SURVEILLANCE OF TRYPANOSOMA SPP OF RODENTS AND STUDIES IN THEIR TRANSMISSION PROBABILITY BY FLEAS IN SOME RURAL EGYPTIAN AREAS.

A new public health problem arises from animal trypanosomes that afflict human by a disease called atypical human trypanosomiasis. Although humans have an innate protection against most Trypanosoma species, nineteen cases of atypical human trypanosomiasis caused by the animal trypanosome as T. b. brucei, T. vivax, T. congolense, T. evansi and T. lewisi have been recorded. Some of theserecorded cases were transient, six required trypanocidal treatments however two patients died. Rodent trypanosome, T. lewisi is transmitted via ingestion of fleas or their feces containing the infective stage, the metacyclic trypomastigote. Because of the high densities of various species of rodents and their distribution all over the country especially in rural areas, the present work aimed to evaluate the trypanosomiasis among rodents collected from November to March 2016 and study transmission probability by their fleas in some rural areas in Abu Alnomros Center, Giza. The overall trypanosomiasis prevalence among the different rodent species was (21 rats) 24.7%. All the infected rats belonged to Rattus r. spp where the prevalence of infection with Trypanosoma lewisi among that species was very high 51.2% while none of rats belonged to Rattus norvegicus were infected. That may be attributed to the solid immunity gained by the R. norvegicus where most of the collected norvegicus were aged and weighed more than 200 grams. There was an inverse significant correlation between the densities of parasites and the weights of the losts. The rat which recorded the highest parasite density (60,000 parasites/microliter) was a female Rattus r. captured indoor (inside house). As to sex of Rattus rattus spp no significant difference was found between males and females in trypanosomiasis. Also there was no significant correlation between the densities of parasites and the number of white blood cells among Rattus rattus spp. All positive rats were collected indoors (from houses) and all the rats which were captured from outdoors (farms) were negative for T. lewisi. The difference between infections with trypanosomiasis among rats inhabited the houses and that found in farms was highly significant. Only two species of fleas were found on rats, Xenopsylla cheopis and Leptopsylla segnis. The oriental fleas, X cheopis, were found mainly on R. norvegicus where 57.5% of R. norvegicus were positive for X cheopis while only one rat was positive for L. segnis. On other hand the rat fleas, L. segnis, were found mainly on Rattus rattus spp where 39% of these rats were positive for L. segnis. The present work revealed a significant correlation between the infection with T. lewisi, and the presence of L. segnis on the rats however that correlation regarding X. cheopis was not significant.

A COMPARATIVE STUDY BETWEEN DIALYSIS AND KIDNEY TRANSPLANTATION REGARDING THE CAUSES AND SURVIVAL PERIOD OF THE PATIENTS IN WESTERN AREA. LIBYA.

As the number of renal failure patients in Libya reached to 3,700 patients (kindly provided by Libyan Ministry of Health), this study aimed to help Libyan people suffering from renal failure to making a wisdom decision about choice of renal transplantation or treatment with dialysis. This study found the main causes of renal failure among people in western area of Lib- ya, due to ages and survival time between patient undergoing dialysis and kidney transplantation. Out of 140 patients' files that were collected from different hospital and specialized centers in western Libya, 98(70%) patients were treated with dialysis while the rest 42 patients (30%) underwent kidney transplantation. The result also revealed that the mean survival time for those who planted the kidneys was (7.1 years) significantly longer than those treated with dialysis (3.7 years). The mean ages of patients underwent transplantation was (53.4 years) younger than those who were treated with dialysis (44.6). Diabetes and blood pressure complications were the most common diseases associated among both groups while multiple microbial inflammation of kidney was higher among kidney. transplanted group. Also, gastrointestinal bacteria and protozoa played a marked role.

EPIDEMIOLOGICAL SITUATION OF URINARY SCHISTOSOMIASIS IN TAMWAH AREA, GIZA, EGYPT: ASSESSMENT AND CONTROL.

