Acanthamoeba in Southeast Asia - Overview and Challenges.

Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.

Gravid Anopheles gambiae sensu stricto avoid ovipositing in Bermuda grass hay infusion and it's volatiles in two choice egg-count bioassays.

BACKGROUND: A number of mosquito species in the Culex and Aedes genera prefer to lay eggs in Bermuda grass (Cynodon dactylon) hay infusions compared to water alone. These mosquitoes are attracted to volatile compounds from the hay infusions making the infusions effective baits in gravid traps used for monitoring vectors of arboviral and filarial pathogens. Since Bermuda grass is abundant and widespread, it is plausible to explore infusions made from it as a potential low cost bait for outdoor monitoring of the elusive malaria vector Anopheles gambiae s.s. METHODS: This study investigated preferential egg laying of individual An. gambiae s.s. in hay infusion or in tap water treated with volatiles detected in hay infusion headspace compared to tap water alone, using two-choice egg-count bioassays. Infusions were prepared by mixing 90 g of dried Bermuda grass (hay) with 24 L of unchlorinated tap water in a bucket, and leaving it for 3 days at ambient temperature and humidity. The volatiles in the headspace of the hay infusion were sampled with Tenax TA traps for 20 h and analysed using gas chromatography coupled to mass spectrometry. RESULTS: In total, 18 volatiles were detected in the infusion headspace. Nine of the detected compounds and nonanal were selected for bioassays. Eight of the selected compounds have previously been suggested to attract/stimulate egg laying in An. gambiae s.s. Gravid females were significantly (p < 0.05) less likely to lay eggs in hay infusion dilutions of 25, 50 and 100 % and in tap water containing any of six compounds (3-methylbutanol, phenol, 4-methylphenol, nonanal, indole, and 3-methylindole) compared to tap water alone. The oviposition response to 10 % hay infusion or any one of the remaining four volatiles (4-hepten-1-ol, phenylmethanol, 2-phenylethanol, or 4-ethylphenol) did not differ from that in tap water. CONCLUSIONS: Anopheles gambiae s.s. prefers to lay eggs in tap water rather than Bermuda grass hay infusion. This avoidance of the hay infusion appears to be mediated by volatile organic compounds from the infusion. It is, therefore, unlikely that Bermuda grass hay infusion as formulated and used in gravid traps for Culex and Aedes mosquitoes will be suitable baits for monitoring gravid An. gambiae s.s.

The roles of water, sanitation and hygiene in reducing schistosomiasis: a review.

Schistosomiasis is a disease caused by infection with blood flukes of the genus Schistosoma. Transmission of, and exposure to, the parasite result from faecal or urinary contamination of freshwater containing intermediate host snails, and dermal contact with the same water. The World Health Assembly resolution 65.21 from May 2012 urges member states to eliminate schistosomiasis through preventive chemotherapy (i.e. periodic large-scale administration of the antischistosomal drug praziquantel to school-aged children and other high-risk groups), provision of water, sanitation and hygiene (WASH) and snail control. However, control measures focus almost exclusively on preventive chemotherapy, while only few studies made an attempt to determine the impact of upgraded access to safe water, adequate sanitation and good hygiene on schistosome transmission. We recently completed a systematic review and meta-analysis pertaining to WASH and schistosomiasis and found that people with safe water and adequate sanitation have significantly lower odds of a Schistosoma infection. Importantly though, the transmission of schistosomiasis is deeply entrenched in social-ecological systems, and hence is governed by setting-specific cultural and environmental factors that determine human behaviour and snail populations. Here, we provide a comprehensive review of the literature, which explores the transmission routes of schistosomes, particularly focussing on how these might be disrupted with WASH-related technologies and human behaviour. Additionally, future research directions in this area are highlighted.

A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol.

INTRODUCTION: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. METHODS AND ANALYSIS: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. ETHICS AND DISSEMINATION: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health--Project grant from the National Health and Research Council (NHMRC), Australia. TRIAL REGISTRATION NUMBER: ACTRN12614000680662; Pre-results.

