Campylobacter infections in children exposed to infected backyard poultry in Egypt.

Campylobacteriosis is a zoonotic disease which has a worldwide public health impact. The disease is endemic in Egypt; however, the epidemiology in animals and humans has not been fully characterized. The objective of this study was to compare the risk of Campylobacter faecal carriage in children exposed to Campylobacter-infected vs. non-infected backyard poultry and to identify risk factors for a backyard being classified as infected. A total of 103 households which owned backyard poultry were sampled from a rural community in Egypt. Within these households 379 poultry and 106 children were tested for C. jejuni and C. coli; 23·5% and 5·5% of poultry were positive for C. jejuni and C. coli, respectively. In the studied households; 12·3% of children were positive for C. jejuni, and 2·8% were positive for C. coli. Using logistic regression, households with poultry positive for C. jejuni had 3·86 (95% confidence interval 1·0-15·0) times the odds of having children positive for C. jejuni compared to those housed with poultry which all tested negative. Backyard poultry may present a transmission route of C. jejuni to children. Backyards with poor cleaning and disinfection, wet litter and manure disposed of within the backyard had increased odds of being positive for C. jejuni. Enhancing biosecurity and management in poultry backyards may reduce the risk of the disease.

Seroprevalence of hepatitis E virus in humans and geographically matched food animals in Egypt.

The aim of current study was to investigate the epidemiology of Hepatitis E virus (HEV) in humans and geographically matched food animals as a novel zoonotic assessment in Egypt. Blood samples were collected from patients who had a history of jaundice and attended to fever and general hospitals. Animal blood samples were collected from cows, buffaloes, sheep and goats convenient to HEV seropositive humans. Enzyme Immuno Assay (EIA) protocol was used to determine IgG anti-HEV. Sex and pregnancy were investigated as potential risk factors for HEV infection. Of 134 examined humans, 51 (38.1%) were positive for IgG anti-HEV. The males showed 26.8% seropositivity while the recorded female seropositivity was 50.8%, with a significant difference at P = 0.005, Odds Ratio (OR) = 0.35 at 95% confidence interval (CI): 0.17-0.73. There was a significant difference at P = 0.02 between seropositivity in pregnant (25%) and non-pregnant women (59.6%); OR was 0.23 (95% CI: 0.06-0.81). Anorexia was the most common symptom whereas paraesthesia and back pain were the least within icteric seropositive HEV humans. Hepatitis E virus seropositivity was recorded in 21.6%, 14%, 4.4% and 9.4% from examined cows, buffaloes, sheep and goats, respectively. The infected food animals were convenient to positive HEV humans who may declare the epidemiological picture of potential zoonotic HEV.

Comparative evaluation of the use of artificial neural networks for modelling the epidemiology of schistosomiasis mansoni.

There has been a marked increase in the application of approaches based on artificial intelligence (AI) in the field of computer science and medical diagnosis, but AI is still relatively unused in epidemiological settings. In this study we report results of the application of neural networks (NN; a special category of AI) to schistosomiasis. It was possible to design an NN structure which can process and fit epidemiological data collected from 251 schoolchildren in Egypt using the first year's data to predict second and third years' infection rates. Data collected over 3 years included age, gender, exposure to canal water and agricultural activities, medical history and examination, and stool and urine parasitology. Schistosoma mansoni infection rates were 50%, 78% and 66% at the baseline and the 2 follow-up periods, respectively. NN modelling was based on the standard back-propagation algorithm, in which we built a suitable configuration of the network, using the first year's data, that optimized performance. It was implemented on an IBM compatible computer using commercially available software. The performance of the NN model in the first year compared favourably with logistic regression (NN sensitivity = 83% (95% confidence interval [CI] 78-88%) and positive predictive value (PPV) = 63% (95% CI 57-69%); logistic regression sensitivity = 66% (95% CI 60%-72%) and PPV = 59% (95% CI 53%-65%). The NN model generalized the criteria for predicting infection over time better than logistic regression and showed more stability over time, as it retained its sensitivity and specificity and had better false positive and negative profiles than logistic regression. The potential of NN-based models to analyse and predict wide-scale control programme data, which are inevitably based on unstable egg excretion rates and insensitive laboratory techniques, is promising but still untapped.

Prevalence of intestinal parasitic infections in Riyadh district, Saudi Arabia.

A total of 23,516 stool specimens collected from patients attending three medical centres in Riyadh, Saudi Arabia, were examined for intestinal parasites. Of these 5737 (24.4%) were positive. Entamoeba histolytica (8.8%) and Giardia lamblia (6.3%) were the commonest parasites found, and in the age group of one to 15 years. Giardia was found in 14.8% of males and 11.9% of females. Other intestinal parasites present included Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Hymeolepis nana. Ancylostoma duodenale, Enterobius vermicularis. Taenia saginata and Schistosoma hematotium.

Evaluation of portal hypertension in cases of hepatosplenic schistosomiasis using ultrasound.

Patients with hepatic schistosomiasis develop high degrees of portal hypertension. Various invasive techniques have been used to evaluate this degree of portal hypertension. In this work sonography was used as a safe, noninvasive technique to study the relationship between the degree of portal hypertension, as measured by percutaneous splenic manometry, and the diameters of the portal and splenic veins. A total of 25 patients were included in this study. A positive correlation was found between the degree of portal hypertension and the increase in the diameters of the portal and splenic veins.

Changing pattern of schistosomiasis in Egypt 1935--79.

A village in the Nile surveyed for schistosomiasis by J. A. Scott in 1935 was surveyed again in 1979. The same number of people as in the 1935 survey were randomly selected for investigation by the same parasitological techniques as those used by Scott. The prevalence of Schistosoma mansoni infection had increased from 3.2% to 73%, whereas S. haematobium infection, which had been very common in 1935 (74%), had almost disappeared (2.2%). In the local district hospital since 1972 the percentage of urine specimens found to contain S. haematobium ova has dropped from 30 to 9%, while the percentage of stool specimens containing S. mansoni ova has increased from 2 to 22%. In the local irrigation canals snail intermediate hosts for S. mansoni have outnumbered those for S. haematobium by a factor of 5--40 in the past 7 years. Changes in the proportions of snail vectors appear to be related to construction of the Aswan High Dam and to changes in the water-flow patterns of the Nile. The change in the relative frequencies of the two infections had important public-health implications, since the hepatosplenic schistosomiasis caused by S. mansoni is more difficult to treat and is associated with more morbidity and mortality than the urinary schistosomiasis caused by S. haematobium.

Distal splenorenal shunts (Warren's operation) B-mode and real time ultrasonographic assessment.

B mode and real time ultrasonography have been used in a trial to demonstrate the patency of distal splenorenal shunt done in Warren's operation. Thirty seven patients with portal hypertension, and bleeding oesophageal varices were the subject of this study. Using B-mode ultrasonography in 70% of cases (26 patients), the splenic, left renal vein and the site of anastomosis were demonstrated. In 8% (3 patients), both splenic and left renal veins were seen patent, but the site of anastomosis was not detected. In the remaining 22% (8 patients), neither the left renal vein nor the site of anastomosis could be demonstrated. Using the Real-time two dimensional ultrasound, 9 of the 37 patients were examined. The patency of both veins and the site of the shunt was demonstrated in 90% (8 patients).