Epidemiology of schistosomiasis in Egypt: travel through time: review

Schistosomiasis is a parasitic disease caused by blood flukes [Trematodes] of the genus Schistosoma [S.]. It is well documented that schistosomiasis haematobium was endemic in Ancient Egypt. Infection was diagnosed in mummies 3000, 4000 and 5000 years old. Scott was the first to describe the pattern of schistosomiasis infection in Egypt. Schistosomiasis haematobium was highly prevalent [60%] both in the Nile Delta and Nile Valley South of Cairo in districts of perennial irrigation while it was low [6%] in districts of basin irrigation. Schistosoma mansoni infected 60% of the population in the Northern and Eastern parts of the Nile Delta and only 6% in the Southern part. Neither S. mansoni cases nor its snail intermediate host were found in the Nile Valley South of Cairo. The building of the Aswan High Dam -which was completed in 1967 - did not cause any increase in schistosomiasis prevalence. In 1990, a study conducted in nine governorates of Egypt confirmed the change in the pattern of schistosomiasis transmission in the Delta. There was an overall reduction in S. mansoni prevalence while Schistosoma haematobium had continued to disappear. In Middle and Upper Egypt there was consistent reduction in the prevalence of S. haematobium except in Sohag, Qena, and Aswan governorates. However, foci of S. mansoni were detected in Giza, Fayoum, Menya and Assiut. All schistosomiasis control projects implemented in Egypt from 1953 to 1985 adopted the strategy of transmission control and were based mainly on snail control supplemented by anti-bilharzial chemotherapy. In 1997, the National Schistosomiasis Control Program [NSCP] was launched in the Nile Delta. It adopted morbidity control strategy with Praziquantel mass treatment as the main component. In 1996, before the NSCP, 168 villages had S. mansoni prevalence >30%, 324 villages 20-30% and 654 villages 10-20%. By the end of 2010, in the whole country only 29 villages had prevalence >3% and none had more than 10%

Current management of diabetic macular edema

Diabetic macular edema, a finding in diabetic retinopathy, is a leading cause of vision loss in working-age adults. Several management strategies that have been advocated for the treatment of diabetic macular edema, including laser photocoagulation, intravitreal corticosteroid injection, and vascular endothelial growth factor inhibitors, are discussed

Triclabendazole in the treatment of human fascioliasis: a community-based study

The efficacy of triclabendazole in the treatment of chronic Fasciola infection was assessed. A total of 134 asymptomatic cases of established Fasciola infection were treated: 68 individuals received a single dose of 10 mg/kg and 66 individuals received 2 doses of 10 mg/kg on 2 consecutive days. Cure was assessed 5 weeks after treatment and 79.4% of the first group and 93.9% of the second group were cured. The drug was well tolerated; no serious side-effects were noted. One patient developed biochemical cholestasis the third day after treatment, but her enzyme profiles returned to normal after 2 months. We conclude triclabendazole is a safe and potent fasciolicidic drug

Reduction of schistosoma mansoni endemicity by prasiquantel mass chemotherapy in Kafr El-Sheikh Governorate, the Nile Delta, Egypt

S. mansoni is highly endemic in Kafr EL-Sheikh governorate [KES] with prevalence estimates of 40%. Data from previous studies suggest that selective chemotherapy could reduce S, mansoni endemicity although reinfection rates remained high. Mass chemotherapy, using a single dose of praziquantel [40 mg / Kg] has rarely been evaluated and has never been assessed in Egypt. Praziquantel was offered to all members of two endemic villages in KES governorate, EL-Ghanaiem and EL-Tababkha [area I], regardless of infection status except when contraindicated, whereas selective chemotherapy of positives only was offered to the participants from EL-Rouse village [area II]. At baseline four Kato slides for each stool specimen were examined for S. mansoni ova. Two follow-ups, about two months apart, were made to determine treatment efficacy in area I only. Persons continuing to be positive for ova were retreated. One year from baseline, all persons in both areas were re-examined. At baseline the prevalence of S. mansoni was 64.7% and 69.5%, GMEC of infected cases was 82 and 104.7 epg in area I and area II respectively. One year after the baseline examination S. mansoni prevalence was reduced remarkably in area I [27.5%] compared to 45.9% in area II. GMEC declined to 20.7 and 41.7 epg in area I and area II respectively. It is clear that mass chemotherapy sharply reduced the endemicity of S. mansoni infection. Thus for the control of schistosomiasis mansoni in highly endemic areas, it is recommended to start with mass chemotherapy and treatment is better to be integrated with other control measures