Distribution of Legionella pneumophila bacteria and Naegleria and Hartmannella amoebae in thermal saline baths used in balneotherapy.

The present study was aimed at investigating the coexistence and interactions between free living amoebae of Naegleria and Hartmannella genera and pathogenic Legionella pneumophila bacteria in thermal saline baths used in balneotherapy in central Poland. Water samples were collected from November 2010 to May 2011 at intervals longer than 1 month. The microorganisms were detected with the use of a very sensitive fluorescence in situ hybridisation method. In addition, the morphology of the amoebae was studied. Despite relatively high salinity level, ranging from 1.5 to 5.0 %, L. pneumophila were found in all investigated baths, although their number never exceeded 10(6) cells dm(-3). Hartmannella were not detected, while Naegleria fowleri were found in one bath. The observation that N. fowleri and L. pneumophila may coexist in thermal saline baths is the first observation emphasising potential threat from these microorganisms in balneotherapy.

[Culex quinquefasciatus sensitivity to insecticides in relation to the urbanization level and sewage water in Yopougon, a township of Abidjan (Côte-d'Ivoire)]. / Sensibilité de Culex quinquefasciatus aux pyréthrinoïdes en relation avec le niveau d'urbanisation et l'évacuation des eaux usées dans la commune de Yopougon à Abidjan (Côte-d'Ivoire).

This survey, conducted from July 2003 to June 2004, was to assess the variation of the level of sensitivity of Cx. quinquefasciatus to the pyrethroids recommended for the impregnation of the mosquito nets, in the township of Yopougon situated in the Northwest of Abidjan city in relation with the bed of a drainage channel of sewage water that passes through the township from the north to the south. Five districts have been chosen along this channel according to the level of urbanization, for the withdrawal of the pre-imaginal populations of Cx. quinquefasciatus in collections of stagnant sewage water of this township. The female Cx. quinquefasciatus aged three to five days from the exits of the insectarium have been exposed to papers impregnated with deltamethrin 0.05%, permethrin 1% and DDT 4% in view of the diagnosis of a possible resistance of these populations to these insecticides. The populations of Cx. quinquefasciatus proved to be resistant to the three insecticides used, in four districts. On the other hand, the population of Cx. quinquefasciatus from the district "Zone industrielle," situated upstream of the channel, proved to be sensitive to permethrin 1%, and a drastic decrease of sensitivity of the same mosquito has been observed with deltamethrin 0.05% and DDT 4%.

Use of Moringa oleifera seed extracts to reduce helminth egg numbers and turbidity in irrigation water.

Water from wastewater-polluted streams and dug-outs is the most commonly used water source for irrigation in urban farming in Ghana, but helminth parasite eggs in the water represent health risks when used for crop production. Conventional water treatment is expensive, requires advanced technology and often breaks down in less developed countries so low cost interventions are needed. Field and laboratory based trials were carried out in order to investigate the effect of the natural coagulant Moringa oleifera (MO) seed extracts in reducing helminh eggs and turbidity in irrigation water, turbid water, wastewater and tap water. In medium to high turbid water MO extracts were effective in reducing the number of helminth eggs by 94-99.5% to 1-2 eggs per litre and the turbidity to 7-11 NTU which is an 85-96% reduction. MO is readily available in many tropical countries and can be used by farmers to treat high turbid water for irrigation, however, additional improvements of water quality, e.g. by sand filtration, is suggested to meet the guideline value of ≤ 1 helminth egg per litre and a turbidity of ≤ 2 NTU as recommended by the World Health Organization and the U.S. Environmental Protection Agency for water intended for irrigation. A positive correlation was established between reduction in turbidity and helminth eggs in irrigation water, turbid water and wastewater treated with MO. This indicates that helminth eggs attach to suspended particles and/or flocs facilitated by MO in the water, and that turbidity and helminth eggs are reduced with the settling flocs. However, more experiments with water samples containing naturally occurring helminth eggs are needed to establish whether turbidity can be used as a proxy for helminth eggs.

