Current status of S. mansoni infection in El-Prince village, Alexandria Governorate

The present work was implemented to determine the current status of Schistosoma mansoni infection in "El-Prince" village, near Alexandria, which was studied before as a control village between 1985 and 1990. Stool examination was performed on 571 of the inhabitants by Kato thick smear technique and intensity of infection was determined. Prevalence was found to be 15.4% with a percentage decrease of 53% from the 1990 survey. The geometric mean egg count (GMEC) ranged from 19.05 eggs/gram of stools in children aged five years or less to 81.86 in the oldest group greater than 50 years of age and averaged 42.26. Age stratified prevalence of infection peaked at 31.4% in the (20 to 25)-year-old age group. High prevalence of 23.6% was also observed in the age group from 36 to 50 years. Infection in males was higher than females (17.8% vs.13.5%). However the difference was not statistically significant (chi2 = 2.2, P = 0.0086). Risk factors significantly associated with the infection were an age more than 5 years, male gender, males with water contact activities and having done a previous laboratory analysis for schistosomiasis. The community category of the village changed from high prevalence in 1990 to moderate prevalence in 2002. Most of the infected individuals (85%) had light intensity of infection (less than 99 eggs /g stools). Active screening and treatment programs should be maintained in the area. More control measures should be directed towards older people who should be included in evaluation of control programs.     

Breast-feeding patterns in a rural village in Giza, Egypt.

In a longitudinal study of infant feeding in rural Giza, Egypt, we found that 68.8% of the recruited mothers initiated early suckling of colostrum, but only 51.2% of the infants were exclusively breast-fed in the first week. Solid foods were introduced much earlier than at the recommended age of 4 to 6 months. Sixty percent of the mothers who participated in the study considered breast-feeding plus regular or irregular complementary feeding to be exclusive breast-feeding.     

Bionomics of the anopheline vectors in an endemic area in Fayoum Governorate, Egypt

A one-year longitudinal entomological study was carried out at Kafr Fazara village, Sinnuris District, Faiyoum Governorate from January to December 1996. The results revealed that three species of anophelines were found. A. sergenti was the most prevalent species followed by A. multicolor and the least prevalent one was A. pharoensis. The influence of climatic conditions on anopheline abundance was also studied. The mean monthly temperature has a significant effect on larvae abundance, while no significant correlation was found concerning relative humidity or wind speed for both larvae and adult anophelines. The transmission season of P. falciparum in Faiyoum Governorate extended to more than eight months a year which could explain the persistence of malaria up there. The bionomics of the recorded vectors were discussed.     

Maternal mortality in Giza, Egypt: magnitude, causes, and prevention.

This article presents results from a population-based study of the magnitude and causes of maternal mortality in the Giza governorate of Egypt in 1985-86. Deaths to women in the reproductive ages were identified through the death registration system. Family members of the deceased were interviewed using the "verbal autopsy" approach. Immediate and underlying causes of death were then assessed by a medical panel. This methodology allows for the classification of multiple causes of death and is appropriate when registration of adult deaths is nearly complete, but reporting on cause of death on death certificates is poor. Of all reproductive-age deaths, 19 percent were maternal deaths. The maternal mortality ratio for Giza is estimated to be, at minimum, 126 maternal deaths per 100,000 live births. The maternal mortality rate is estimated to be, at minimum, 22 maternal deaths per 100,000 women aged 15-49, over 100 times the rate in Sweden. An average of 2.3 causes per maternal death were reported; the most common causes were postpartum hemorrhage (31 percent of cases) and hypertensive diseases of pregnancy, such as toxemia and eclampsia (28 percent of cases). Women experiencing hemorrhage, hypertensive diseases of pregnancy, or other serious complications must have easy access to hospital and maternity centers equipped for handling these conditions. Since most deliveries occur at home, many with the help of traditional birth attendants, TBAs will need training in early diagnosis, treatment, and/or effective referral of problem pregnancies.     

Asymptomatic bacteriuria in school children in a rural area, Egypt.

Forty hundred and fifty urine samples collected from school children in a rural area were screened for the presence of significant bacteriuria. The incidence of asymptomatic bacteriuria was found to be 7% with Predominance in females (11%) than in males (3.6%). From the total bacterial isolates E. coli were isolated in 18% of cases, Co-agulase positive staphylococci in 30%, co-agulase negative staphylococci in 15%, streptococcus pyogenes in 6%, Klebsiella species in 9% and enterococci in 21% of cases. There was no difference between the incidence of asymptomatic bacteriuria (ABU) in younger children than in older ones. We recommended a routine screening for ABU among school children for the early diagnosis and management of such cases.     

