2. Conference 9 invitation (Liver and Environment) Risks& Solutions Conference 9 invitation (Liver and Environment) Risks& Solutions Tanta University, Faculty of Medicine and the Egyptian Society of Liver& Environment (ELSE) kindly invite you October 1 st – 2 nd /2014 Tanta Faculty of Medicine Hall of Conferences

4. Risks of HBV, HCV and HIV infection in street children By Prof Dr Abdel Raouf Abou El Azm Tanta University President of the Egyptian Society of liver and Environment else.eg.liver@gmail.com

5. Street children??? No rights?

6. Number in Egypt? Security Reports? Press reports - 600 000 - 1 Million - 2 Millions - 5 Millions A report mentioned (must be killed as dogs)

7. Street children problems Social Social Economic Economic Health Health Security Security

8. Famous triad is applied Poverty Poverty Ignorance Ignorance Disease Disease

9. Living in Polluted environment Food, water and air: Living in train stations - parking - cinemas - Markets - buildings under construction - and near large mosques Food and water: parasites - diarrhea - a common intestinal - dysentery - and food poisoning Air: TB Food and water: parasites - diarrhea - a common intestinal - dysentery - and food poisoning Air: TB

10. Street children Street children

11. تغذية Hunger, pollution and malnutrition

12. Food Not clean (dirty sources: gift- stolen or from rubbish) Not clean (dirty sources: gift- stolen or from rubbish) Expired Expired Little (not sufficient to satisfy hunger) Little (not sufficient to satisfy hunger) 83% of street children are malnourished since birth and anemia 83% of street children are malnourished since birth and anemia

13. The risk of HBV, HCV and HIV infection in the community Blood and blood products Blood and blood products Instruments contaminated with blood or secretions Instruments contaminated with blood or secretions Sex Sex Drug abuse Drug abuse From the mother to her children From the mother to her children

14. Why street children are the highest incidence of infection? More than 25- 30 % of street children infected with viral hepatitis B, C More than 25- 30 % of street children infected with viral hepatitis B, C (Asmaa Mohamed) 1 - Blood and blood products The exercise of physical violence leading to the occurrence of injuries 2- Use tools possible contamination of blood

15. Street children Street children

16. 3 - Sex (mostly at the age of sexually active) - 58.4% of children had sex and 79% 3 - Sex (mostly at the age of sexually active) - 58.4% of children had sex and 79% of them had sex under threat - Subjected to sexual abuse - Rape - prostitution - Multiplicity of partnership - Sex outside genitals of them had sex under threat - Subjected to sexual abuse - Rape - prostitution - Multiplicity of partnership - Sex outside genitals

17. Street children 5

18. 4- Different kinds of drug abuse

19. Street children Street children

20. Street children

21. 5- From the mother to her children - Where an unwanted pregnancy - Aborting the Ripper unhealthy ways - Where an unwanted pregnancy - Aborting the Ripper unhealthy ways

22. Street children Street children

23. What is the solution?