[Investigation of the antiparasitic activity of paracels series apparatuses].

The paper provides a preliminary positive assessment of the results of experimental studies of the inactivating effect of a bioresonance technology against Lamblia cysts and Cryptosporidium oocysts placed in the aquatic environment in vitro.

Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events--United States, 2005-2006.

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-disease outbreaks (WBDOs) associated with drinking water. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of disease associated with recreational water in the United States. In addition, data are collected on individual cases of recreational water-associated illnesses and infections and health events occurring at aquatic facilities but not directly related to water exposure. REPORTING PERIOD: Data presented summarize WBDOs and case reports associated with recreational water use that occurred during January 2005--December 2006 and previously unreported disease reports and outbreaks during 1978--2004. DESCRIPTION OF THE SYSTEM: Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs and cases associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water and health events at aquatic facilities are summarized in this report. RESULTS: During 2005--2006, a total of 78 WBDOs associated with recreational water were reported by 31 states. Illness occurred in 4,412 persons, resulting in 116 hospitalizations and five deaths. The median outbreak size was 13 persons (range: 2--2,307 persons). Of the 78 WBDOs, 48 (61.5%) were outbreaks of gastroenteritis that resulted from infectious agents or chemicals; 11 (14.1%) were outbreaks of acute respiratory illness; and 11 (14.1%) were outbreaks of dermatitis or other skin conditions. The remaining eight were outbreaks of leptospirosis (n = two), primary amebic meningoencephalitis (n = one), and mixed or other illnesses (n = five). WBDOs associated with gastroenteritis resulted in 4,015 (91.0%) of 4,412 illnesses. Fifty-eight (74.4%) WBDOs occurred at treated water venues, resulting in 4,167 (94.4%) cases of illness. The etiologic agent was confirmed in 62 (79.5%) of the 78 WBDOs, suspected in 12 (15.4%), and unidentified in four (5.1%). Thirty-four (43.6%) WBDOs had a parasitic etiology; 22 (28.2%), bacterial; four (5.1%), viral; and two (2.6%), chemical or toxin. Among the 48 gastroenteritis outbreaks, Cryptosporidium was confirmed as the causal agent in 31 (64.6%), and all except two of these outbreaks occurred in treated water venues where Cryptosporidium caused 82.9% (29/35) of the gastroenteritis outbreaks. Case reports associated with recreational water exposure that were discussed and analyzed separately from outbreaks include three fatal Naegleria cases and 189 Vibrio illnesses reported to the Cholera and Other Vibrio Illness Surveillance System. For Vibrio reporting, the most commonly reported species were Vibrio vulnificus, V. alginolyticus, and V. parahaemolyticus. V. vulnificus illnesses associated with recreational water exposure had the highest Vibrio illness hospitalization (77.6%) and mortality (22.4%) rates. In addition, 32 aquatic facility-related health events not associated with recreational water use (e.g., pool chemical mixing accidents) that occurred during 1983--2006 were received from New York. These events, which caused illness in 364 persons, are included in this report but analyzed separately. INTERPRETATIONS: The number of WBDOs summarized in this report and the trends in recreational water-associated disease and outbreaks demonstrate a substantial increase in number of reports from previous years. Outbreaks, especially the largest ones, occurred more frequently in the summer at treated water venues and caused gastrointestinal illness. Deficiencies leading to WBDOs included problems with water-quality, venue design, usage, and maintenance. Case reports of illness associated with recreational water use expand our understanding of the scope of waterborne illness by further underscoring the contribution of less well-recognized swimming venues (e.g., oceans) and illness (e.g., nongastrointestinal illness). Aquatic facilities are also a focus for injuries involving chemicals or equipment used routinely in the operation of swimming venues, thus illustrating the lack of training of some aquatics staff. PUBLIC HEALTH ACTIONS: CDC uses WBDO surveillance data to 1) identify the etiologic agents, types of aquatic venues, water-treatment systems, and deficiencies associated with outbreaks and case reports; 2) evaluate the adequacy of efforts (i.e., regulations and public awareness activities) to provide safe recreational water; 3) expand the scope of understanding about waterborne disease and health events associated with swimming and aquatics facilities; and 4) establish public health prevention priorities, data, and messaging that might lead to improved regulations, guidelines, and prevention measures at the local, state, and federal levels.