Vector potential of culicine mosquitoes in Faiyum Governorate, Egypt

Culicine mosquito populations were studied for 1 year in 2 neighboring villages in Faiyum Governorate, Egypt. Dominant species in larval collections included Culex pipiens, Cx. univitattus, Cx. antennatus, Aedes caspius and Uranotaenia unguiculata; Culiseta longiareolata was less common. Culex pipiens accounted for 98% of 3,743 mosquitoes captured in human-biting collection (164 man-nights), 96% of 1,136 mosquitoes collected inside houses and animal sheds (396 inspections), and 98% of 15,000 mosquitoes from 22 donkey-baited traps. Adult Cx. univittatus, Cx. antennatus and Ae. caspius were infrequently captured by any of the collection techniques. Although larval collections identified 5 common species, only Cx. pipiens showed a significant association with the human population.     

Parasitological profile of the surveyed population for malaria in an endemic area in Faiyoum Governorate, Egypt

Egypt represents the only focus in the Mediterranean region where Plasmodium falciparum transmission still occurs. A longitudinal parasitological study has been implemented (September 1995 to December 1996) in Faiyoum, Egypt. A total of 9065 blood slides for malaria parasites were taken from all people in the study area as mass blood examination (MBE); those attending the malaria unit as passive case detection (PCD) as well as from neighborhood of the detected cases (NOD). They were stained by Giemsa stain and examined under standard conditions for positivity, parasite species and parasite density. Our results show that MBE detected 61.5% of malaria cases while 23.1% and 15.4% of the confirmed cases were detected through PCD and NOD respectively. The overall parasite rate was 5.7/1000 examined population. P. falciparum was the most predominant species (96.1%), followed by P. vivax (3.9%). The epidemiological factors causing the persistence of malaria transmission in the study area are discussed.     

The importance of age and water contact patterns in relation to Schistosoma haematobium infection

Data obtained by Dalton & Pole in 1978 were analysed in order to assess the relative importance of age and water contact patterns in explaining the variations in level of infection with Schistosoma haematobium observed among their study population. It was found that age and sex were the only two significant factors, and that the information about an individual's water contact pattern contained in the data was of no further help in predicting his level of infection. This conclusion is in marked opposition to that reached by Dalton & Pole.     

Assessment of microbiological water quality and its relation to human health in Gaza Governorate, Gaza Strip

OBJECTIVE: To assess the contamination level of total and faecal coliforms in water wells and distribution networks, and their association with human health in Gaza Governorate, Gaza Strip. METHODS: Data were obtained from the Palestinian Ministry of Health on contamination of total and faecal coliforms in water wells and distribution networks, and on the incidence of water-related diseases in Gaza Governorate. An interview questionnaire was conducted with 150 residents of Gaza. RESULTS: The contamination level of total and faecal coliforms exceeded that of the World Health Organization (WHO) limit for water wells and networks. However, the contamination percentages in networks were higher than that in wells. Giardiasis was strongly correlated with faecal coliform contamination in water networks (r=0.7) compared with diarrhoeal diseases and hepatitis A (r=0.3 and 0.1, respectively). Diarrhoeal diseases were the highest self-reported diseases among interviewees in Gaza city. Such diseases were more prevalent among people using municipal water than people using desalinated water and water filtered at home for drinking (OR=1.6). Intermittent water supply and sewage flooding seemed to contribute largely to self-reported diseases. People in Gaza Strip have good knowledge on drinking water contamination, and this is reflected in good practice. CONCLUSIONS: Water quality has deteriorated in Gaza Strip. This may contribute to the prevalence of water-related diseases. Self-reported diseases among interviewees in Gaza City were associated with source of drinking water, intermittent water supply, sewage flooding and age of water, and wastewater networks.     

Epidemic Schistosoma mansoni in a known S. haematobium area

An epidemic of bloody diarrhoea was observed in 1997 and 1998 in Bessoum, north Cameroon. Of 1176 inhabitants, 16.7% went for medical consultation to a public health centre located 10 km away. This epidemic was probably due to the recent introduction of Schistosoma mansoni in an ancient focus of S. haematobium, following the development of irrigated farming. The prevalences amongst primary school children were 76.6% for S. haematobium in urine, and 60.9% for S. mansoni in stool. S. mansoni was found in urine in 28.1%. This epidemic emergence may be secondary to interspecific competition between the 2 schistosomes.     

Schistosoma mansoni infection and cognitive functions of primary school children, in Kafr El Sheikh, Egypt

There is growing concern that parasitic infection may detrimentally affect children's mental function. In this study our main objective was to investigate the effects of schistosoma mansoni infection on cognitive functions of school children aged 9-12 years in Kafr El Sheikh Governorate. Out of 2601 children screened parasitologically, 60.7% were S. mansoni positive. Children recruited for the case-control study were 40 with light S. mansoni infection (<100 epg), 40 with heavy infection (>400 epg) and 40 parasite-free served as control. All children were subjected to the Arabic Version of Wechsler Intelligence Scale for Children (WISC) and the Verbal Fluency Test. Though, the general IQ scores of infected children were insignificantly lower than their controls, yet they recorded a significantly lower performance IQ as well as, poorer performance on comprehension, vocabulary and picture completion subtests. Implications for preventive measures will be discussed.     

