Final Analysis Report

FINAL ANALYSIS REPORT

ROUND ONE DATA

ASSIUT GOVERNORATE

SUBMITTED TO: SECRETARIATE OF SRP

FROM: THE CORE TEAM

Members of The Core Team:

Prof. Dr. Mohamed Hasan Husein, PI

Prof. F. DeWolfe Miller, Co-PI and senior USA Collaborator

Dr. Medhat Kamal ElSayed, Deputy PI

Dr. Maha Talaat, Co-PI

Prof. Dr. Amal El-Badawy, Co-PI

PREPARED BY: Dr. Maha Talaat

TABLE OF CONTENT

INTRODUCTION: 1

OBJECTIVES: 1

SAMPLE DESIGN AND SAMPLE SELECTION: 2

DATA COLLECTION AND DATA RECORDING 2

DATA ANALYSIS 3

SAMPLE SELECTED 4

DROP OUT RATES5

COMMENTS 5

S. mansoni

RESULTS 6

TESTING SAMPLE VERSUS TOTAL CENSUS 7

OBJECTIVE EPI 1 9

PREVALENCE OF S. haematobium AND GMEC BY EZBA 10

AGE SEX SPECIFIC PREVALENCE AND GMEC OF S. haematobium11

Prevalence and GMEC of S. haematobium by EDUCATION13

Prevalence and GMEC of S. haematobium by OCCUPATION13

Prevalence and GMEC of S. haematobium by treatment14

Prevalence and GMEC of S. haematobium by HISTORY OF INFECTION14

Prevalence and GMEC of S. haematobium by bathing 15

Prevalence and GMEC of S. haematobium by WASHING CLOTHES 16

Prevalence and GMEC of S. haematobium by washing clothes16

Prevalence and GMEC of S. haematobium by playing in canal17

Prevalence and GMEC of S. haematobium ACCORDING TO DEGREE OF PLAYING IN CANAL 17

PREVALENCE OF S. mansoni IN STOOL AND GEOMETRIC MEAN EGG COUNT IN DIFFERENT EZBAS 18

AGE AND SEX prevalence of S. mansoni AND GEOMETRIC MEAN EGG COUNT 19

DISTRIBUTION OF AND GEOMETRIC MEAN EGG COUNT ACCORDING TO LEVEL OF EDUCATION 20

OBJECTIVE EPI 2 21

ENVIRONMENTAL CHARACTERISTICS OF DWELLING UNITS ( HOUSES) AND ITS RELATIONSHIP TO SCHISTOSOMIASIS INFECTION INSIDE THE HOUSE 22

RESULTS OF MULTIPLE REGRESSION ANALYSIS USING STEPWISE METHOD FOR ENVIRONMENTAL CHARACTERISTICS OF HOUSES AND ITS RELATION TO INFECTION INSIDE THE HOUSE 25

OBJECTIVE EPI 3 26

DISTRIBUTION OF LIVER FIBROSIS IN THE DIFFERENT VILLAGES 27

AGE AND SEX DISTRIBUTION OF LIVER FIBROSIS 28

DISTRIBUTION OF LIVER FIBROSIS ACCORDING TO HISTORY OF PREVIOUS BILHARZIAL INFECTION 29

DISTRIBUTION OF LIVER FIBROSIS ACCORDING TO HISTORY OF PREVIOUS TREATMENT 29

ANALYSIS REPORT FOR EPI 123

ASSIUT GOVERNORATE

INTRODUCTION:

The present document reports on the findings in the data collected for the epidemiological study EPI 123. The present document reports on the findings in the data collected for the epidemiological study EPI 123 for the governorate Assiut. The data were collected by the following field team under the direction of Dr. Hammam M. Hammam.

Principle Investigator

Dr. Hammam M. Hammam

Chairman

Department of Community Medicine

Tropical Medicine and Parasitology

Faculty of Medicine

Assiut University

Assiut, Egypt

Field Team and Laboratory Members

FAM Allam

FM Moftah

MA Abdel-Aty

AH Hany

KF Abd-El-Motagaly

MA Nafeh

R Khalifa

Nabiel N.H. Mikhail

The report starts by a brief description of the analysis with limitations found in the data collected. Finally; the document includes the findings tabulated and organized according to the objectives.

SAMPLE DESIGN AND SAMPLE SELECTION:

In brief, the sample selection; designed to achieve the above stated objectives, was a multi-stage probability sample selection. Within each governorate, villages were selected by systematic random sampling technique. Ezbas (satellites) were selected within each village by a stratified random selection process. Stratification of ezbas within villages was based on the number of houses in each ezba. Houses were selected within each ezba by a systematic random sampling techniques. Finally; all individuals living in the selected houses were recruited in the sample. Individuals living in only 20% of the selected houses were identified for ultrasound and clinical examination.

DATA COLLECTION AND DATA RECORDING

Data were collected on specially developed data forms. The forms included:

. Roster :Considered as a complete list of all individuals selected in the sample.

. House :Included environmental data about houses (and dwelling units) selected in the sample.

. Person :Included personal demographic data, history of previous infection, previous treatment and water contact behavior.

. Stool :There were three stool forms that included data about stool characteristics, schistosomiasis ova count as well as other parasitic infection.

. Urine :There were two urine forms for the collection of urine data that included the schistosomiasis ova count and dip stick findings in the urine.

. Ultrasound:Included data about ultrasound measurements for the liver, spleen and urinary system.

. Clinical :Included some clinical findings.

Special computer screen data forms were developed in Arabic and English languages to enter data on computers. These forms were complied in a specially developed program. Data entry used the software called EPI INFO 5.

DATA ANALYSIS

The software called Survey Data Analysis (SUDAAN) was used in the final analysis. This software has the advantage of including the probability of selection and thereby can provide estimate that are representative to the population from which the sample was drawn. It also has the advantage of adjusting for non response. The use of this software was essential because of the complexity of the sample design.

