Motawea, S., Soliman, M., El-Nemr, H. (2003). Why Schistosomiasis Mansoni is still highly Prevalent in Rural Ezbas in Kafr El Sheikh, Egypt?. Journal of High Institute of Public Health, 33(1), 1-24. doi: 10.21608/jhiph.2003.198197
Saad M. Motawea; Mohamed Soliman; Hosam El-Nemr. "Why Schistosomiasis Mansoni is still highly Prevalent in Rural Ezbas in Kafr El Sheikh, Egypt?". Journal of High Institute of Public Health, 33, 1, 2003, 1-24. doi: 10.21608/jhiph.2003.198197
Motawea, S., Soliman, M., El-Nemr, H. (2003). 'Why Schistosomiasis Mansoni is still highly Prevalent in Rural Ezbas in Kafr El Sheikh, Egypt?', Journal of High Institute of Public Health, 33(1), pp. 1-24. doi: 10.21608/jhiph.2003.198197
Motawea, S., Soliman, M., El-Nemr, H. Why Schistosomiasis Mansoni is still highly Prevalent in Rural Ezbas in Kafr El Sheikh, Egypt?. Journal of High Institute of Public Health, 2003; 33(1): 1-24. doi: 10.21608/jhiph.2003.198197
Why Schistosomiasis Mansoni is still highly Prevalent in Rural Ezbas in Kafr El Sheikh, Egypt?
1Community Medicine Department, Mansoura Faculty of Medicine, Egypt
2Parasitology Department, Mansoura Faculty of Medicine, Egypt
Abstract
The present study was performed to determine the possible risk factors for the high prevalence of Schistosomiasis in Ezbas [Satellites and hamlets] than a mother village [Ebshan], Kafr El-Sheikh Governorate. The first stage of the study was a cross sectional descriptive study. The target population were all the inhabitants above 2years [4780] of ten Ezbas and a systematic random sample from the mother village [5000]. Both were subjected to Stool analysis by Kato-Katz technique. The estimated total prevalence rate of schistosomiasis of the examined population from Ezbas was 14.7% while it was 4.3% in the mother village with a statistical significant difference as regards the intensity of infection. There was a significant relationship between prevalence of schistosomiasis and Geometric Mean Egg Count GMEC by population density. The prevalence was higher among males than females and that the peak age specific prevalence rate among the inhabitants of Ezbas was [36.5%] for males and [30.4%] for females in the age group 15-<20years with an upward shift in the age scale and lower prevalence in the mother village. The second stage was a case control study where schistosomal cases from all the Ezbas [704] and age and sex matched controls [705] from the mother village were subjected to a questionnaire compiling socio-demographic data, housing environment, Knowledge, Attitudes and Practices [KAP] about Schistosomiasis and water contact behaviour. History taking and thorough clinical examination were done and abdominal ultrasonography was performed for a random sample. Malacological studies of the snail Biomphalaria alexandrina were carried out in all water channels. The risk factors for the high prevalence of schistosomiasis in Ezbas than the mother village were illiteracy [OR=63.1], true agricultural work [79.7], low social class score [OR=2.5], low housing condition score [OR= 3.7], risky houses as regards the nearness to contaminated canals [OR=11.3] when the distance was less than 5 meters and [OR= 5.3] when the distance was 5-10m and sewage disposal into canals [OR=48]. Among the inhabitants of Ezbas, the most risky KAP were; lack of correct knowledge about the effective method of prevention [OR=32.1], non-avoiding direct or indirect contamination of water channels [OR=46.8], non-avoiding exposure and practicing contact to contaminated water channels even after treatment [OR=183.3] and lack of periodic screening after treatment [OR=1.38]. The most risky occupational behavior for males was irrigating fields [OR=110.3], cleaning canals [OR=77.7], washing animals [OR=23.4] and fishing [OR=22.5). The most risky occupational behavior for males and females were rice and vegetable implantation [OR=113] and removal of harmful grass [OR=11.1]. Grain washing was a risky behaviour for females [OR=38.2]. The most risky socio-cultural behavior were playing and swimming for children<15years [OR=36], washing utensils for females [OR=40.6] and ablution [OR=16.8] and bathing [OR=10.6] for males. The risk increases with daily exposure [OR=6] and with a duration >2hours in each exposure [OR=25.8] and presence of infected B. Alexandrina snails in water channels (OR=39.4]. Most of them [85.5%] had received a previous treatment by praziquantel [PZQ]; [26.8%] of them significantly received 3 doses of PZQ in the last year. Most of the cases [86.2%] were asymptomatic. Hepatomegaly, Splenomegaly and perioral fibrosis were more significantly prevalent among the inhabitants of Ezbas compared to the control as diagnosed by abdominal ultrasound [31.1%, 23.2% and 17.9% respectively). A modification of the National Schistosomiasis Control Project is recommended for more concern towards the numerous Ezbas which still have a high prevalence and intensity of schistosomiasis.
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