الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Schistosomiasis is a debilitating disease caused by infection with one of several species of the trematode Schistosoma . The most important are: S.haematobium and S. mansoni which are found in Egypt. The disease spread is due to proliferation of manmade environments suitable for the molluscan intermediate host. The concurrent recognition that schistosomiasis is an impediment to the eco’nomic growth of nations in the tropics has stimulated research. Classically the speci fie diagnosis of infect ion is based on the microscopic ” demonstration of eggs ,in the excreta. The assessment of” the worm burden is provided by the quantificat,ion of eggs in the faeces or urine. However, sometimes this may be difficult for example in early, light infections or in those persons partially treated or with the so called closed infect ion, so negat ive stool or urine do not exclude the infection. In such cases we a.re in need of other methods of dia.gnosis. In epidemiological work in which there may be some~mes . difficulties in obtaining and examining adequate L quantities of urine and stool specimens from large number of individuals, a simple and economical immuno dia.gnostic test would be of value in diagnosis and assessment of the disease although it is unlikely ever to replace entirely the parasitological methods of examine. t io n. The aim of the present work is to: 1- Study the distribution of ~chistosomiasis among the recruits (the study group) from Northern Delta region and the various factors affecting it. 2- To assess several parameters specially the sensitivi ty and specificity of the most commonly used nowadays immunodiagnostic tests i.e. ELISA and IDT using SEA. t and SWAP used in the diagnosis of schistosomiasis. 3- To study the development and the type of anaemia associated with schistosomiasis. 1000 recriuts from five governorates Alexandria, Behera, Kafr EI-Sheekh, Gharbia and Matrouh aged 18- )0 yea.rs were representing the study group. Stool, urine and blood samples were taken from everyone. The following techniques were used: , 1- Simple sedimentation for detection of Schistosoma eggs in stools. 2- Centrifugal sedimentation for detection of Schisto $oma eggs in urine. 3- MIFC for detection of protozoa and helminthic eggs. 4~ Micro-ELISA technique with SEA and SWAP for detec tion of Schistosoma antibodies. 5- Delayed intradermal test using SEA and SWAP. i , . I The required data were reported in a special data! I she et . The prevalence of schistosomiasis among the st~dy group was 5.4 for S. mansoni and 17 for mixed infection. The most infect ed age in the study group was 20 - years. A significant reverse relationship between the prevalence of infection and the level of education and the income per capita per month. A significant relationship between the low prevalence of infection with those having sanitary water supply and latrines. The results of immunodiagnostic tests revealed that ELISA using SEA had a low sensitivity with-high specificity than SWAP. ELISA using SEA was able to diagnose 78.9 of cases found positive by parasitological diagnosis, with 81.6 specificity. On the other hand ELISA using SWAP was able to diagnose 91.97 of cases found positive by parasitological diag nosis with 72.8 specificity. The same trend was observed in delayed IDT. IDT using SEA was able to diagnose 76.38 of cases found positive by parasitological diagnosis with 81.6 speci ficity. On the other hand delayed IDT using SWAP was able to diagnose 95.6 of cases found positive by parasitological diag nosis with 83.3 specificity. As a general rule the sepcitivity of the immunodiagnostic tests (ELISA or IDT) using SWAP gave a better sensitivity than S.EA. On the other hand SEA gave a better specificity than SWAP. This study indicates that for epidemiological surveys we can use ELISA or delayed IDT according to the available facilities using soluble worm antigen preparation (SWAP). The antigen has to be purified and recently prepared to increase its sensitivity and specificity.