Table 1 shows the identified sample distributed by district, village and ezba. The table shows the number of households identified through the sample design in each ezba.

TABLE 1:SAMPLE SELECTED

DISTRICT / VILLAGE / EZBA / NUMBER OF SAMPLED HOUSES
ASSIUT / Shatb / Shatb / 126
El-Sekka El-Hadid / 93
El-Arab / 54
ABUB / Bein Ibrahim / Beni Ibrahim / 90
Nag'a Kom Bessau / 57
Abdel Khalek / 18
ASSIUT / El-Maasara / El-Maasara / 116
El-Masri / 52
El-Awaisa / 23
Nazlet El-Maasra / 25
MANFALOT / Beni-Shaaran / Beni-Shaaran / 97
Nag'a Ali Mansour / 64
Arab El-Amaeim / 67
AL-KOUSSEIA / Al-Temsaheia / Al-Temsaheia / 97
Al Manheia Al Soghra / 88
El-Sheikha Naffisa / 24
SAHEL SELIM / Alshameia / Alshameia / 111
El-Sheikh Shahata / 104
Nazlet Rayan / 70
Rashed / 65
El-Khola / 40
EL-GHANAEIM / El-Meshay'a / El-Meshay'a / 116
El-Gheit / 55
El-Gabal / 71
EL-BADARA / Nugu'e El-Meadi / Shanshan / 91
Souour / 114
El-Marakbia / 91
EL-BADARA / El-Bayadeya / El-Bayadeua / 69
El-Heisha / 71
Sanous / 18
EL-KOUSIA / Bouk / Bouk / 120
TOTAL SAMPLED HOUSEHOLDS / 2797

DROP OUT (NON-RESPONSE) RATES

The sample design lead to the identification of 2797 households to be recruited. The number of households actually recruited in the sample was 2286 households. Only 398 households were either found empty or refused co-operation and these represented 14.2% household drop out. The number of individuals living in the households actually recruited were 14,204 individuals. Individuals that did not respond to person interview were 6226 individuals representing 43.8% person non-response. Of the 14,204 individuals, 4936 individuals did not provide a stool representing 34.4% stool drop out and 4649 individuals did not have urine results representing 32.7% urine drop out. The number of individuals who underwent ultrasonographic examination were 1787 individuals, which represented 12.6% of the sampled individuals. The sample design was to target 20% of the sampled individuals for ultrasound examination and this shows approximately around 37% drop-out rate for ultrasound examination.

Table 2 summarizes the drop out rate for different parameters.

TABLE 2:DROP OUT RATES

ITEM / REFERENCE FOR DROP OUT CALCULATION / % DROP OUT
HOUSE / SAMPLE OF HOUSEHOLDS / 14.2%
PERSON / INDIVIDUALS IDENTIFIED TO BE LIVING THE RECRUITED HOUSEHOLDS / 43.8%
STOOL / INDIVIDUALS IDENTIFIED TO BE LIVING THE RECRUITED HOUSEHOLDS / 34.7%
URINE / INDIVIDUALS IDENTIFIED TO BE LIVING THE RECRUITED HOUSEHOLDS / 32.7%
ULTRASOUND / INDIVIDUALS SAMPLED FOR ULTRASOUND / 37.0%

COMMENTS

☞High drop-out rates were observed in urine , stool and ultrasonographic examination results, but especially high drop-out was seen in personal data collection.

☞Repeated identification codes were observed in the data, which required many corrections. In spite of all corrections done, difficulty in merging of data files was experienced.

RESULTS

TESTING SAMPLE VERSUS TOTAL CENSUS

The actual sample of individuals were examined for the age and sex distribution. Age groups of five years were used. The age and sex distribution of the whole rural population was obtained from the 1986 census of the Central Agency for Population Mobilization and Statistics (CAPMAS). Both distributions were compared for marked deviations. This was used as an indication for how the sample drawn represented the population from which it was drawn.

Figure 1 shows the age and sex distribution of the actually sampled individuals versus the total census. The figure gives a clear idea for how far the actual sample was representative for the total rural population for the Assiut governorate.

Analysis Report Assiut Gov 1

OBJECTIVE EPI 1

Objective EPI 1 was achieved as a description of the prevalence and intensity of infection for both S. mansoni and S. haematobium according to different parameters. First, the pattern of distribution of the type of infection and its intensity over the governorate will be presented in different ezbas of the governorate.

The burden of infection will be described in different age groups, sex, occupation, level of education and according to some water contact behaviors (e.g. bathing in canals, washing clothes in canal and playing in canals).

