Water contact behavior and schistosomiasis in an upper Egyptian village.

Preliminary findings of a study of the role of microspatial behavior and local ecological circumstances in the persistence of Schistosoma haematobium infection in El Ayaisha village, Upper Egypt, are presented. Twelve types of water contact activities were studied in three cohorts of 274,324 and 392 male students aged 5-16 during a 2-year period. Swimming and playing resulted in more frequent and intensive contact with potentially infective water and in more pollution of snail habitats with schistosome eggs than any other type of activity. Irrigation was probably not a major cause of S. haematobium infection in schoolboys and drinking water and fishing carried the smallest risk for this age group. Mapping and discriminate analysis of infection and transmission indicators revealed spatial associations between water contact, schistosome transmission and infection among the various age groups. The highest egg excretion rates in individuals and the highest prevalence rates were noted in the neighborhoods nearest to the canals. Water contact and contamination of water by the heavily infected school age boys is seasonally concentrated during the summer, when intermediate host snails and infective cercariae are also most common in the water. Frequency, type and duration of water contact change with age together with types of water bodies used, causing corresponding changes in exposure risk. Nevertheless, other factors, including acquired immunity, preexisting infections, chemotherapy and the effect of the study on the normal water contact behavior of the study population must also be evaluated. Contact with the Nile and the canals by the general nonschool population of El Ayaisha was studied to verify the observations among the schoolboys and to study socially linked activities and the transmission potential of the various transmission sites. Results are evaluated in regard to the feasibility of various schistosomiasis control measures in El Ayaisha.