Operational research was conducted in Qena Governorate, Upper Egypt, to gather the information needed to design an integrated control programme for intestinal helminths in the area. To this aim, qualitative and quantitative techniques were used on a sample representative of the entire governorate. Mothers were questioned about their knowledge and perception of intestinal helminths, their hygienic habits and health-seeking behaviour. At the same time, a coprological survey was conducted on all the children 2 to 12 years of age living in the selected households (n = 2657) to provide baseline data on the prevalence of infection with these parasites. The survey results showed that intestinal helminth infections were more prevalent in rural areas and in three of the 12 Governorate districts. Almost all the respondents considered worms harmful and were aware of the need for treatment. More than adequate knowledge was present on ways to prevent infection. Good hygienic practices were associated with a low prevalence of infection in the household. Practical recommendations were formulated to design a helminth control programme tailored to the local situation and to prioritize allocation of resources. Passive case detection appeared to be appropriate to the level of infection in Qena (< 15%). The intervention should target areas and districts where prevalence of infection was higher, and all children below 12 years of age. Health education, besides encouraging mothers to refer their children to the health units for treatment, should focus on improving hygienic behaviour. While schools might be the best channel to contact children, the use of informal channels of communication, such as television, should be promoted to reach the mostly illiterate mothers. The research highlights the importance of gathering information on mothers' perceptions and behaviour in the design and implementation of a community-based intestinal helminths control programme.

During 1994 a cross-sectional survey was carried out on a sample representative of the population in Qena Governorate, Upper Egypt, to investigate the relationship between intestinal helminthic infection among children and a wide range of variables (demographic, behavioural, cultural, socioeconomic, and environmental). Data were collected by direct observation and by administering a questionnaire to mothers in charge of the household in a sample of 768 households representative of the entire population in the governorate. A stool sample survey was conducted at the same time on all children 2-12 years of age living in the selected households (n = 2657). Diagnosis of intestinal helminths was made on the basis of the Kato-Katz thick-smear technique. After univariate analyses, conducted to define associations among individual, familial, and community variables and prevalence of infection, the relevant variables were included in a multivariate logistic model to assess the importance of each factor as an independent determinant of infection. Several factors were independently associated with increased risk of intestinal helminth infection. In particular, the age of the child (between 4 and 5 years) (individual), the age of marriage for the mother (cultural), type of garbage disposal (household), and type of settlement (environmental) gave the highest predictive value for infection. The present results are consistent with those of former studies and highlight the importance of a multisectorial approach in the control of intestinal helminth infection.