The epidemiology of Schistosoma haematobium and S. mansoni infections in the Egypt-49 project area. 3. Prevalence of bilharziasis in relation to certain environmental factors

The influence of the size and location of communities in relation to the different types of watercourse, the availability of a protected water supply, types of housing and the presence of other sanitary facilities on the prevalence of bilharziasis in the Egypt-49 project area has been studied. There is no direct relationship between the size of village and the prevalence of bilharziasis. Main drains and distributaries are potent sources of infection and, in terms of the total population exposed, distributaries play the most significant role in the transmission of infection. Of the other factors, the availability of a protected water supply seems to have the greatest effect on the prevalence. Although the presence of a latrine in the dwelling does not of itself influence the extent of schistosome infection, which is caught from polluted water, the installation of latrines assists in the cultivation of healthy habits, thereby lessening the prevalence not only of bilharziasis but also of certain other infections.     

Hospital waste management at the Ministry of health hospitals in Cairo Governorate,Egypt

Hospitals and clinics have been mistakenly assumed to be healthy places to work. Waste generated from different health facilities (hospitals, centers and clinics) pose some risks on both health and environment. The present study is concerned with analyzing the situation of the administrative structure, clinical activities, and waste management system present in the MOH hospitals in Cairo Governorate. The study was carried out on 24 MOH hospitals of which 14 are general hospitals and 10 are specialized (skin and venereal, ophthalmologic, psychiatric and chest specialities). The study identifies waste generators in each unit and describes and analyzes the waste generated from these hospitals in terms of quality and quantity. The study investigates and assesses the current waste management system in terms of organization, staffing, equipment used among others. The conclusions give a list of the major environmental health problems associated with hospital waste in Cairo.     

How the number of living sons influences contraceptive use in Menoufia Governorate, Egypt

Couples in rural areas of many Arab societies, including Egypt, have consistently reported strong preferences for having sons. However, these reported preferences are not always reflected in reproductive behavior. In 38 rural villages in Menoufia Governorate in Egypt, women's responses to a community-based contraceptive distribution program were examined, taking into consideration both the number of living children and the number of living sons each women reported having. Controlling for number of living children, women with more sons were more likely to be using contraception before the distribution program began. Among women not using contraception before the program, those with more sons were more likely to initiate contraceptive use and were more likely to continue use for a nine-month period following the distribution. These findings imply that in addition to obstacles related to contraceptive availability, there are several cultural, social, and economic factors that influence fertility behavior and exert considerable pressure on married couples to have large families, including several sons. Unless the pressure exerted by these factors is changed or reduced, the impact of family planning programs is likely to reach a plateau at a relatively low prevalence level.     

Selection of susceptible lines of Biomphalaria alexandrina and Bulinus truncatus snails to S.mansoni and S.haematobium infection.

Selection of progenies from infected B.alexandrina and B.truncatus snails resulted in higher infection rates. This observation was consistent when the source of micardia were from either infected human or hamsters. Infection rate of B.alexandrina increased up to 88.2% while B.truncatus did not. Compatibility between the parasites and their intermediate hosts were also studied.     

Preliminary evaluation of morbidity due to S. haematobium and S. mansoni in the area of the future Adjarala Dam in Benin

The aim of this study was to provide a preliminary assessment of morbidity due to schistosomiasis in the area of the future Adjarala Dam in Benin. We included 412 schoolchildren from five villages in the study. The mean age of the children was 9.4 +/- 2.3 years and the sex ratio (F/M) was 0.94. These children underwent parasitological examination. The children provided urine samples, which were examined by eye, filtered and tested for blood and protein. Stool samples were examined using Kato's technique and an ultrasound scan of the urinary tract was performed. We carried out a survey of snails at the possible transmission sites of all the villages, with a view to identifying the intermediate hosts. We detected S. mansoni and S. haematobium in the area. Urinary schistosomiasis was mesoendemic (prevalence of 19.7%) whereas schistosomiasis due to S. mansoni was hypoendemic (prevalence of 3. 9%). Ultrasound scans showed that 28% of the children had bladder lesions and that 2.5% were carriers of hydronephrosis. We compared the diagnostic performances of the various indirect indicators of morbidity. We found that a history of hematuria was the most sensitive indicator (88%) but that the sensitivity of this indicator differed significantly according to the sex of the child. Hematuria >= 1+ was the most effective indicator. Snail surveys showed that Biomphalaria pfeifferi and Bulinus globosus were present in the area.