PERSISTENT COLONIC SCHISTOSOMIASIS AMONG SYMPTOMATIC RURAL INHABITANTS IN THE EGYPTIAN NILE DELTA

Abstract

Background and Aims: Human schistosomiasisis one of the most important and unfortunately neglected tropical diseases. The aim of the current study was to investigate the prevalence and characterize colonic schistosomiasis, among symptomatizing rural inhabitants of the Middle Northern region of the Egyptian Nile delta. Patients and Methods:  This study recruited 193 inhabitants of the rural community in the Egyptian Nile Delta referred for colonoscopy because of variable symptoms. After giving a written informed consent, they were exposed to thorough history; clinical examination; stool analysis; abdominal ultrasonography, and pan-colonoscopy with biopsies. Results:Twenty-four cases out of the 193 patients had confirmed active schistosomiasis with prevalence rate of 12.4%.  Bleeding with stool was the predominant manifestation of active schistosomainfection among the cases either alone or in combination with abdominal pain. On clinical examination, the majority of the patients (n=17; 70.8%)did not have organomegaly and 25% of them had clinically palpable splenomegaly. As far as, 75% of them had sonographically detected hepatic peri-portal fibrosis. Also 66.6% of patients havesignificant endoscopic lesions (polyps, ulcers, mass-like lesions), and 16.6% of them had colonic affection beyond the recto-sigmoid region. Conclusion:Colonic schistosomiasis still running among symptomatizing rural inhabitants of the Egyptian Nile Delta at a rate of 12.4%. Of them66.6% had significant endoscopic colorectal lesions. This persistent transmission of schistosomiasis in the rural community of the Egyptian Nile Delta sounds the alarm for continuing governmental efforts and plans to screen the high-risk groups.