TABLE 3: PREVALENCE OF S. haematobium AND GEOMETRIC MEAN EGG COUNT IN DIFFERENT EZBAS IN ASSIUT GOVERNORATE

VILLAGE OR
SATELLITE / Nº EXAMINED / PREV.± S.E.
% / GMEC ± S.E.
10ml URINE
SHOTB / 571 / 5.53 ± 0.26 / 9.80 ± 0.523
EL-SEKKA EL-HADID / 441 / 3.46 ± 0.21 / 7.02 ± 0.605
EZBET EL-ARAB / 273 / 20.92 ± 0.46 / 7.35 ± 0.259
BENI IBRAHIM / 340 / 7.21 ± 0.44 / 3.85 ± 0.183
NAG'A KOM BESSAU / 256 / 5.26 ± 0.40 / 10.79 ± 0.535
EZBET ABDEL KHALEK / 127 / 4.34 ± 0.19 / 3.81 ± 0.159
EL-MAASARA / 389 / 3.25 ± 0.28 / 7.23 ± 0.732
EZBET EL-MASRI / 220 / 10.02 ± 0.44 / 5.00 ± 0.269
EZBET EL-AWAISA / 81 / 17.33 ± 0.48 / 2.00 ± 0.048
NAZLET EL-MAASARA / 117 / 20.69 ± 0.39 / 5.95 ± 0.184
BENI-SHAARAN / 525 / 4.42 ± 0.23 / 5.46 ± 0.378
NAG'A ALI MANSOUR / 396 / 4.74 ± 0.22 / 8.07 ± 0.710
ARAB EL-AMAEIM / 242 / 2.80 ± 0.30 / 3.34 ± 0.222
AL-TEMSAHEIA / 449 / 6.18 ± 0.41 / 6.42 ± 0.421
ALMANSHEIA ALSOGHRA / 314 / 8.69 ± 0.41 / 8.80 ± 0.834
EZBET EL-SHEIKHA NAFFISA / 104 / 6.54 ± 0.34 / 4.47 ± 0.252
ALSHAMEIA / 400 / 5.69 ± 0.40 / 6.09 ± 0.503
EZBET EL-SHEIKH SHAHATA / 308 / 2.38 ± 0.21 / 10.49 ± 1.015
NAZLET RAYAN / 218 / 6.01 ± 0.34 / 4.12 ± 0.231
EZBET RASHAD / 233 / 9.38 ± 0.34 / 4.37 ± 0.190
EZBET EL-KHOLA / 135 / 6.40 ± 0.42 / 7.52 ± 0.328
EL-MESHAYA'A / 464 / 2.70 ± 0.20 / 7.75 ± 0.687
EZBET EL-GHEIT / 305 / 1.45 ± 0.16 / 3.79 ± 0.646
EZBET EL-GABAL / 322 / 3.12 ± 0.15 / 5.47 ± 0.261
EZBET SHANSHAN / 301 / 7.04 ± 0.21 / 6.19 ± 0.176
EZBET SOROUR / 387 / 5.95 ± 0.26 / 8 .92 ± 0.537
EZBET EL-MARAKBIA / 379 / 6.76 ± 0.21 / 4.43 ± 0.120
EL-BAYADEYA / 304 / 4.10 ± 0.21 / 9.02 ± 0.496
EZBET EL HEISHA / 391 / 13.46 ± 0.24 / 4.29 ± 0.087
EZBET SANOUS / 102 / 4.50 ± 0.24 / 3.44 ± 0.091
BOUK / 461 / 3.64 ± 0.27 / 6.84 ± 0.740
TOTAL / 9555 / 5.21 ± 0.45 / 6.63 ± 0.476

TABLE 4: Age and sex Prevalence and GMEC of S. haematobium

AGE / SEX / Nº EXAMINED / PREV.% ± S.E. / GMEC ± S.E.
10ml URINE
0-4TOTAL
MALE
FEMALE / 1195
637
558 / 1.17 ± 0.40
0.74 ± 0.36
1.62 ± 0.60 / 3.01 ± 0.643
2.55 ± 1.434
3.26 ± 1.023
5-9TOTAL
MALE
FEMALE / 1603
829
774 / 4.78 ± 1.07
4.98 ± 1.22
4.56 ± 1.14 / 5.87 ± 1.274
5.89 ± 1.009
5.85 ± 2.891
10-14 TOTAL
MALE
FEMALE / 1447
737
710 / 10.20 ± 0.67
13.69 ± 1.09
6.55 ± 1.44 / 9.06 ± 1.009
9.98 ± 0.750
7.29 ± 1.981
15-19 TOTAL
MALE
FEMALE / 1048
496
552 / 10.60 ± 1.50
14.02 ± 2.51
6.85 ± 1.71 / 7.99 ± 1.513
9.75 ± 2.016
5.12 ± 0.876
20-24 TOTAL
MALE
FEMALE / 571
220
351 / 6.61 ± 1.76
9.83 ± 2.89
2.99 ± 1.19 / 9.34 ± 4.701
10.08 ± 5.162
7.07 ± 4.840
25-29 TOTAL
MALE
FEMALE / 619
239
380 / 4.15 ± 0.94
4.24 ± 1.74
4.04 ± 1.52 / 5.81 ± 1.831
7.93 ± 2.756
4.03 ± 2.011
30-34 TOTAL
MALE
FEMALE / 490
191
299 / 4.42 ± 1.10
8.52 ± 2.09
0.33 ± 0.23 / 2.53 ± 0.925
2.43 ± 0.904
7.37 ± 7.241
35-39 TOTAL
MALE
FEMALE / 549
233
316 / 3.05 ± 0.66
4.85 ± 1.23
1.24 ± 0.62 / 3.96 ± 1.877
4.79 ± 2.412
1.85 ± 0.929
40-44 TOTAL
MALE
FEMALE / 408
171
237 / 2.02 ± 0.72
2.94 ± 1.38
1.05 ± 0.89 / 3.48 ± 0.703
3.36 ± 0.867
3.86 ± 0.182
45-49 TOTAL
MALE
FEMALE / 388
177
211 / 3.40 ± 1.28
5.13 ± 2.35
1.74 ± 1.01 / 5.48 ± 1.066
6.31 ± 1.272
3.68 ± 2.151
50-54 TOTAL
MALE
FEMALE / 334
122
212 / 5.25 ± 1.78
9.34 ± 3.54
1.53 ± 1.15 / 4.92 ± 3.244
6.55 ± 4.351
1.00 ± 0
55-59 TOTAL
MALE
FEMALE / 222
104
118 / 1.07 ± 0.59
1.55 ± 1.06
0.59 ± 0.60 / 6.92 ± 2.366
6.92 ± 2.366
.
60 + TOTAL
MALE
FEMALE / 681
363
318 / 3.00 ± 0.49
5.11 ± 0.98
0.82 ± 0.63 / 3.78 ± 1.212
3.11 ± 0.663
13.35 ± 5.409
TOTAL
MALE
FEMALE / 9555
4519
5036 / 5.21 ± 0.45
7.00 ± 0.51
3.34 ± 0.54 / 6.63 ± 0.476
7.31 ± 0.453
5.35 ± 0.660

