Rapid diagnosis of schistosomiasis in Yemen using a simple questionnaire and urine reagent strips.

Schistosomiasis ranks second to malaria in terms of socioeconomic and public health importance in Yemen. This study assessed the validity of a morbidity questionnaire and urine reagent strips as a rapid tool for screening schoolchildren for urinary schistosomiasis as compared with the presence of eggs in urine as the gold-standard parasitological diagnosis. The study examined urine samples and interviewed 696 children (mean age 12.5 years) attending a primary-preparatory school in south Yemen. Urinary schistosomiasis was confirmed in 126 (18.1%) children. Diagnostic performance was poor for 2 items in the morbidity questionnaire (self-reported history of previous infection and self-reported history of antischistosomal treatment). However, self-reported dysuria, self-reported haematuria in the questionnaire and microhaematuria by reagent strips (alone or with macrohaematuria) revealed good diagnostic performance. The results indicated that reagent strips are a valid method for detection of microhaematuria for identifying individuals and communities infected with Schistosoma haematobium.

Rapid diagnosis of schistosomiasis in Yemen using a simple questionnaire and urine reagent strips

Schistosomiasis ranks second to malaria in terms of socioeconomic and public health importance in Yemen.This study assessed the validity of a morbidity questionnaire and urine reagent strips as a rapid tool for screening schoolchildren for urinary schistosomiasis as compared with the presence of eggs in urine as the gold-standard parasitological diagnosis.The study examined urine samples and interviewed 696 children [mean age 12.5 years]attending a primary-preparatory school in south Yemen.Urinary schistosomiasis was confirmed in 126 [18.1%]children.Diagnostic performance was poor for 2 items in the morbidity questionnaire [self-reported history of previous infection and self-reported history of antischistosomal treatment]. However, self-reported dysuria, self-reported haematuria in the questionnaire and microhaematuria by reagent strips [alone or with macrohaematuria]revealed good diagnostic performance.The results indicated that reagent strips are a valid method for detection of microhaematuria for identifying individuals and communities infected with Schistosoma haematobium

يحتل داء البلهارسيات الموقع الثاني بعد الملاريا من حيث الأهمية من وجهة نظر الصحة العمومية في اليمن. وتقيم هذه الدراسة صحة استبيان يتناول المراضة مع استخدام أشرطة وكواشف للبول، باعتبارهما أداتين سريعين لتحري أطفال المدارس بحثا عن داء البلهارسيات البولي، ومقارنة ذلك بوجود البيوض في البول باعتباره المعيار الذهبي للتشخيص بفحص الطفيليات. وقد شملت الدراسة فحص عينات بول مع مقابلة 696 طفلا [وسطي أعمارهم 12.5 عاما]ممن يداومون في مدرسة ابتدائية في جنوب اليمن. وقد تأكد تشخيص داء البلهارسيات البولي لدى 126 طفلا [18.1 %]. واتضح أن الأداء التشخيصي كان سيئا في بندين اثنين من بنود استبيان المراضة [وهما الإبلاغ الذاتي عن سوابق عدوى بولية سابقة، والإبلاغ الذاتي عن سوابق معالجة مضادة للبلهارسيا]. وبالمقابل فقد أثبت كل من الإبلاغ الذاتي عن عسر التبول، والإبلاغ الذاتي عن تبول الدم في الاستبيان، وكشف أو كاشف وجود الدم في البول بكميات زهيدة بالفحص المجهري بالأشرطة ذات الكواشف [لوحده أو مع وجود الدم في البول بالعين المجردة]أنها ذات أداء تشخيصي جيد. وتشير النتائج إلى أن الأشرطة ذات الكواشف تعتبر طريقة صحيحة لكشف وجود البول في الدم بكميات زهيدة، من أجل التعرف على الأفراد والمجتمعات المصابة بعدوى البلهارسيا الدموية

La schistosomiase vient en deuxième place après le paludisme en termes de poids socioéconomique et de problème de santé publique au Yémen.La présente étude a évalué la validité d'un questionnaire sur la morbidité ainsi que des bandelettes urinaires réactives comme outils rapides de dépistage de la schistosomiase urinaire chez des écoliers par rapport à la recherche d'oeufs dans les urines en tant que méthode diagnostique parasitologique de référence.Au cours de l'étude, les échantillons d'urine de 696 enfants fréquentant une école primaire ou préparatoire dans le sud du Yémen ont été examinés, puis les enfants ont été interrogés [âge moyen 12, 5 ans]. Une schistosomiase urinaire a été confirmée chez 126 enfants [18, 1 %]. La performance du diagnostic était médiocre pour deux items du questionnaire sur la morbidité [antécédents auto déclarés d'une infection antérieure et d'un traitement contre la schistosomiase]. Toutefois, une dysurie autodéclarée, une hématurie autodéclarée dans le questionnaire et une microhématurie par bandelettes urinaires réactives [seule ou associée à une macrohématurie]ont fait ressortir une bonne performance diagnostique.Les résultats ont indiqué que les bandelettes urinaires réactives étaient une méthode valable pour le dépistage de la microhématurie permettant d'identifier les personnes et les communautés infestées par Schistosoma haematobiurn

Malaria in late pregnancy in Al Hodeidah Governorate, Yemen.

