The epidemiology of schistosomiasis in Egypt: Qena governorate.

Abstract

Abstract. Qena is the southernmost governorate of Egypt included in the Epidemiology 1, 2, 3 national study. A probability sample selected 17,822 individuals from 2,950 households in 34 ezbas and 10 villages from a total rural target population of 1,731,252 (based on the most recent 1986 census of the population by the Egyptian Central Agency for Public Mobilization And Statistics). Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, respectively, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 4.8 Ϯ 0.7% (ϮSE) and geometric mean egg count (GMEC) was 7.0 ova per 10 ml of urine. Considerable variation in prevalence was observed between the villages and ezbas, ranging from 0.0% to 20%, with the smaller ezbas having a slightly higher overall prevalence. The age-and sex-specific patterns of S. haematobium showed typical peak prevalence in early adolescence, with males having a higher prevalence than females. A history of hematuria was associated with current infection (odds ratio ϭ 3.6, 95% confidence interval ϭ 2.32-5.63). Hepatomegaly and splenomegaly determined by physical examination present in 7.9% and 3.0%, respectively. Ultrasonography-determined hepatomegaly of the left liver lobe was found in 10.1%. Ultrasonography-detected hepatomegaly in both the left and right lobes increased in prevalence from approximately 5% in children to 15-20% in adults. The prevalence of ultrasonography-detected splenomegaly increased slightly with age. Grade III periportal fibrosis was detected in only 2 individuals in the sample. Bladder wall lesions and obstructive uropathy were also very infrequent. Other associations with these measures are given. Most villages and ezbas had an S. mansoni prevalence of less than 1%. The exception was Nag'a El-Sheikh Hamad, where the prevalence was 10.3 Ϯ 0.5% (GMEC ϭ 57.4 Ϯ 2.6). Two other communities also had a prevalence Ͼ1% (Ezbet Sarhan and Kom Heitin).The Qena governorate, in Upper Egypt, is best known as the location of some of Egypt's most famous Pharaonic temples, such as Karnek and Dendera, and its Pharaonic tombs, the Valley of the Kings, in Tebes on the west bank of Luxor. The governorate is located about 535-650 km south of Cairo on the Nile River, as shown on the map in Figure 1 of the report in this supplement by El-Khoby and others. 1 Qena is bordered on the north by Sohag and on the south by the Aswan governorate. The Nile valley is at its narrowest in Egypt here and the arable land, a green strip only 1 or 2 km on either side of the river, is bordered by barren desert on both sides. The governorate is perennially irrigated throughout by principal main and distributory canals (Egyptian Ministry of Irrigation, unpublished data). The major crop is sugar cane, which requires large quantities of water drawn by pumps from surrounding canals. Other food crops are grown in small plots adjacent to the villages and are irrigated manually. In this region where the...

Prevalence and risk factors of Schistosoma haematobium infections among primary school children in Igbokuta Village, Ikorodu North Local Government, Lagos State.

“…Similar results were obtained in Nigeria by Tohon et al, 22 . However, this is in contrast with result obtained in the Qena governorate in Egypt where males were more infected than females 23 . The higher prevalence rate of urinary schistosomiasis in this study reflects the higher level of exposure, habits, lifestyle and dependence of the inhabitants on the infected contaminated water bodies.…”

Emergence of Schistosoma mansoni infection in upper Egypt: the Giza governorate.

“…Atnia was the only village with this level of S. mansoni infection among 33 villages or ezbas surveyed that had an overall prevalence of 2% or less. 9 In similar representative studies, further south in the governorates of Assyut 19 and Qena, 20 S. mansoni was found only sporadically with only a few number of individuals infected in a given village or hamlet. No single village or hamlet had sufficiently high prevalence to be designed as a foci.…”

“…17,18 Schistosoma haematobium prevalence was similar in magnitude to the most recently reported cross-sectional estimates from representative samples in 1993 of Minya (8.9%), 9 Assiut (5.2%), 19 and Qena (5.4%). 20 In Middle and Upper Egypt, S. haematobium has been steadily decreasing for more than a decade 2,17,18,21 and has all but disappeared from the Nile Delta. 4,5 Although the elucidation of this decrease remains to be defined, chronologically, the decrease was first noted almost a decade after the closure of the Aswan High Dam.…”

Diagnosis of Urinary Schistosomiasis: A Novel Approach to Compare Bladder Pathology Measured by Ultrasound and Three Methods for Hematuria Detection

“…However, the baseline level for communities was disproportionately determined by six observations from a series of publications from one study in Egypt. [23][24][25][26][27]30 This extensive study, which reported relatively low prevalences of bladder pathology in situations of low endemicity, may have resulted in some underestimation of the rate of false-positive results, but it could only account for half of the difference between studies on children and communities. Thus, misclassification or false-positive results due to other diseases such as urinary tract infections and urethral stenosis seem to be substantially more prevalent in children than adults.…”