Epidemiology and immunodiagnosis of schistosomiasis haematobium in low endemic area in Egypt.

A survey was performed in Behbeet village in Giza governorate including 370 individuals (172 males and 198 females) representing 10% of the house holds. Clinical, stool, urine and serological tests accompanied by a questionnaire were applied to all participants to find out the prevalence, intensity of infection of S. haematobium, underlying sociodemographic factors, morbidity indicators and the awareness and treatment status among the infected population. It was revealed that the overall prevalence of S. haematobium based on the detection of eggs in urine was 18.1% while the prevalence of antibodies to S. haematobium species specific microsomal antigen was 57.6% detected by enzyme-linked immuno-transfer blot (EITB). The highest age specific prevalence and intensity of infection were detected among school children in the early teenage. Males were at a higher risk of contracting infection than females with a sex ratio of 2.5:1. Occupational and recreational water contact were significantly more frequent among the egg positives than the negative ones. Present history of haematuria and microhaematuria detected by reagent strips had the strongest association with S. haematobium infection followed by leucocyturia and dysuria. Microhaematuria had the strongest negative predictive value (85.7%) in discrimination between egg positive and negative groups while its positive predictive value was the highest (92.9%) when seropositives and negatives were discriminated. Less than half of the infected population were aware of having the disease (43.3% and 41.8% among the egg positives and seropositives, respectively) and lower percentages reported receiving previous treatment for schistosomiasis. No significant differences were detected between groups (P>0.05). Culturally appropriate and effective health education of the population, and training of the staff of rural health units to improve diagnostic and outreach skills are recommended.