Water contact and Schistosoma haematobium infection: a case study from an upper Egyptian village.
The quantitative relationship between water contact and Schistosoma haematobium infection was studied in a cohort of male school children aged 6-17 in El Ayaisha village, Upper Egypt, during a two-year study. An exposure index (total body minutes, TBM) was used to identify the activities responsible for exposure to cercariae-infested water and to examine the relationship between water contact and infection. Results show that 65% of all contacts and 86% of all TBM were due to swimming in the Nile and canals and that swimming was the most important exposure and contamination activity. Using multivariate analysis, several sites, study periods, residence groups and mostly canal contacts were significantly correlated with egg-counts. Positive relationships could also be identified using egg-counts with water contact data from preceding study periods, indicating the influence of pre-existing infections, prepatency and seasonality of water contact and transmission. TBM were usually more significantly correlated with egg-counts than frequency and duration of contact. The relevance of the findings for control programmes and the use of school children and the exposure index for water contact studies are discussed.