الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Humans have suffered from intestinal parasitic infections (IPI), a serious worldwide health issue, since the beginning of humanity. A diverse group of helminths and protozoa known as intestinal parasites cause billions of infections globally. In Egypt, IPIs are a common public health problem. The reported rate of prevalence in different regions of Egypt vary significantly between studies.
This study is one of the pioneering research studies addressing the adherence to antiparasitic medications, a multicenter study that included all rural health units in El-Montaza Health District in Alexandria, Egypt.
The main aim of the study was to assess the degree of adherence, barriers and effectiveness of therapeutic regimens IPIs among patients attending rural health units in El-Montaza Health District in Alexandria, Egypt.
A total of 450 patients diagnosed with IPIs were enrolled, evaluated and followed up until the completion of the prescribed therapeutic regimen.
The main findings in this study:
- The majority of the participants 86.0% were rural residents.
- Almost two thirds of the participants 63.1% were in the middle socioeconomic class with the majority of the parents having low literacy.
- Patients living in rural areas for more than 5 years 81.7% had high adherence compared to patients living in slums/squatters.
- Low adherence was also significantly higher among patients with low literacy 66.8% and students 48.9%.
- Socioeconomic status is significant determinant of adherence of patients to therapeutic regimens.
- The main barriers for adherence to the management of parasitic infections was the offensive size and/or taste of the prescribed medications 69.8%. Health care place related issues included transportation time, difficult accessibility. Some participants reported financial barriers 27.8% namely the cost of laboratory investigation and inadequate wage for out-of-pocket medical expenses.
- Regarding the time between follow-up visits and number of lost for follow-up among study participants.
- Most of the participants were not adherent to the actual date of follow up and tended to visit the outpatient clinic several days later, the delay for the second and third follow up visits were 79.6% and 97.3% respectively.
- There was a significant association between personal hygiene practices and IPIs.
6.2. Conclusions:
Although the prevalence rates of gastrointestinal parasites in this study were almost comparable to those found in studies conducted in other regions of Egypt, the rates of infections are still crucial for public health. Early diagnosis of reported clinical symptoms may aid in the early detection of parasite infection and efficient treatment. Intestinal parasite screening and deworming are advised, along with necessary sanitary measures, health education, improvements of socioeconomic situations, and other measures all are recommended. Poor health outcomes and higher health care expenses are among the consequences of poor adherence to therapy of IPI. For outcomes to be improved, adjustments to health systems and policy are crucial. Interventions for reducing adherence barriers must become a focal point of efforts to enhance population health. A shift in the focus of health care from one that prioritizes reactive episodic care in reaction to acute disease to one that is proactive and emphasizes lifetime health is necessary for the effective treatment of persistent disorders.
6.3. Recommendation:
1- Establishing awareness programs targeting different levels of social, cultural and administrative of population.
2- Control strategies should be adopted for periodical examination, proper diagnosis, treatment, and follow up of patients.
3- The expansion of medical and health services for an improvement in community health must enforced by a health education program. In particular, proper sanitation and better personal hygienic behavior awareness, should be promoted.
4- Special emphasis should be given to impl