Progress in the control of schistosomiasis in Egypt 1985-1988

Continuing epidemiological evaluation of schistosomiasis intervention measures applied in Middle and Upper Egypt since 1985 indicate that a large measure of control of Schistosoma haematobium has been achieved in relation to both prevalence and intensity of the infection and incidence of new infections. Transmission control has, however, been inadequate in many areas, since numerous re-infections occurred in treated schoolchildren. Variable compliance rates in the chemotherapy delivery system were probably, in part, an important contributory factor, and short-comings of the selective and/or focal mollusciciding strategy were also probably responsible for many new cases and re-infections. Chemotherapy delivery has now been improved following the introduction of single dose treatments with praziquantel and it is expected that there will be an increased demand for treatment following the introduction of a new information-education-communication campaign. In communities with geometric mean egg-output of less than 50 per 10 ml of urine, acceptable control of the potential for development of schistosomal disease can be expected. It is concluded, therefore, that the future maintenance control strategy in this project area may call for more frequent chemotherapy treatments in identified foci of high prevalence and intensity, with complementary focal mollusciciding and/or targeted treatment of schoolchildren, in order to prevent the serious consequences of infection. In 1988 the annual cost of schistosomiasis control measures per person throughout the project area (2 million irrigated feddans (c .800,000 hectares] containing 12 million people) was 0.5 Egyptian pounds (LE) (US$ 0.20), representing 5.2% of the annual expenditure per person in Egypt (LE 9.6) for all health services.