الفهرس 
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Abstract
Phlebotomine sandflies of the genus Phlebotomus transmit the protozoan parasites responsible for leishmaniasis and a number of viruses known to cause human illness.
Leishmaniasis includes two major diseases, cutaneous leishmaniasis which causes skin ulcers and visceral leishmaniasis which causes a severe systemic disease that is usually fatal without treatment. Mucocutaneous leishmaniasis is a rare but severe form affecting the nasal and oral mucosa. Both VL and CL occur in Egypt although the prevalence is relatively low, it is primarily a disease of rural populations, but in some areas urban transmission exists. VL was found near Alexandria, in El Agamy in the eighties while CL was primarily identified in northern Sinai.
Among the different sampling methods of sandflies, sticky traps were proven to be a successful method in collection. The present study, is a longitudinal entomological survey in which sticky traps were applied in four different areas representing different demographic situations in West Alexandria; Al-Agamy, Marakia, old King Mariout and Al- Hawareya.
Study setting
1- Al-Agamy: Samples were collected either from El Bitash or Abo youssef,
2- Old King Mariout: represents the area where Bedouins live in poor houses with poor hygienic measures. Most of the houses are surrounded by a yard with a sandy soil; in which they raise cattle and poultry and sometimes dogs are present.
3- Al-Hawareya: is considered an area of higher social standards than the old King Mariout, it consists of villas, some of them are inhabited all the year long, but most of the villas are inhabited a few months a year and the rest of the year it is guarded by Bedouins
4- Marakya: is a summer resort; located about 51 kilometers away from Alexandria.
5- Specimens were removed from the paper sheets by a brush soaked in ethyl alcohol,and dehydrated for 15 minutes in alcohol with the following: 70%, 85%, 95%, and absolute alcohol. They were then immersed in a clearing agent (xylol), before being mounted in Canada balsam for permanent mounting, for sex and species identification, in addition to calculation of external and internal density of sandflies, number of sandflies per square meter and number of sandflies per trap.
Predesigned questionnaire was prepared for primary health care physicians and local inhabitants of the area of study, it included information regarding; personal data, knowledge and attitude of PHC physicians in the PHC facilities of the selected areas about leishmaniasis, awareness of the public about the disease and the vector, and environmental factors (Temperature and Humidity) measured by thermohygrometer.
The results obtained are summarized as follows:
One hundred and forty three p. papatasi were collected in the four demographically different areas of the study (Al-Agamy, Al-Hawareya, old King Mariout and Marakya resort); the highest prevalence is 44.8% in Al-Hawareya, followed by 29.4% in Al Agamy then 25.8% in old King Mariout while Marakya was free of sandflies, with male to female sex ratio 1:1.6 and two peaks of abundance in both July and September.
Out of the collected sandflies, 51.7% were from interior traps while 48.3% were from exterior traps. During the study from May to November 2010, adult sandflies showed increased activity during months of high humidity and relatively high temperature; the highest number of sandfly was recorded in both July and September at a temperature of 29-30 C and RH ranging from 60% to 73%, while the lowest monthly abundance of sandfly was in November at a temperature of 23-25 C and RH ranging from 55% to 60%.
The monthly population densities of sandflies in west Alexandria were calculated; the average internal density was the highest 11% in July and the lowest was 2% in November. The average external density was the highest 9% in July and the lowest was 2% in October. The number of sandfly per trap was the highest 10 in July and the lowest was 2.75 in November and the number of sandfly per square meter was the highest 83.3 in July and the lowest was 22.9 in November.
Among the twenty PHC physicians who were interviewed in the PHC facilities of the area of the study, 55% of the physicians had satisfactory knowledge; regarding the disease there is a negative association between knowledge and the number of years the physicians had been in practice.The physicians with post-graduate studies showed more satisfactory knowledge than those with no post-graduate studies. Regression techniques identified association between physician post-graduate studies and knowledge; there is an inverse relationship between knowledge and physician age and a negative association between knowledge and years of experience. In general Eighty five percent of the PHC physicians showed good attitude about leishmaniasis, however 15% only agreed that leishmaniasis is a disease of public health problem in Egypt, 15% agreed that leishmaniasis is a notifiable disease in Egypt, 35% agreed that the public health impact of leishmaniasis has been grossly underestimated and 45% agreed that the actual number of cases of leishmaniasis is not recorded.
Among the sixty inhabitants of the four selected areas of the study were interviewed, 15 from each area, 90% had not heard about leishmaniasis. The present study recorded the poor awareness of the community about any of the activities of the malaria, filariasis and leishmaniasis unit which is under supervision of the ministry of health which are periodic painting of houses with insecticides, periodic medical examination, annual sandfly survey by using sticky traps and campaigns to educate about the disease.
By examining the inside and outside housing conditions of the four areas of the study, they were found to be a suitable microclimate for sandfly breeding, 50% of the surveyed houses have cracks in either the walls or the floors; 86.7% in Al-Agamy, 60% in old King Mariout and 53.3% in Al-Hawareya, 51.7% of the respondents have animals such as dogs, cats and cattle inside or around the house, 30% raise birds and 61.7% of the respondents said they have rodents either inside or around their houses.
Seventy three percent (73.3%) of the surveyed houses have gardens; 53.3% in Al-Agamy, 40% in old King Mariout, 100% in Al-Hawareya and 100% in Marakya, of which 90.9% grew plants and trees and 66.7% of the surveyed houses had a dump place or wastes around the house; 66.7% in Al-Agamy, 100% in old King Mariout and 100% in Al-Hawareya..