(369) CF Global Work in Egypt: Progress of Collaboration Between University of Michigan and Four Universities Across the Country>

Background: Egypt’s current CF Care indicates that without a systematic and sustained intervention, CF could rapidly lead to death, with a high economic and emotional cost to patients and their families. Training of the care teams on CF care and developing of specific guidelines to help improve treatment, outcomes, and quality of life for these patients are needed. A collaboration between the University of Michigan CF center (UM CFC) and several universities’ children’s hospitals in Egypt started in 2021 to help establish a CF care centers network and develop national guidelines for physicians, care team and CF patients in Egypt.

Methods: Recently, sweat testing equipment were provided to 4 Univ. hospitals across Egypt & training on their use was done. Two other Univ. have their own equipment. That provides wider range of detection across the country. Also, a limited Egyptian mutational analysis is ongoing. Assessing the resources and needs at each of the 4 University Children’s Hospitals through site visit to each hospital was done in the Fall of 2021. The members of each team and their administrators in each university hospital were met to help assess and address their needs.

Results: Currently, over 100 CF patients were diagnosed using the new equipment (in addition to over 500 diagnosed earlier). The following areas of concerns were identified and steps to address some of these items were started:

1- None of the universities has CF comprehensive treatment plan or guidelines.

2- Lack of necessary CF medications including mucolytic and the modulators

3- Insufficient clinic space

4- No social workers, respiratory therapist, or dietitian

5- Not enough dedicated physical therapy (PT) and nursing support

6- Sweat testing is slowly starting. Reaching out to other universities and physicians across Egypt was strongly
recommended to increase referrals. Also, performing the test in more days/ week and more clinics was recommended.

7- Spirometry equipment is not available in pediatrics in 2 universities. Equipment is available in adult pulmonology and the children are sent there to be tested.

Conclusions: A comprehensive collaboration plan started in 2021, to help establish CF care centers in Egypt to help improving CF care & reducing morbidity and mortality from the disease. These centers can be a resource for other providers in Egypt and other countries in the area once trained. The UM CFC director will continue to work closely with the teams there over the Summer and Fall of 2022 and beyond to help establish more dedicated centers in each university and develop a national standard of care for CF patients in Egypt. Also, UM team members will be working with the teams’ there starting with PT and dietitian in the Summer, 2022 since these 2 areas are the weakest for all teams. We will also, work with CF families to establish CF Family Advisory Board to help with lobbying the Ministry of Health, to acknowledge the presence of CF in Egypt & to approve the needed CF medications.

Acknowledgements: This work was supported by the Middle East CF Association (MECFA) and CFF.

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