TABLE 5: Prevalence and GMEC of S. haematobium according to level of education

LEVEL OF EDUCATION / Nº EXAMINED / PREV.± S.E.
% / GMEC ± S.E. 10ml URINE
PRIMARY / 1903 / 6.10 ± 1.07 / 7.45 ± 0.87
PREPARATORY
& SECONDARY / 1335 / 8.34 ± 0.68 / 8.92 ± 1.77
UNIVERSITY / 102 / 6.68 ± 3.35 / 8 ± 7.86
BELOW AGE / 623 / 1.07 ± 0.43 / 2.8 ± 0.96
DIDN'T VISIT SCHOOL / 4015 / 4.72 ± 0.55 / 5.2 ± 0.49
TOTAL / 7978 / 5.18 ± 0.43 / 6.64 ± 0.57

TABLE 6: Prevalence and GMEC of S. haematobium according to occupation

OCCUPATION / Nº EXAMINED / PREV.% ± S.E. / GMEC ± S.E.
10ml URINE
FARMER (OWNER) / 1007 / 8.89 ± 1.12 / 5.4 ± 0.62
FARMING LABORER / 178 / 9.65 ± 3.21 / 7.2 ± 5.6
SKILLED LABORER / 31 / 4.98 ± 4.29 / 9.5 ± 6.6
HOUSEWIFE / 2934 / 3.29 ± 0.60 / 5.2 ± 0.8
PROFESSIONAL / 52 / 4.87 ± 3.59 / 1.8 ± 1.1
CLERK / 88 / 1.71 ± 1.57 / 3.6 ± 0.47
STUDENT / 2001 / 7.63 ± 0.89 / 9.5 ± 0.55
LABORER / 89 / 6.21 ± 3.08 / 5.2 ± 3.58
ORZOKI / 75 / 3.12 ± 2.55 / 79.7 ± 26.1
MERCHANT / 33 / 1.20 ± 1.24 / 7 ± 0
MEKAWEL / 0 / . / .
FISHERMEN / 7 / 0 ± 0 / .
OTHER JOB / 583 / 4.24 ± 0.54 / 8.6 ± 3.14
DON'T WORK / 142 / 9.85 ± 2.14 / 2.9 ± 1.39
NOT APPLIED / 758 / 1.70 ± 0.56 / 3.4 ± 0.79
TOTAL / 7978 / 5.18 ± 0.43 / 6.6 ± 0.57

TABLE 7: Prevalence and GMEC of S. haematobium according to history of previous treatment for schistosomiasis

HAVE YOU BEEN TREATED FOR SCHISTOSOMIASIS BEFORE? / Nº EXAMINED / PREV.± S.E.
% / GMEC ± S.E. 10ml URINE
YES / 1565 / 1.51 ± 1.45 / 7.90 ± 0.71
NO / 6065 / 3.56 ± 0.42 / 5.79 ± 0.58
DON'T KNOW / 330 / 3.97 ± 1.20 / 8.21 ± 2.24
TOTAL / 7960 / 5.16 ± 0.43 / 6.73 ± 0.56

TABLE 8: Prevalence and GMEC of S. haematobium according to history of previous infection

DID YOU GET SCHISTOSOMIASIS BEFORE? / Nº EXAMINED / PREV.± S.E.
% / GMEC ± S.E. 10ml URINE
YES / 1602 / 11.90 ± 1.49 / 7.99 ± 0.67
NO / 5774 / 3.36 ± 0.38 / 5.60 ± 0.61
DON'T KNOW / 593 / 4.32 ± 0.86 / 7.38 ± 1.22
TOTAL / 7969 / 5.16 ± 0.43 / 6.73 ± 0.56

TABLE 9: Prevalence and GMEC of S. haematobium according to bathing in canal water

WHEN WAS THE LAST TIME YOU BATHED IN CANAL? / Nº EXAMINED / PREV. ± S.E.
% / GMEC ± S.E.
10ml URINE
NEVER DID / 6374 / 3.87 ± 0.47 / 6.12 ± 0.60
LESS THAN ONE WEEK / 432 / 11.96 ± 2.11 / 5.86 ± 1.93
1-4 WEEKS / 151 / 10.35 ± 2.32 / 7.11 ± 0.91
1-12 MONTHS / 176 / 19.87 ± 4.23 / 9.77 ± 4.05
MORE THAN ONE YEAR / 773 / 8.79 ± 1.92 / 8.55 ± 1.86
DON'T REMEMBER / 7 / 0 ± 0 / ...
OTHER / 50 / 4.71 ± 2.90 / 4.97 ± 4.17
NOT APPLIED / 3 / 0 ± 0 / ...
TOTAL / 7966 / 5.12 ± 0.43 / 6.70 ± 0.54

Analysis Report Assiut Gov 1

TABLE 10: Prevalence and GMEC of S. haematobium according to washing clothes in canal water

WHEN WAS THE LAST TIME YOU WASHED CLOTHES IN CANAL? / Nº EXAMINED / PREV. ± S.E.
% / GMEC ± S.E.
10ml URINE
NEVER DID / 7218 / 4.81 ± 0.38 / 6.82 ± 0.66
LESS THEN ONE WEEK / 479 / 8.02 ± 1.83 / 6.47 ± 1.88
1-4 WEEKS / 99 / 15.81 ± 3.37 / 6.34 ± 1.02
1-12 MONTHS / 19 / 6.53 ± 2.78 / 31.85 ± 9.29
1 YEAR AND MORE / 124 / 0.45 ± 0.33 / 2.79 ± 2.06
DON'T REMEMBER / 0 / ... / ...
OTHER / 7 / 3.97 ± 4.83 / 2.92 ± 1.41
NOT APPLIED / 3 / 0 ± 0 / ...
TOTAL / 7949 / 5.05 ± 0.44 / 6.76 ± 0.60

TABLE 11: Prevalence and GMEC of S. haematobium according to degree of using canal in washing clothes

