Younger Omani adults exhibit worse glycemic levels compared to older adults posing a formidable challenge to diabetes care teams.

Abstract. Bad sample designs and selection bias have plagued studies on schistosomiasis, and as a result some believe that schistosomiasis is too focal, making it difficult to draw reliable samples. The Epidemiology 1, 2, 3 (EPI 1, 2, 3) sample design, although complex, demonstrates that sampling theory is readily applicable to epidemiologic studies of schistosomiasis. The EPI 1, 2, 3 sampling scheme was designed to achieve the smallest feasible standard errors given EPI 1, 2, 3 objectives and certain logistical constraints. The sample design is a multi-stage selection of villages (ezbas, which were stratified by size) and households within each of 9 purposely selected Egyptian governorates. Villages and households were systemically selected from census frames. The sampling of ezbas was especially difficult because of the lack of complete sampling frames and their wide variation in population size. Ultimately, ezbas were stratified by size and then randomly selected from each stratum. Sample sizes for villages and ezbas and individuals within ezbas were calculated based on EPI 1 and 2 objectives, respectively. No re-selection was made for non-respondents. A 20% subsample of the full sample was drawn for clinical and ultrasonographic examinations. The sample selected from individual governorates closely parallel the age structure of the 1986 census of the respective rural populations. Details of the study design and related methods are given below.Epidemiology 1, 2, 3 (EPI 1, 2, 3) was an epidemiologic investigation of Schistosoma haematobium and/or S. mansoni infections in humans. The study methodology was designed and developed specifically to address the 3 EPI 1, 2, 3 objectives.

There has been a recent revival of interest in school-based health programmes in developing countries as a means of reducing the morbidity observed in school-aged children, of improving their physical growth and cognitive development, and of controlling transmission of disease in the community at large. This study used data collected from a large epidemiological survey of schistosomiasis in Egypt to examine what proportion of infected children missed treatment from an established national school-based schistosomiasis control programme simply because they did not attend school. It showed that children who were not enrolled in school had a higher prevalence of infection and were more intensely infected than children who attended school. At the extreme, over 80% of infected girls in one part of Egypt could not be treated by the existing school programme because they did not attend school. If these trends are similar in other countries where school-based programmes are being developed, school-based delivery may exacerbate existing inequalities in society and ways of expanding services to children who do not attend school regularly need to be explored.

Abstract. This is a descriptive report of the Epidemiology 1, 2, 3 project in Egypt that made use of large probability sampling methods. These results focus on Schistosoma mansoni infection in the northern Nile Delta governorate of Kafr El Sheikh. A probability sample of 18,777 persons, representing the rural population of the entire governorate, was drawn. The sample was designed not to exclude villages based on location or presence of health care facilities and to include representation of the smaller ezbas or hamlets. The objective was to obtain detailed estimates on ageand sex-specific patterns of S. mansoni infection, and to provide a baseline for prospective studies. Stool specimens were examined by the Kato method. The estimated mean Ϯ SE prevalence of S. mansoni infection in the rural population was 39.3 Ϯ 3.3% in 44 villages and ezbas after weighing for the effects of the sample design. The estimated mean Ϯ SE geometric mean egg count per gram of stool (GMEC) was 72.9 Ϯ 7.3. Prevalence and GMEC varied considerably by village and ezba, with ezbas having a significantly higher prevalence. Villages and ezba-specific prevalence was strongly associated with GMEC (r 2 ϭ 0.61, P Ͻ 0.001). The prevalence of S. mansoni infection increased by age to 55.4 Ϯ 3.2% at age 16 without a significant change in the adult ages. There were no gender differences until age 6, after which males were consistently higher until middle age, when the differences converged. The age-and sex-specific pattern of GMEC varied widely; however, when the GMEC data were collapsed into 5-year age groups, the GMEC peaked at 81.5 Ϯ 12.1 eggs/g in the 10-14-year-old age group. These estimates provide the basis for evaluating control measures for reducing prevalence, intensity of infection, and transmission.Historically, both Schistosoma mansoni and S. haematobium were highly prevalent in Kafr El Sheikh in Egypt.

We estimated the prevalence of cardiovascular disease (CVD) risk and its clinical implications among 1 110 Omani patients with type 2 diabetes mellitus (DM) using 2 different CVD risk tools: the general Framingham risk profile (GFRP) and the joint World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts. The GFRP tool identified higher proportion of patients compared with joint WHO/ISH tool at 10-year CVD risk 10% to <20% and at 20% to <30%. At CVD risk ≥30%, both assessment tools identified similar proportions of patients (22% vs 24%; P=.120). Compared with WHO/ISH charts, the GFRP identified almost double the number of men eligible for aspirin treatment at CVD risk thresholds of ≥10% (86% vs 43%). In women, the proportions were, 66% and 45%, respectively. For statins, the figures were, 60% and 37%, for men and 28% and 36%, for women. In conclusion, the GFRP overestimates the number of patients eligible for primary prevention of CVD compared with the joint WHO/ISH method.