Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 17;10(9):1210.
doi: 10.3390/pathogens10091210.

Very High Fascioliasis Intensities in Schoolchildren from Nile Delta Governorates, Egypt: The Old World Highest Burdens Found in Lowlands

M Victoria Periago  1 , M Adela Valero  1 , Patricio Artigas  1 , Verónica H Agramunt  1 , M Dolores Bargues  1 , Filippo Curtale  2 , Santiago Mas-Coma  1
Affiliations

Very High Fascioliasis Intensities in Schoolchildren from Nile Delta Governorates, Egypt: The Old World Highest Burdens Found in Lowlands

M Victoria Periago et al. Pathogens. .

Abstract

Quantitative coprological analyses of children were performed in Alexandria and Behera governorates, Egypt, to ascertain whether individual intensities in the Nile Delta lowlands reach high levels as those known in hyperendemic highland areas of Latin America. Analyses focused on subjects presenting intensities higher than 400 eggs per gram of faeces (epg), the high burden cut-off according to WHO classification. A total of 96 children were found to shed between 408 and 2304 epg, with arithmetic and geometric means of 699.5 and 629.07 epg, respectively. Intensities found are the highest hitherto recorded in Egypt, and also in the whole Old World. A total of 38 (39.6%) were males and 58 (60.4%) were females, with high intensities according to gender following a negative binomial distribution. The high burden distribution shows a peak in the 7-10 year-old children group, more precocious in females than males. Results showed high burdens in winter to be remarkably higher than those known in summer. The fascioliasis scenario in Egyptian lowlands shows similarities to highlands of Bolivia and Peru. Diagnostic methods, pathogenicity and morbidity in high burdens should be considered. The need for an appropriate quantitative assessment of heavy infected children to avoid post-treatment colic episodes is highlighted.

Keywords: Alexandria and Behera governorates; Egypt; Nile Delta; children; coprology; gender and age; geographical distribution; high intensities; human fascioliasis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Maps showing endemic areas studied: (A) General map of Egypt showing the northern Lower Egypt including the large Nile Delta and the southern Upper Egypt including the localities of Qena and Luxor; (B) map showing the governorates of the Nile Delta, including the western governorates of Alexandria and Behera; (C) map of the governorates of Alexandria and Behera, including the districts where human samples were collected. Background for A from composed satellite map of Africa orthographic projection by NASA (full resolution of 1624 × 1824 pixels; public domain) via Wikimedia Commons. Backgrounds for B and C from Probe-V satellite by European Space Agency (ESA: https://www.esa.int/ESA_Multimedia/Keywords/Location/Egypt/(sortBy)/view_count/(result_type)/images), high resolution 944.58 kB image accessed on 30 June 2021. Original S. Mas-Coma.
Figure 2
Figure 2
Fascioliasis transmission foci inhabited by lymnaeid snail vectors in the Alexandria governorate: (A) Water canal between cultivated field and road besides school of children in Abis 8 Village 1, Wasat district; (B) similar canal with abundant water hyacinth close to human dwellings in Village 11 of Abis 8, Wasat-El Raml district; (C) irrigation canal in front of city suburb in Village 1 of Abis 8, Wasat-El Raml district; (D) freshwater collection besides human dwellings in El Missiry, Waqad-Haris district; (E) sheep herds are numerous in Village 4 of Abis 8, Wasat-El Raml district; (F) cattle, buffaloes, donkeys and horses are usually present around Village 4 of Abis 8, Wasat-El Raml district. (A,B,D): Photographs by P. Artigas; (C,E,F): Photographs by S. Mas-Coma.
Figure 3
Figure 3
Fascioliasis transmission foci inhabited by lymnaeid snail vectors in the Behera governorate: (A) Rice fields observed from the fourth floor of school of children in El Kazza, Hosh Esa district; (B) irrigation canals filled by water pump in El Kazza, Hosh Esa district; (C) large secondary canal besides human dwellings in El Kazza, Hosh Esa district; (D) small canal for irrigation of cultivated field in the way for livestock manure fertilisation besides village in Zuhra, Kafr El Dawar district; (E) small canals for rice field irrigation close to human dwellings in Bolin El Aaly, Kafr El Dawar district; (F) wider canal with water hyacinth with village in the background in Tiba, Delengate district. (A,E): Photographs by S. Mas-Coma; (B–D,F): Photographs by P. Artigas.
Figure 4
Figure 4
Curves of intensities found in fascioliasis-infected children from the Nile Delta region, Egypt, according to sex. epg = eggs per gram of faeces.
Figure 5
Figure 5
Distribution of the number of fascioliasis-infected children presenting high intensities in the Nile Delta region, Egypt, according to age.
Figure 6
Figure 6
Distribution of the number of fascioliasis-infected boys and girls presenting high intensities in the Nile Delta region, Egypt, according to age.
Figure 7
Figure 7
The whole life cycle of the liver fluke in an image from Hosh Esa district: bathing buffalo as animal reservoir; a freshwater collection inhabited by lymnaeid vectors as transmission focus; woman and girl washing kitchen utensils; household (see left background) in the proximity. Photograph by F. Curtale.
See this image and copyright information in PMC

References

    1. Mas-Coma S., Valero M.A., Bargues M.D. Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control. Adv. Parasitol. 2009;69:41–146. - PubMed
    1. Bargues M.D., Artigas P., Mera y Sierra R., Pointier J.P., Mas-Coma S. Characterisation of Lymnaea cubensis, L. viatrix and L. neotropica n. sp., the main vectors of Fasciola hepatica in Latin America, by analysis of their ribosomal and mitochondrial DNA. Ann. Trop. Med. Parasitol. 2007;101:621–641. doi: 10.1179/136485907X229077. - DOI - PubMed
    1. Bargues M.D., Artigas P., Khoubbane M., Flores R., Glöer P., Rojas-Garcia R., Ashrafi K., Falkner G., Mas-Coma S. Lymnaea schirazensis, an overlooked snail distorting fascioliasis data: Genotype, phenotype, ecology, worldwide spread, susceptibility, applicability. PLoS ONE. 2011;6:e24567. doi: 10.1371/journal.pone.0024567. - DOI - PMC - PubMed
    1. Mas-Coma S., Bargues M.D., Valero M.A. Human fascioliasis infection sources, their diversity, incidence factors, analytical methods and prevention measures. Parasitology. 2018;145:1665–1699. doi: 10.1017/S0031182018000914. - DOI - PubMed
    1. Afshan K., Fortes-Lima C.A., Artigas P., Valero M.A., Qayyum M., Mas-Coma S. Impact of climate change and man-made irrigation systems on the transmission risk, long-term trend and seasonality of human and animal fascioliasis in Pakistan. Geospat. Health. 2014;8:317–334. doi: 10.4081/gh.2014.22. - DOI - PubMed

LinkOut - more resources