Schistosomiasis in Egypt
Social Relevant Issue
Background
Schistosomiasis is in the phylum Platyhelminthes and class Trematoda. It is a parasitic flatworm responsible for serious infections in humans. It parasitizes blood capillaries of either the mesenteries or plexus of the bladder, depending on the infecting species. Schistosomiasis is a severe disease in developing countries that affect clean drinking waters. It affects more than 200 million people and put 800 million at risk. There are three different types of schistosome; Schistosoma mansoni, Schistosoma japonicum, and Schistosoma haematobium. Schistosoma mansoni and Schistosoma japonicum are primarily responsible for intestinal schistosomiasis; noticable if parasitic eggs are released in feces. While Schistosoma haematobium is responsible for urogenital schistosomiasis; noticable if parasitic eggs are released in urine. However, Both intestinal and urogenital schistosomiasis can cause anemia and malnutrition. Their eggs are also able to enter our central nervous system and cause symptoms such as seizures and focal neurological deficits.
Life Cycle of Schistosoma 
The disease
Schistosomiasis symptoms include abdominal pain, diarrhea, bloody stool, or blood in the urine. Those who are infected for a long period of time may develop liver damage, kidney failure, infertility, or bladder cancer. In children, poor growth and learning difficulty can develop. The disease is caused by drinking contaminated fresh water with parasites. These parasites are released from infected freshwater snails. It is most common among children in developing countries. Farmers, fishermen, and people using unclean water during daily living are also at risk for this disease. It is diagnosed by looking at a person’s urine or stool to see if they have parasite eggs in them. It can also be confirmed by finding antibodies against the disease in the blood.
History of Schistosomiasis in Egypt
In Ancient Egypt, schistosomiasis haematobium was endemic. It is the second deadliest parasitic disease among malaria. The infection first occurred in mummies that were 3000, 4000 and 5000 years old and was diagnosed by Ruffer in 1910. He recovered calcified schistosome eggs from two Egyptian mummies of the 20th Dynasty. Then later identified them using radiology in several mummies. During the radiological examination, it showed that the calcified bladders in two other mummies were due to S. haematobium infection. S. haematobium was 60% prevalent both in the Nile Delta and Nile Valley South of Cairo in districts of perennial irrigation. In the Northern and Eastern parts of the Nile Delta, Schistosoma mansoni infected 60% of the population and only 6% in the Southern part.
Schistosomiasis control in Egypt
In 1920, the first attempts to control schistosomiasis in Egypt started. The Ministry of Health in Egypt begin to installed mobile units to examine and stop the spread of disease in early childhood. They treated children in large numbers at elementary, primary and secondary schools. Over years, the numbers of units increased from 6 in 1924 to 56 in 1933 with the number of annual treatments increasing from nearly 47000 to 311000.
The first control scheme planned to prevent this disease started at Dakhla oasis in 1926. They pour copper sulfate in canals nearby homes that would treat about a third of the population. The planned work and all Bulinus snails were killed within 6 months. In the early 1930s, regular surveys taken failed to detect snails and none of the 70 children born after the last mollusciciding in 1929 was infected in 1936 survey.
Even though they were able to control schistosomiasis in some areas, it is still present in the world. Finally, the World Health Organization (WHO) came up with a strategy that was carried out in Egypt. However, this time it aimed at transmission control and not snail control. Praziquantel is an anti-parasite medication used to prevent the disease. It is given once a year to groups of people in infected areas to decrease the number of people infected and, consequently, the spread of the disease. It is the treatment recommended by the World Health Organization (WHO) for those who are known to be infected. This supplement has been used ever since along with snail control methods to be more effective.
REFERENCES
. December 4, 2014. The Relationship between Water, Sanitation and Schistosomiasis: A Systematic Review and Meta-analysis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4256273/
By Rashida M.R.BarakatEpidemiology of Schistosomiasis in Egypt: Travel through Time: Review.
http://www.sciencedirect.com/science/article/pii/S2090123212000525
https://en.wikipedia.org/wiki/Schistosomiasis