A hundred-year retrospective on cryptosporidiosis.

Tyzzer discovered the genus Cryptosporidium a century ago, and for almost 70 years cryptosporidiosis was regarded as an infrequent and insignificant infection that occurred in the intestines of vertebrates and caused little or no disease. Its association with gastrointestinal illness in humans and animals was recognized only in the early 1980s. Over the next 25 years, information was generated on the disease's epidemiology, biology, cultivation, taxonomy and development of molecular tools. Milestones include: (i) recognition in 1980 of cryptosporidiosis as an acute enteric disease; (ii) its emergence as a chronic opportunistic infection that complicates AIDS; (iii) acknowledgement of impact on the water industry once it was shown to be waterborne; and (iv) study of Cryptosporidium genomics.

Six human cyclosporiasis: with general review.

Cyclospora cayetanensis is an emerging coccidian pathogen known in animal since a long time, but recognized in human in last two decade. The present study of cyclosporiasis specified its characteristic features. An epidemiological, clinical and biological retrospective study was carried out on 6 patients, 24 to 67 years old, who complained of diarrhea and weight loss, after a travel abroad. The only pathogenic agent found in every patient was Cyclospora cayetanensis. The patients returned back from Asian countries and from Madagascar. They were cured by Trimethoprim-sulfamethoxazole (TMZ). Diarrhoea was the main symptom of infection by C. cayetanensis. Undoubtedly, transmission occurred by the oro-fecal route, and/or by consumption of infected water or foods. Diagnosis was asserted, recovery of this protozoan parasite in the stools samples. TMZ proved to be the most effective and possibly replaced Ciprofloxacine. The prophylaxis recommended control measure of water supply and foods. Cyclospora should be considered in the assessments of patients with unexplained prolonged diarrhoea, if the investigation for bacterial and parasitological diarrhoea or the traveler's diarrhoea were negative.

Schistosomiasis in African infants and preschool children: to treat or not to treat?

The occurrence of schistosomiasis in African infants and preschool children has been largely overlooked, with preventive chemotherapy usually focused on school-aged children instead. Two recent surveys by Bosompem et al. and Odogwu et al. have shown that schistosomiasis in younger children is much more common than previously thought. This article highlights the importance of the disease in this age group and discusses the future prospects for schistosomiasis control.

Dracunculiasis (Guinea worm disease) eradication.

Since the seminal review by Ralph Muller about Dracunculus and dracunculiasis in this serial publication in 1971, the Centers for Disease Control and Prevention and The Carter Center forged, during the 1980s, a coalition of organizations to support a campaign to eradicate dracunculiasis. Eighteen of 20 countries were known in 1986 to have endemic dracunculiasis, i.e., Benin, Burkina Faso, Cameroon, Chad, Côte d'Ivoire, Ethiopia, Ghana, India, Kenya, Mali, Mauritania, Niger, Nigeria, Pakistan, Senegal, Sudan, Togo, and Uganda. Transmission of the disease in Yemen was documented in 1995, and the World Health Organization (WHO) declared Central African Republic endemic in 1995. As of the end of 2004, a total of 16026 cases of dracunculiasis were reported from 12 endemic countries (91% of these cases were reported from Ghana and Sudan, combined), a reduction greater than 99% from the 3.5 million cases of dracunculiasis estimated in 1986 to occur annually; the number of endemic villages has been reduced by >91%, from the 23475 endemic villages in 1991; disease transmission has been interrupted in 9 of the 20 endemic countries; and WHO has certified 168 countries free of dracunculiasis, including Pakistan (1996), India (2000), Senegal and Yemen (2004). Asia is now free of dracunculiasis.

