Abstract
BackgroundControl of human schistosomiasis remains a longstanding issue on the agenda of the Egyptian Ministry of Health and Population (MOHP). Substantial impact on morbidity and prevalence of S. mansoni was widely reported after the National Schistosomiasis Control Program (NSCP) extended selective treatment with praziquantel (PZQ) to the Nile Delta in 1992 and upgrading this approach to mass drug administration (MDA) in 1997. Disease elimination, however, eludes NSCP as the micro-level includes many high-risk foci that sustain transmission, which has not been subjected to investigation.MethodsThe study included five high-risk Nile Delta villages situated in the Kafr El-Sheikh Governorate. The total sample size amounted to 2382 individuals of both sexes and all ages. Diagnosis was based on four Kato-Katz slides from two consecutive stool samples. Data were investigated using SPSS, comparing proportions with the Chi square test and means with the Student t test, while strength of the associations were subjected to Odds Ratio (OR) analysis.ResultsThe overall prevalence of schistosomiasis in the study area was found to be 29 %, while the mean geometric mean egg count (GMEC) was low (66.78 ± 4.4) indicating low intensity of infection. The mean village prevalence rates ranged from 16.5 % to 49.5 % and the GMECs from 35.2 to 86.2 eggs per gram (EPG) of stool. The difference of prevalence between villages was statistically significant at P < 0.05, and the prevalence was significantly higher among males than among females, P < 0.05, OR =1.4 and 95 % CI (1.16-1.60). Infection peaked in the next youngest age group (5- ≤ 10 years of age) at an average prevalence of 50.8 % with the GMEC reaching 209 EPG of stool in the village with the highest prevalence. The average prevalence and GMEC among children <5 years were 20.6 % and 92.7 EPG, respectively.ConclusionTransmission of S mansoni in high-risk areas in the Nile Delta remains uninterrupted calling for improved, more comprehensive control strategies. Further investigations are needed to find out whether these results are due to inefficacy of PZQ, surviving immature worms or drug resistance.
Highlights
Control of human schistosomiasis remains a longstanding issue on the agenda of the Egyptian Ministry of Health and Population (MOHP)
PZQ mass drug administration (MDA) is recommended if the prevalence of schistosomiasis exceeds 3 % compared to 20 % according to the WHO recommendations [11, 20,21,22]
With the prevalence rates for the other villages ranging from 16.5 % to 32.3 %, it is evident that all the study villages must be considered as having moderate schistosomiasis risk
Summary
Control of human schistosomiasis remains a longstanding issue on the agenda of the Egyptian Ministry of Health and Population (MOHP). The signing on 31 January 2012 of the London Declaration by international politicians, heads of pharmaceutical businesses and health-related, non-governmental organizations (NGOs) represents a breakthrough in the fight against the world’s neglected tropical diseases (NTDs) [1]. This commitment, based on a plan presented by the. Humans get infected during water contact through the release of the infectious schistosome cercarial stage from the parasite’s intermediate snail host. The cerariae grow into adult worms, which excrete a large number of eggs that will eventually infect the snail when hatched in water. The disease eventually produces fibrosis and obstructive manifestations due to damage of the liver (in S. mansoni infections) or the bladder (in S. haematobium infections) [4]
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