Why schistosomiasis mansoni is still highly prevalent in rural EZBAS in Kafr El Sheikh, Egypt?

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 between Ezbas and the mother village as regards the intensity of infection. There was a significant relationship between prevalence of schistosomiasis and 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-<20 years with cut upward shift in the age scale and lower prevalence in the mother village. The second stage was a case control study where Schistosoma cases from all the Ezbas [704] and age and sex matched controls [705] Porn the mother village were subjected to a questionnaire compiling sociodemographic data housing environment. Knowledge. Attitudes and Practices [KAP] about Schistosomiasis and water contact behavior. 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 [OR=5 .3] when the distance was 5-1 Om and sewage disposal into canals [OR=48]. Among the inhabitants of Ezbas, the most risky KAP were; lack of correct knowledge and out 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 [0R=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 behavior for females [OR=38.2]. The most risky socio-cultural behavior were playing and swimming for children< 15 years [OR=36], washing utensils for females [OR=40.6] and for males; ablution [OR=16.8] and bathing [OR=10.6]. The risk increases with daily exposure [OR= 6] and with a duration >2hours in each exposure [OR=25.8] and 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 per portal 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 and bas which still have a high prevalence and intensity of schistosomiasis

Importance of E hislolytica antigen in serodiagnosis and follow-up of patients with amoebic liver abscess

This study was composed of two sections: A community based study and a hospital based study. The community based study was conducted on 200 apparently healthy individuals who were chosen randomly from rural areas. They were examined clinically, sonographically and their stools were analyzed microscopically for E. histolytica cysts. They were examined serologically by ELISA test for the circulating amoebic antigen to determine the normal titer of antigenemia among healthy individuals and cyst passers. It was found that all of them were negative for antigenemia at 1/16 which was considered the diagnostic titer of amoebic hepatitis. The study was carried on 27 patients suffering from amoebic liver abscess [ALA] to detect the role of circulating amoebic antigen in the diagnosis and follow up of these cases. Circulating amoebic antigen was detected in 66.66% of patients with ALA before therapy which was decreased significantly to 14.82% two months after therapy. There was no significant association between the diameter of the abscess and the titer of the circulating amoebic antigen in their sera

Importance of E histolytica antigen in serodiagnosis and follow-up of patients with amoebic liver abscess

A community - based study was conducted on 200 apparently healthy individuals randomly chosen from rural areas. They were examined clinically, sonographically and parasitologically for E. histolytica cysts and by ELISA for circulating amebic antigen. They were negative for antigenemia at 1/16, which was considered the diagnostic titer of amebic hepatitis. A hospital - based study was carried out on 27 patients suffering from amebic liver abscess [ALA]. Circulating amebic antigen was detected in 66.66% of them before treatment, which decreased to 14.82% 2 months after treatment. There was no significant association between the diameter of the abscess and the level of circulating amebic antigen. It was concluded that the circulating amebic antigen may be useful for the diagnosis and follow up of amebic liver abscess patients