DO YOU ALWAYS USE CANAL IN WASHING CLOTHES? / Nº EXAMINED / PREV. ± S.E.
% / GMEC ± S.E.
10ml URINE
ALWAYS / 391 / 7.99 ± 1.98 / 4.82 ± 0.91
SOMETIMES / 152 / 10.99 ± 3.68 / 3.99 ± 2.19
RARELY / 69 / 9.26 ± 3.44 / 107.50 ± 6.03
NEVER / 1 / 0 ± 0 / ...
TOTAL / 613 / 8.82 ± 1.46 / 6.58 ± 1.35

TABLE 12: Prevalence and GMEC of S. haematobium according to playing in canal

WHEN WAS THE LAST TIME YOU PLAYED IN CANAL? / Nº
EXAMINED / PREV. ± S.E.% / GMEC ± S.E.
10ml URINE
NEVER DID / 6606 / 6.81 ± 0.71 / 59.78 ± 3.40
LESS THAN ONE WEEK / 507 / 6.39 ± 1.20 / 63.44 ± 7.73
1-4 WEEKS / 146 / 7.04 ± 3.07 / 53.66 ± 5.28
1-12 MONTHS / 114 / 8.94 ± 5.89 / 58.30 ± 8.92
1 YEAR AND MORE / 524 / 7.09 ± 1.56 / 74.25 ± 6.08
DON'T REMEMBER / 5 / ... / 85.82 ± 36.76
OTHER / 57 / 14.93 ± 22.98 / 84 ± 0
NOT APPLIED / 1 / ... / ...
TOTAL / 7960 / 6.89 ± 0.71 / 62.62 ± 3

TABLE 13: Prevalence and GMEC of S. haematobium according to degree of playing in canal

DO YOU ALWAYS PLAY IN CANAL ? / Nº
EXAMINED / PREV. ± S.E. % / GMEC ± S.E.
10ml URINE
ALWAYS / 469 / 15.10 ± 3.14 / 6.24 ± 1.25
SOMETIMES / 313 / 10.06 ± 2.31 / 3.93 ± 1.25
RARELY / 137 / 8.48 ± 1.91 / 22.62 ± 7.63
NEVER / 1 / 0 ± 0 / ...
TOTAL / 920 / 12.15 ± 1.76 / 6.46 ± 0.50

TABLE 14: Prevalence of S. mansoni in stool and geometric mean egg count in different ezbas

VILLAGE / SATELLITE / Nº EXAMINED / PREV.± S.E. / GMEC ± S.E.
/gm STOOL
EZBET EL-ARAB / 283 / 0.39 ± 0.05 / 72 ± 0
EL-MAASARA / 394 / 1.37 ± 0.17 / 43.04 ± 10.68
EZBET EL-MASRI / 236 / 1.17 ± 0.14 / 84.03 ± 9.96
EZBET EL-AWAISA / 90 / 1.01 ± 0.14 / 1440 ± 0
NAZLET EL-MAASARA / 120 / 1.48 ± 0.11 / 23.50 ± 1.28
ALSHAMEIA / 394 / 0.72 ± 0.10 / 90.99 ± 23.06
EZBET EL-SHEIKH SHAHATA / 293 / 2.18 ± 0.30 / 19.75 ± 0.82
EZBET EL-KHOLA / 139 / 1.57 ± 0.23 / 29.33 ± 0.51
EL-MESHAYA'A / 462 / 0.63 ± 0.11 / 31.06 ± 1.78
EZBET EL-GABAL / 354 / 1.32 ± 0.09 / 108.59 ± 6.44
EZBET EL-MARAKBIA / 367 / 0.38 ± 0.05 / 12 ± 0
EZBET SANOUS / 100 / 0.87 ± 0.10 / 132 ± 0
BOUK / 426 / 0.46 ± 0.08 / 151.79 ± 12.26
TOTAL / 9268 / 0.42 ± 0.17 / 48.94 ± 7.5

TABLE 15: Age and sex distribution of S. mansoni and geometric mean egg count

AGE / SEX / Nº EXAMINED / PREV.± S.E.
% / GMEC ± S.E.
/gm STOOL
0-4Total
Male
Female / 1389
720
669 / 0.08 ± 0.08
0 ± 0
0.16 ± 0.16 / 12 ± 0
.
12 ± 0
5-9Total
Male
Female / 2099
1109
990 / 0.95 ± 0.61
1.08 ± 0.70
0.79 ± 0.55 / 37.04 ± 11.89
37.08 ± 16.36
36.95 ± 9.36
10-14 Total
Male
Female / 1623
865
758 / 1.42 ± 1.06
1.95 ± 1.39
0.79 ± 0.69 / 89.74 ± 18.98
110.82 ± 38.69
47.08 ± 6.89
15-19 Total
Male
Female / 1094
609
485 / 1.77 ± 1.32
2.00 ± 1.50
1.43 ± 1.09 / 111.77 ± 25.90
161.38 ± 26.92
46.98 ± 8.30
20-24 Total
Male
Female / 737
320
417 / 1.87 ± 1.74
3.36 ± 3.29
0.29 ± 0.27 / 122.59 ± 17.38
113.12 ± 10.01
300.37 ± 160.52
25-29 Total
Male
Female / 755
290
465 / 0.85 ± 0.54
1.49 ± 1.15
0.32 ± 0.32 / 121.28 ± 52.68
118 ± 67
132 ± 0
30-34 Total
Male
Female / 653
283
370 / 0.32 ± 0.32
0.35 ± 0.36
0.28 ± 0.29 / 165.92 ± 35.93
432 ± 0
48 ± 0
35-39 Total
Male
Female / 719
307
412 / 1.35 ± 0.72
1.60 ± 0.78
1.10 ± 0.87 / 39.74 ± 13.84
62.09 ± 46.72
16.97 ± 1.18
40-44 Total
Male
Female / 520
237
283 / 0.84 ± 0.47
1.75 ± 0.98
0 ± 0 / 84.74 ± 48.18
84.74 ± 48.18
.
45-49 Total
Male
Female / 498
232
266 / 1.63 ± 1.18
3.37 ± 2.39
0 ± 0 / 30.60 ± 6.42
30.60 ± 6.42
.
50-54 Total
Male
Female / 458
196
262 / 1.33 ± 0.72
2.45 ± 1.25
0.39 ± 0.39 / 50.78 ± 15.84
48.89 ± 17.38
60 ± 0
55-59 Total
Male
Female / 269
110
159 / 2.13 ± 2.03
4.50 ± 4.26
0 ± 0 / 49.09 ± 10.10
49.09 ± 10.10
.
60-64 Total
Male
Female / 419
196
223 / 0.85 ± 0.60
1.32 ± 0.93
0.45 ± 0.45 / 57.32 ± 6.11
52.59 ± 4
72 ± 0
65 + Total
Male
Female / 433
242
191 / 0.48 ± 0.49
0.43 ± 0.44
0.55 ± 0.58 / 225.72 ± 28.38
120 ± 0
420 ± 0
TOTAL TOTAL
MALE
FEMALE / 11666
5716
5950 / 1.04 ± 0.73
1.51 ± 1.04
0.53 ± 0.39 / 73.90 ± 10.40
83.39 ± 20.16
49.58 ± 8.37

