to assess the profile of pulmonary fungal infection among COPD patients with and without comorbidities to determine their prevalence, risk factors, and outcome among those patients. Patients and methods In this prospective cross-sectional analytic study, different samples (sputum, bronchoalveolar lavage, blood, and others) from 177 COPD patients at risk for pulmonary fungal infection were examined using mycological analysis (direct microscopy and culture). Bronchoalveolar lavage and blood samples were examined using the human 1,3-β-D-glucan and galactomannan ELISA tests. Results The prevalence of pulmonary fungal infection was significantly higher in COPD patients with comorbidities (77.8%) versus COPD patients without comorbidities (53.1%) (P0.001), with a predominance of Candida and Aspergillus spp. in both groups. Mechanical ventilation, corticosteroid therapy, ICU admission, and age were major risk factors for pulmonary fungal infection in COPD patients with comorbidities [P=0.012, odds ratio (ODR)=2.23; P=0.028, ODR=1.99; P=0.025, ODR=1.94; and P=0.034, ODR= 2.60; respectively]. COPD patients with comorbidities had significantly higher mortality rate (12.3%) compared with COPD patients without comorbidities (3.1%; P0.05). Blood galactomannan antigen was positive in 16 (19.7%) COPD patients with comorbidities versus seven (7.3%) in COPD patients without comorbidities (P0.05). Conclusion COPD patients with comorbidities had a higher prevalence of pulmonary fungal infection and higher mortality rate compared with COPD patients without comorbidities. Age, mechanical ventilation, corticosteroid therapy, and ICU admission were independent risk factors for pulmonary fungal infection in COPD patients with comorbidities.