Epidemiological Observations and Control Assessment of Schistosomiasis and Intestinal Parasites in El Suleimania Agricultural Scheme, River Nile State, Sudan

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Osman, Hana Abbas
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This investigation was conducted in EL Suleimania Scheme, River Nile State, to provide some elements of analytical micro-epidemiology with special emphasis on parasite aggregation and dynamics related to the Knowledge, attitude and practice of the people. Two parasitological surveys were conducted, six months spaced, where all villagers and school children were examined microscopically, for schistosomiasis and intestinal parasites. In addition, a designed questionnaire was conducted to assess the socioeconomical factors influencing transmission pressure of the parasites. Considering human as a basic unit of study, several variables that reflected the socioeconomic aspect and the population's way of life were strongly linked with the infection parameters e.g. age-class, gender, occupational category, educational level and ethnic groups. All infected villagers and school children were treated under medical supervision with intensive health education programme. The influential role of chemotherapy and health education programmes in reduction of infection parameters of Bilharzia and intestinal parasites was evaluated. In addition, the sensitivity of some accessible diagnostic techniques of urine and faecal samples were qualitatively and quantitatively assessed. The situation of urinary schistosomes in such neglected area was bleaked and desolated, 51.4%, among the school children, with intensity of 89.8 egg/10 ml of urine. On the other side, the prevalence rate among the villagers was 20.5%, while the geometric mean egg count was 69.8, respectively. In addition, the infected school children by intestinal parasite(s), was 40.1%, while only 16.3% of the villagers were ensured to be infected. The study revealed that more than half of the investigated communities were infected before by Bilharzia, who still carries a disproportionate share of the community's total worm burden. Some determinant factors were linked to the transmission pressure of Bilharzia and intestinal parasites in surveyed area. These include: the geological and the ecological bases of the study area, as well as the proximity to the waterbodies, water-contact activities and the socioeconomic status of the surveyed villages. The surveys pointed out that the personal hygiene is low in the investigated communities, which well reflected in the considerable infection rates of the urinary schistosomiasis and intestinal parasites. Thus, a concrete well-designed health education programme was highly advocated for speeding up the process of acquiring better habits utilizing the religious messages in the mosque. The school children, farmers and agricultural labourers scored the highest prevalence rates. The worm load among the jobless villagers represents more than 20 folds those in the farmers and around 20 folds those of the overall intensity of the villagers. These findings were manipulated within the frame of the water-contact activities of the different occupants. No consistent pattern was observed correlating the type of building, the number of rooms, ethnic groups, and the residential location to the two infection parameters. The intervention reduced the rates of Bilharzia and intestinal parasites among the school children by 83% and 84.8% respectively, while those of the villagers declined by 75.1% and 63.2% respectively. The essential obtained findings pertaining the reduction of intestinal parasites among the school children. First, all school children were cleaned from three intestinal helminthes, Trichuris, Ancylostoma and Enterobius. Second, the overall prevalence of ascariasis was declined among the school children with a rate of 91.9%, while that of the tape-worms reduced with a rate of 79.9%. A programme of community development to help the villagers to help themselves in raising standards of living and participated in control activities was highly advocated. These include: protection of waterbodies, construction of latrines, installment and maintenance of the water-supply system as well as reactivation of the non-functional dispensary. No variation was detected in the efficiency of the reagent strips compared to the centrifugation in identification of the positive urine samples. The confounding factors in the sensitivity of the reagent strips in the Southern State were discussed. The modified Kato technique significantly outnumbered the direct smear technique in detection of Ascaris and H. nana eggs. Furthermore, there was no variation between the modified Kato technique and the direct smear one in detection of the intestinal protozoa. Consolidation of the reduced infection parameters among the surveyed villagers was discussed considering the pre- and post-interventional findings. Finally, based on the findings of the study, some effective measures for combating the investigated parasites were recommended
271 page
Epidemiological Observations,Control Assessment,Schistosomiasis,Intestinal Parasite, El Suleimania Agricultural Scheme