A double-blind field trial on the effects of artemether on Schistosoma japonicum infection in a highly endemic focus in southern China.

To further strengthen the evidence-base of artemether for the control of schistosomiasis japonica, a randomised controlled trial was carried out in the Poyang Lake region, a highly endemic area in southern China. A total of 783 individuals, aged 6-60 years, were enrolled. They were first given a single oral dose of praziquantel (50 mg/kg). Then, they were randomly assigned oral artemether (6 mg/kg) or placebo, administered once every 2 weeks for 9-11 doses, covering the entire transmission season for Schistosoma japonicum in 2004. Stool examination 1 month after the final dosing revealed eggs of S. japonicum in 3/373 (0.8%) of the artemether recipients and 56/361 (15.0%) in placebo recipients (chi2=53.69, P<0.001). Compared to the baseline, the geometric mean intensity of S. japonicum infection had decreased by 96.1% in the artemether group, and increased by 50.8% in the placebo group. No acute cases of schistosomiasis japonica were observed in the artemether group, whereas three such cases were reported from the placebo group. Compliance with regard to multi-doses of artemether and placebo was 84.9, and 77.9%, respectively. This study confirms that repeated oral artemether produces no drug-related adverse effects, significantly reduces incidence and intensity of patent S. japonicum infection and results in high compliance. Hence it can be used as an additional tool for the control of schistosomiasis japonica in the lake regions of China.

Evaluation of a programme for control of schistosoma haematobium infection in Yemen.

An intervention study was conducted in Khamir, north of Sana'a, for control of urinary schistosomiasis using chemotherapy and health education. The validity and cost-effectiveness of reagent strips as a rapid diagnostic tool to screen for Schistosoma haematobium infection was also assessed along with visible haematuria. Prevalence of S. haematobium infection 14 months post-intervention fell from 58.9% to 5.8% and frequency of heavy infection from 40.0% to 18.9%. Health education sessions resulted in significant decrease in the frequency of contact with water sources and greater adherence to preventive measures. Mass chemotherapy plus health education is a feasible and effective method for reducing S. haematobium infection in Yemen. Reagent strips and visible haematuria could be cost-effective in remote areas with limited access to health services.

Present and future control of cryptosporidiosis in humans and animals.

Although water treatment processes to remove Cryptosporidium are improving and detection methods for identifying the parasite in water are becoming more sensitive, outbreaks of cryptosporidiosis continue in the human population. Animals, especially dairy calves, often become infected as C. parvum oocysts are present in high numbers, remain viable for long periods of time after excretion and no disinfectants, prophylactic or therapeutic reagents exist. Vaccination against C. parvum is being attempted in ruminants for the purpose of generating hyperimmune colostrum containing antibodies that may be effective in passive immunotherapy against cryptosporidiosis in the young. A number of recombinant C. parvum surface or internal antigens have been expressed by DNA-cloning technology. Immune colostrum specific for several recombinant C. parvum proteins have demonstrated efficacy in murine and ruminant models against cryptosporidiosis. The P23 and CP15 antigens appear to be the most promising candidates for vaccine development. Recent studies have demonstrated efficacy of the drug nitazoxanide against C. parvum infection in humans. In the near future, control of this parasitic disease in humans and animals will rely on a combination of passive immunotherapy and selective drug treatment.

Possible estuary-associated syndrome: symptoms, vision, and treatment.