Analysis Report Assiut Gov 1

TABLE 16: Distribution of S. mansoni and geometric mean egg count according to level of education

Level of Education / Nº EXAMINED / S. MANSONI INFECTION
PREV.% ± S.E. / GMEC ± S.E.
/gm STOOL
Primary / 1855 / 0.51 ± 0.30 / 13.49 ± 0.36
Preparatory & Secondary / 1288 / 1.33 ± 0.72 / 74.15 ± 23.84
University / 96 / 0 ± 0 / ...
Below age / 614 / 0 ± 0 / ...
Didn't visit school / 3802 / 0.23 ± 0.09 / 127.45 ±112.86
TOTAL / 7655 / 0.50 ± 0.23 / 53.76 ± 9.0

TABLE 17: distribution of S. mansoni and geometric mean egg count according to occupation

OCCUPATION / Nº EXAMINED / S. MANSONI INFECTION
PREV.± S.E. % / GMEC ± S.E.
/gm STOOL
FARMER (OWNER) / 958 / 0.01 ± 0.01 / 84.00 ± 0
FARMING LABORER / 167 / 0.94 ± 0.88 / 48.00 ± 0
SKILLED LABORER / 30 / 0 ± 0 / .
HOUSE WIFE / 2761 / 0.28 ± 0.16 / 317.63 ± 180.49
PROFESSIONAL / 48 / 0 ± 0 / .
CLERK ! / 79 / 4.60 ± 2.93 / 23.46 ± 13.62
STUDENT / 1968 / 0.74 ± 0.45 / 74.71 ± 57.99
LABORER / 81 / 1.75 ± 1.64 / 12.70 ± 0.21
ORZOKI / 76 / 0 ± 0 / ...
MERCHANT / 32 / 5.14 ± 4.58 / 24 ± 0
MEKAWEL / 1 / 0 ± 0 / ...
FISHERMEN / 8 / 15.02 ± 2.54 / 12.00 ± 0
OTHER JOB / 552 / 0.39 ± 0.36 / 13.53 ± 2.23
NOT WORKING / 133 / 0.36 ± 0.34 / 36 ± 0
NOT APPLIED / 761 / 0 ± 0 / ...
TOTAL / 7655 / 0.50 ± 0.23 / 53.76 ± 9.0

OBJECTIVE EPI 2

Objective EPI 2 was achieved through describing the environmental characteristics of households within each ezba and relating these characteristics to the number of infected houses within ezbas in a fashion similar to ecological analysis. The correlation coefficient (r) and its level of significance (p value) are presented in the table.

Step wise multiple regression analysis was performed to identify the variables among villages. These variables are listed below the provided table.

Analysis Report Assiut Gov 1

TABLE 18: Environmental characteristics of dwelling units ( houses) and its relationship to schistosomiasis infection inside the house in the Assiut governorate