To investigate the consequences of maternal malaria during late pregnancy, we conducted a preliminary study in the 2 hospitals in Al Hodeidah on 276 women who had uncomplicated vaginal deliveries. Only 17 women had malaria (Plasmodium falciparum), 6 with peripheral parasitaemia and 11 with both peripheral parasitaemia and placental malaria. Coincident infection carried a 9.44 times higher risk of preterm delivery and a 12.2 times greater risk of low birth weight (< 2500 g). Anaemia was diagnosed in 46.4%, associated with malaria in 11.7% of cases. All risk factors, rural residence (OR 5.18), maternal age < 20 years (OR 4.93) and primigravidae (OR 8.29), were significantly associated with malaria infection.

Malaria in late pregnancy in Al Hodeidah governorate, Yemen

To investigate the consequences of maternal malaria during late pregnancy, we conducted a preliminary study in the 2 hospitals in Al Hodeidah on 276 women who had uncomplicated vaginal deliveries. Only 17 women had malaria Plasmodium falciparum], 6 with peripheral parasitaemia and 11 with both peripheral parasitaemia and placental malaria. Coincident infection carried a 9.44 times higher risk of preterm delivery and a 12.2 times greater risk of low birth weight [< 2500 g]. Anaemia was diagnosed in 46.4%, associated with malaria in 11.7% of cases. All risk factors, rural residence [OR 5.18], maternal age < 20 years [OR 4.93] and primigravidae [OR 8.29], were significantly associated with malaria infection

Bioenvironmental and meteorological factors related to the persistence of malaria in Fayoum Governorate: a retrospective study.

The present study was conducted to determine the magnitude of the malaria problem in Fayoum Governorate and to ascertain the determinant factors behind its persistence in this area. Malaria records in Fayoum Governorate for the period 1971-1999 were reviewed retrospectively. The data show that no Plasmodium vivax cases were recorded during 1997-1999 and prediction up till 2004 indicated no positive cases expected. No P. falciparum cases were detected in 1998 and 1999. The prediction trend for this species showed an apparent but not statistically significant decrease in the incidence. The factors responsible for the persistence of malaria in this governorate are discussed.

Bioenvironmental and meteorological factors related to the persistence of malaria in Fayoum Governorate: a retrospective study

The present study was conducted to determine the magnitude of the malaria problem in Fayoum Governorate and to ascertain the determinant factors behind its persistence in this area. Malaria records in Fayoum Governorate for the period 1971-1999 were reviewed retrospectively. The data show that no Plasmodium vivax cases were recorded during 1997-1999 and prediction up till 2004 indicated no positive cases expected. No P. falciparum cases were detected in 1998 and 1999. The prediction trend for this species showed an apparent but not statistically significant decrease in the incidence. The factors responsible for the persistence of malaria in this governorate are discussed

Bionomics of anopheline vectors in Zabid District, Al-Hodeidah Governorate, Republic of Yemen.

The bionomics of anopheline vectors were analysed in randomly selected centres, representing fixed and spot-check stations. Three anopheline species were found. Anopheles arabiensis was the most prevalent species (84.2%) with a sporozoite rate of 0.7%, followed by A. culicifacies adenensis (14.9%) and A. rhodesiensis rupicolus (0.9%). Maximum indoor resting density was recorded during March, July and August. Positive sprayed sites for females were higher in bedrooms (40.4%) than animal sheds (26.9%). A total of 2560 anopheline larvae were collected of which 79.5% were A. arabiensis, 19.4% were A. culicifacies adenensis and 1.1% A. rhodesiensis rupicolus. A. arabiensis was assumed to be the most efficient malaria vector based on epidemiological evidence and the finding of natural sporozoite infected females.

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.

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.

Human fascioliasis in Egypt: effect of infection and efficacy of bithionol treatment.

The present study was conducted on 14 patients with established fascioliasis. The effect of infection on the haematological and biochemical parameters was determined and the liver and gall bladder were studied by ultrasonography. Bithionol was given in the dose of 30 mg kg-1 body weight every other day for 5 doses. The therapeutic efficacy was assessed by egg and eosinophilic counts and quantitative estimation of antibody titres by indirect haemagglutination test. Results revealed that fascioliasis caused normocytic hypochromic anaemia and eosinophilia. Serum bilirubin, ALT and AST were within normal range. Ultrasonography showed a normal echogenic pattern of the liver and gall bladder. One case showed thickness of the gall bladder wall which was tender under the transiducer. Fasciola eggs disappeared completely after the 5th dose giving a cure rate of 100%. Antibody titres reached a normal level at the end of the 3rd month post treatment. Bithionol proved to be a potent fasciolicidal drug with minimal side-effects.

Effect of urinary bilharzial infection on male pubertal development and endocrine functions.

One hundred seventy-five males aged 9-20 years were selected. The subjects comprised two groups; controls and patients infected with urinary bilharziasis not associated with any other parasite. Pubertal development was assessed. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and progesterone were determined by radioimmunoassay procedure. Delay in pubertal development was evident in the normal control group as indicated by higher chronological age mean values at the various stages as compared to other world norms. Urinary bilharziasis exaggerated the delay in pubertal development as compared to that in the control group. In relation to the control group, the group with urinary bilharziasis had higher levels of serum FSH and LH, which were significant only at stages III and IV. No significant difference was noted between the two groups for serum testosterone and progesterone levels, except for the high progesterone mean value at stage V in the group with urinary bilharziasis.

The molluscicidal properties of Ambrosia maritima L. (compositae). 1. Design for a molluscicide field trial.

The composite plant, Ambrosia maritima is toxic to the snail intermediate hosts of schistosomiasis. A field trial was required to confirm this activity. A preliminary survey of irrigation canals and drains was conducted using two snail sampling methods. The results have been used to indicate the minimum number of watercourses which would have to be treated and the number of sampling stations per watercourse required to establish statistical significance in a kill of snails obtained from a molluscicide treatment.