The human illness designated as possible estuarine-associated syndrome (PEAS) by the Centers for Disease Control and Prevention (CDC) has been associated with exposure to estuaries inhabited by toxin-forming dinoflagellates, including members of the fish-killing toxic Pfiesteria complex (TPC), Pfiesteria piscicida and Pfiesteria shumwayae. Humans may be exposed through direct contact with estuarine water or by inhalation of aerosolized or volatilized toxin(s). The five cases reported here demonstrate the full spectrum of symptoms experienced during acute and chronic stages of this suspected neurotoxin-mediated illness. The nonspecific symptoms most commonly reported are cough, secretory diarrhea, headache, fatigue, memory impairment, rash, difficulty in concentrating, light sensitivity, burning skin upon water contact, muscle ache, and abdominal pain. Less frequently encountered symptoms are upper airway obstruction, shortness of breath, confusion, red or tearing eyes, weakness, and vertigo. Some patients experience as few as four of these symptoms. The discovery that an indicator of visual pattern-detection ability, visual contrast sensitivity (VCS), is sharply reduced in affected individuals has provided an objective indicator that is useful in diagnosing and monitoring PEAS. VCS deficits are present in both acute and chronic PEAS, and VCS recovers during cholestyramine treatment coincident with symptom abatement. Although PEAS cannot yet be definitively associated with TPC exposure, resolution with cholestyramine treatment suggests a neurotoxin-mediated illness.

Some aspects in the control of schistosomosis and soil-transmitted helminthosis in Yemeni children.

OBJECTIVE: Prevalence, intensity and incidence of schistosomosis and soil-transmitted helminthosis among school children in an ignored area in Yemen were determined. The study aimed to investigate the impact of single doses of Praziquantel or Albenedazole or both, relating to sanitary, socioeconomic and behavioral practices on the prevalence and intensity of infections. METHODS: Out of a total number of 897 pupils, 453 were randomly selected from AlMahweet town and 444 from rural surrounding areas. Millipore filtration, modified Kato and precipitation techniques were applied for urine and stool analysis. RESULTS: Prevalence rates were 27% for schistosomosis, 61% for ascariosis, 21% for trichuriosis, 2% for fascilosis, 0.3% for entrobiosis, 0.7% for hook worm infection and 0.2% for strongloydiosis. Factors found confounding the relationship between schistosomosis and residence, under logistic regression analysis, were sex and frequency of water contact. Probability of infection by Bilharzia for boys who reside in rural AlMahweet and visit the water source is 0.52, compared to 0.30 for their mates who reside in AlMahweet town. Odds ratio estimates accounted for via residence was 2.5, via water contact 1.7 and via boys 3.2. With regards to other helminthic infections, availability of latrines remained the only significant factor under ANOVA. CONCLUSION: In conclusion, annual campaigns for treatment as a single control measure can reduce the infection rate of S. mansoni by 62.5%, T. trichura by 48% and A. lumbricoides by 24%. Whereas for S. hematobium the appropriate time interval for intervention should be shortened according to the findings of a properly designed intervention study before used as a single control measure. Since 77% of the children were infected by other helminthes, therefore mass treatment should be extended to cover all children. For those boys in rural AlMahweet who visited the water source during the week before the interview, mass treatment for schistosomosis is recommended since the prediction of infection rate reached 52%.

Index of potential contamination for schistosomiasis.

Schistosomiasis occurs under a wide variety of climatic, geographical and other conditions. The basic reason for the transmission of schistosomes is, however, the low level of sanitation in endemic areas with the result that faeces or urine, or both, containing schistosome eggs get into water that contains freshwater snails susceptible to infection. Unfortunately, the degree of contamination of natural habitats with schistosome ova is difficult to estimate; consequently, there are few data on how much contamination, relative to a defined snail population density, is necessary to initiate or maintain transmission of schistosomiasis. This article discusses a little-used method to estimate the degree of contamination or transmission - the index of potential contamination (IPC). The expected changes in IPC after praziquantel treatment will be considered, as well as the level of reduction in IPC that might be needed to affect transmission or reduce morbidity.