VILLAGE / SATELLITE / Nº OF HOUSES / TAP IN / WASH CANAL / MUD BRICK / ZERIBA / ELECTRIC / WASHER / RADIO / TV / LATRINE / INFECTION
SHOTB / 87 / 82.76 / 0 / 7.06 / 66.28 / 89.53 / 70.93 / 73.26 / 75.58 / 90.70 / 8.05
EL-SEKKA EL-HADID / 72 / 58.33 / 0 / 6.06 / 60 / 84.51 / 64.79 / 65.71 / 66.20 / 87.32 / 2.78
EZBET EL-ARAB / 43 / 0 / 2.33 / 7.14 / 74.42 / 69.77 / 58.14 / 67.44 / 65.12 / 79.07 / 41.86
BENI IBRAHIM / 58 / 79.31 / 0 / 6.90 / 84.48 / 91.38 / 68.42 / 78.57 / 72.41 / 73.68 / 10.34
NAG'A KOM BESSAU / 44 / 63.64 / 0 / 0 / 74.42 / 90.70 / 60.47 / 81.40 / 83.72 / 67.44 / 4.55
EZBET ABDEL KHALEK / 17 / 5.88 / 0 / 0 / 100 / 82.35 / 70.59 / 70.59 / 76.47 / 82.35 / 11.76
EL-MAASARA / 66 / 39.39 / 0 / 22.22 / 50 / 73.02 / 50 / 69.23 / 64.62 / 77.78 / 3.03
EZBET EL-MASRI / 38 / 0 / 26.32 / 32.43 / 48.65 / 42.11 / 23.68 / 52.63 / 42.11 / 74.29 / 18.42
EZBET EL-AWAISA / 17 / 0 / 58.82 / 41.18 / 52.94 / 35.29 / 29.41 / 58.82 / 41.18 / 64.71 / 17.65
NAZLET EL-MAASARA / 20 / 0 / 80 / 33.33 / 89.47 / 35 / 0 / 65 / 30 / 30 / 35
BENI-SHAARAN / 79 / 29.11 / 1.27 / 23.08 / 51.28 / 84.81 / 46.15 / 62.34 / 64.56 / 74.68 / 6.33
NAG'A ALI MANSOUR / 54 / 22.22 / 0 / 50.94 / 83.33 / 96.30 / 45.28 / 87.04 / 88.68 / 65.38 / 5.56
ARAB EL-AMAEIM / 43 / 55.81 / 0 / 59.52 / 54.76 / 90.70 / 56.10 / 80.95 / 73.81 / 90.24 / 2.33
AL-TEMSAHEIA / 70 / 51.43 / 52.86 / 8.70 / 59.42 / 88.57 / 44.29 / 80 / 71.01 / 95.59 / 5.71
ALMANSHEIA ALSOGHRA / 61 / 32.79 / 32.79 / 20 / 50 / 78.69 / 40.98 / 63.93 / 62.30 / 73.77 / 11.48
EZBET EL-SHEIKHA NAFFISA / 19 / 5.26 / 47.37 / 15.79 / 89.47 / 0 / 0 / 57.89 / 26.32 / 52.63 / 5.26
ALSHAMEIA / 83 / 78.31 / 27.71 / 20 / 58.23 / 86.25 / 58.75 / 63.29 / 53.25 / 89.47 / 6.02
EZBET EL-SHEIKH SHAHATA / 60 / 50 / 33.33 / 16.95 / 56.90 / 85 / 38.33 / 61.02 / 53.33 / 86.21 / 1.67
NAZLET RAYAN / 45 / 0 / 71.11 / 42.22 / 66.67 / 55.56 / 15.56 / 33.33 / 24.44 / 51.11 / 4.44
EZBET RASHAD / 44 / 0 / 88.64 / 39.53 / 77.27 / 77.27 / 27.27 / 43.18 / 43.18 / 36.36 / 11.36
EZBET EL-KHOLA / 30 / 6.67 / 80 / 6.67 / 41.38 / 86.67 / 41.38 / 48.28 / 56.67 / 53.33 / 6.67
EL-MESHAYA'A / 87 / 45.98 / 0 / 37.35 / 52.33 / 68.97 / 29.07 / 54.02 / 52.87 / 70.59 / 1.15
EZBET EL-GHEIT / 50 / 2 / 16 / 34.04 / 64 / 6 / 8 / 34 / 10 / 64 / 0
EZBET EL-GABAL / 58 / 3.45 / 8.62 / 33.33 / 68.97 / 1.72 / 1.72 / 41.38 / 1.75 / 41.38 / 1.72
EZBET SHANSHAN / 67 / 31.34 / 11.94 / 17.19 / 61.19 / 67.16 / 9.09 / 52.24 / 31.34 / 43.28 / 4.48
EZBET SOROUR / 80 / 17.50 / 18.75 / 11.54 / 67.50 / 68.75 / 11.25 / 50 / 32.91 / 33.75 / 3.75
EZBET EL-MARAKBIA / 69 / 37.68 / 21.74 / 5.88 / 71.01 / 82.61 / 7.25 / 68.12 / 26.47 / 63.77 / 8.70
EL-BAYADEYA / 55 / 18.18 / 9.09 / 11.11 / 57.41 / 90.91 / 43.64 / 72.73 / 54.55 / 87.04 / 3.64
EZBET EL HEISHA / 62 / 1.61 / 59.68 / 14.52 / 78.69 / 35.48 / 6.45 / 48.39 / 25.81 / 50 / 19.35
EZBET SANOUS / 16 / 0 / 87.50 / 6.25 / 75 / 75 / 31.25 / 56.25 / 43.75 / 81.25 / 6.25
BOUK / 92 / 11.96 / 59.78 / 15.91 / 56.52 / 65.22 / 10 / 40 / 32.22 / 72.53 / 3.26
r
P / -0.356
0.045 / 0.212
0.245 / -0.055
0.765 / 0.32
0.074 / -0.152
0.407 / -0.019
0.916 / 0.1
0.588 / 0.008
0.966 / -0.181
0.323
TOTAL / 1686 / 32.86 / 23.9 / 20.2 / 63.7 / 70.7 / 35.2 / 60.6 / 50.5 / 69.2 / 7.35

ALL CELL ENTRIES ARE PERCENT EXCEPT FOR No. OF HOUSE WHICH IS THE NUMBER OF HOUSES (DWELLING UNITS) SAMPLE FOR THAT EZBA OR SATELLITE AND THE r

(CORRELATION COEFFICIENT) AND p (p VALUE)

TAPIN: TAP WATER INSIDE THE HOUSE ELECTRICITY: THE HOUSE HAS ELECTRICITY

WASH CANAL: USE CANAL WATER IN WASHING WASHER: A WASHING MACHINE IS AVAILABLE INSIDE THE HOUSE

MUD BRICK: HOUSE BUILT OF MUD BRICK

ZEREBA: HOUSE HAS AN ANIMAL SHED ATTACHED TO OR PART OF IT

RADIO: A RADIO IS AVAILABLE INSIDE THE HOUSE

TV: A TV IS AVAILABLE INSIDE THE HOUSE

INFECTION: THE PERCENT OF HOUSES WITH AT LEAST ONE HOUSE MEMBER INFECTED WITH SCHISTOSOMIASIS

r: CORRELATION COEFFICIENT

p: p VALUE FOR THE r

Analysis Report Assiut Gov 1

TABLE 19:Results of multiple regression analysis using stepwise method for environmental characteristics of houses and its relation to infection inside the house

Multiple R / .52229
R Square / .27279
Adjusted R Square / .22264
Standard Error / 8.12655
Analysis of Variance
DF / Sum of squares / Mean squares
Regression / 2 / 718.41275 / 359.20637
Residual / 29 / 1915.18330 / 66.04080
F = 5.43916Signif F = .0099
Variable / B / SE B / Beta / T / Sig T
TAPIN / -.218500 / .067484 / -.633722 / -3.238 / .0030
RADIO / .311023 / .128983 / .471962 / 2.411 / .0225
( Constant ) / -4.228281 / 7.062380 / -.599 / .5540

OBJECTIVE EPI 3

Objective EPI 3 was to estimate the public health impact of morbidity due to schistosomiasis. The distribution of liver fibrosis and its staging is presented in different ezbas and by age and sex distribution. The relationships of liver fibrosis to history of previous infection and treatment are presented.