Preliminary studies were carried out on schistosomiasis in Giza Governorate for the last three years. These studies revealed that Tamwah village was one of areas afflicted by the highest number of Schistosoma haematobium infection cases. 'The study assessed the epidemiological situation of S. haematobium by parasitological and snail surveys. During April 2016, urine samples of 1285 children collected from three primary schools were centrifuged for microscopic examination. Also a snail survey was done along the shore (700m length). The snail were classified and examined for cercariae by light exposure and crushing. The results revealed that S. haematobiwn was 4.04% (52 cases). Majority were males (76.9% out of positive cases), with highly significant. There was a strong correlation between age of children and infection (44.2%) among oldest children (11 years) lowest (3.8%) was among the youngest group (6 years). Enterobius verinicularis ova in females' urine samples was 0.54% (7 cases). One was mixed infection with S. haematobium. The highest percentage among children infected with S. haematobium had pus cells 6- 30/HPF and RBCs less than 100/HPF in urine. There were crystals of uric acid, Ca oxalates and triple phosphate 5.8 %, 1.8% & 0.8% respectively. The snails were Lanistes carinatus, Bellamya unicolor, Physa micropleura, Succinia cleopatra, Cleopatra bulmnoides, Bulinus trancatus & Lymnaea natalensis. The commonest was B. trancatus followed by L. natalensis. Builinus spp. were positive for schistosomiasis -cercaria and Lymnaea spp were positive for virgulate xiphidiocercariae; parasites of bates, birds and amphibians.

REEVALUATION OF MALARIA PARASITES IN EL-FAYOUM GOVERNORATE, EGYPT USING RAPID DIAGNOSTIC TESTS (RDTS).

Malaria as a disease has been identified in Egypt since ancient times. Malaria was endemic in almost all parts of the country but prevalence showed a steady decrease by 1990, and regressed in most of the Governorates. Then by the end of 1998 till now Egypt become free from local transmission of malaria. All reported cases were imported mainly from Sudan. However, the outbreak of falciparum (1 case) and vivax (23 cases) that occurred (May 2014) in Aswan Governorate strongly indicated that malaria is reemerging in the country. El-Fayoum should be take special attention, rather than being the last residual focus. The efficient malaria vector A. sergenti, the proven vector A. pharoensis and the suspected vector A. multicolor were encountered. This work reevaluated malaria status by using RDTs in survey and Giemsa stained thick films to confirm positive cases and estimation of parasite rate, formula, densities and species, also to study the ecological and entomological efficacy factors. The result showed that out of 2044 examined persons, 14 (0.68%) were passive cases, i.e., attending themselves to El-Fayoum Malaria Units after their return from Sudan. Microscopic examination of their stained thick films obtained from MOH&P shows that 9 (64.2%) out of passive cases were positive 3 of them are P. falciparum (33.3%) and the rest P. vivax 6 (66.7%) The species formulas of P. falciparum and P. vivax were 33.3% and 66.7% respectively. Concerning the density class, only one vivax case was of low density class while the other cases were of high density class. All positive cases were males, imported from Sudan and most of them were merchants having trade activities in Sudan. All examined persons during active case detection ACD (1551) and neighborhood of detected cases NOD (479) were malaria negative by rapid diagnostic tests. The areas recording the highest number of imported cases were Abu Shanap, Aboxa (Ballona) and Kafr Aboud (Abshaway Center) but no Anopheline spp larvae were detected. While in Al Nazla A. sergeni and A. multicolor larvae were detected where there was no any imported case or even traveler to Sudan. If the situation is reversed, i.e., an imported case inhabit Al Nazla, reemergence of local malaria may start. The situation of Kafr Fazara is greatly changed by using fine sand instead of clay in manufacturing red brick after prevention excavation of land. No imported cases or Anopheline spp larvae were recorded.