Liver morbidity describing liver fibrosis, cirrhosis and mixed affection are presented by age and sex distribution.

TABLE 20: Distribution of liver fibrosis in the different villages

VILLAGE / SATELLITE / Nº EXAMINED / NO FIBROSIS / STAGE 1 / STAGE 2
SHOTB / 98 / 76.5 / 22.4 / 1
EL-SEKKA EL-HADID / 61 / 88.5 / 11.5 / 0
EZBET EL-ARAB / 66 / 75.8 / 24.2 / 0
BENI IBRAHIM / 82 / 82.9 / 17.1 / 0
NAG'A KOM BESSAU / 54 / 75.9 / 24.1 / 0
EZBET ABDEL KHALEK / 11 / 100 / 0 / 0
EL-MAASARA / 68 / 85.3 / 14.7 / 0
EZBET EL-MASRI / 31 / 96.8 / 3.2 / 0
EZBET EL-AWAISA / 10 / 70 / 30 / 0
NAZLET EL-MAASARA / 5 / 100 / 0 / 0
BENI-SHAARAN / 120 / 94.2 / 5.8 / 0
NAG'A ALI MANSOUR / 84 / 92.9 / 7.1 / 0
ARAB EL-AMAEIM / 39 / 89.7 / 10.3 / 0
AL-TEMSAHEIA / 61 / 82 / 18 / 0
ALMANSHEIA ALSOGHRA / 33 / 97 / 3 / 0
EZBET EL-SHEIKHA NAFFISA / 8 / 100 / 0 / 0
ALSHAMEIA / 78 / 87.2 / 12.8 / 0
EZBET EL-SHEIKH SHAHATA / 57 / 78.9 / 21.1 / 0
NAZLET RAYAN / 27 / 96.3 / 3.7 / 0
EZBET RASHAD / 44 / 86.4 / 13.6 / 0
EZBET EL-KHOLA / 24 / 100 / 0 / 0
EL-MESHAYA'A / 86 / 95.3 / 4.7 / 0
EZBET EL-GHEIT / 41 / 87.8 / 12.2 / 0
EZBET EL-GABAL / 59 / 89.8 / 10.2 / 0
EZBET SHANSHAN / 101 / 89.1 / 10.9 / 0
EZBET SOROUR / 88 / 87.5 / 11.4 / 1.1
EZBET EL-MARAKBIA / 76 / 96.1 / 3.9 / 0
EL-BAYADEYA / 59 / 93.2 / 5.1 / 1.7
EZBET EL HEISHA / 76 / 96.1 / 3.9 / 0
EZBET SANOUS / 27 / 96.3 / 3.7 / 0
BOUK / 113 / 84.1 / 15.9 / 0
TOTAL / 1787 / 88.2 / 11.6 / 0.2

TABLE 21: Age and sex distribution of liver fibrosis

AGE / SEX / Nº EXAMINED / NO LIVER FIBROSIS / STAGE 1 / STAGE 2
0-4 TOTAL
MALE
FEMALE / 246
123
123 / 97.15
96.70
97.60 / 2.85
3.30
2.40 / 0
0
0
5-9 TOTAL
MALE
FEMALE / 288
138
150 / 90.28
86.20
94.00 / 9.72
13.80
6.00 / 0
0
0
10-14 TOTAL
MALE
FEMALE / 271
143
128 / 88.93
85.30
93.00 / 11.07
14.70
7.00 / 0
0
0
15-19 TOTAL
MALE
FEMALE / 193
83
110 / 77.72
72.30
81.80 / 22.28
27.70
18.20 / 0
0
0
20-24 TOTAL
MALE
FEMALE / 86
27
59 / 82.56
74.10
86.40 / 17.44
25.90
13.60 / 0
0
0
25-29 TOTAL
MALE
FEMALE / 112
43
69 / 84.82
72.10
92.80 / 14.29
25.60
7.20 / 0.89
2.30
0
30-34 TOTAL
MALE
FEMALE / 70
27
43 / 84.29
74.10
90.70 / 14.29
22.20
9.30 / 1.43
3.70
0
35-39 TOTAL
MALE
FEMALE / 110
35
75 / 94.55
97.10
93.30 / 4.55
2.90
5.30 / 0.91
0
1.30
40-44 TOTAL
MALE
FEMALE / 86
34
52 / 87.21
88.20
86.50 / 12.79
11.80
13.50 / 0
0
0
45-49 TOTAL
MALE
FEMALE / 82
31
51 / 85.37
71.00
94.10 / 14.63
29.00
5.90 / 0
0
0
50-54 TOTAL
MALE
FEMALE / 59
28
31 / 89.83
85.70
93.50 / 10.17
14.30
6.50 / 0
0
0
55-59 TOTAL
MALE
FEMALE / 44
21
23 / 93.18
90.50
95.70 / 6.82
9.50
4.30 / 0
0
0
60+ TOTAL
MALE
FEMALE / 140
78
62 / 84.29
83.30
85.50 / 15.71
16.70
14.50 / 0
0
0
TOTALTOTAL
MALE
FEMALE / 1787
811
976 / 88.19
84.50
91.30 / 11.64
15.30
8.60 / 0.17
0.20
0.10

TABLE 22: Distribution of liver fibrosis according to history of previous bilharzial infection