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SOME RESEARCH NEEDSInter-sectoral communication with engineers, agriculturalists, sanitarians and government administrators together with new research methods and approaches may provide new insights into the broad spectrum of human behaviours bearing on schistosomiasis. In particular, cost-benefit analysis and studies of people's coping behaviour, attitudes and perceptions in different environmental and socioeconomic settings may elucidate constraints such as poverty, economic/health trade-offs and relevant social factors. It is clear that safe domestic water supplies, laundering facilities and swimming pools constitute alternatives for the use of schistosome-infested water bodies (23,24). But improved facilities must also meet the economic, social and cultural needs of local populations, such as women's for low-cost, accessible taps without long waiting lines that provide an adequate and reliable water supply (25,26). Similarly from what has been noted in various Ethiopian irrigation schemes (27) and subsistence communities (12, 28-30); taste, appearance and hardness of water must meet the expectation of local people and hygienic standards (28). Social and behavioral scientists can be instrumental in identifying people's preferences, with the objective of assuring community acceptance and use, of different types of water supplies and facilities, with the objective of assuring community acceptance and use(31-39). There is also a need to study any new forms of health-enhancing behaviour generated by successful disease control programs for their feedback and multiplier effects in multi-disease environments. The development and successful maintenance of safe and acceptable water supplies and sanitation facilities using community inputs, for example, may not only reduce the incidence of schistosomiasis and other water-related diseases but also encourage community development efforts (31,32). Thus it is desirable to develop educational messages aimed at changing behaviour affecting the transmission and control of a wide range of communicable diseases whose transmission and spread are affected by water and environmental sanitation. REFERENCES1.World Health Organization. Workshop on the Role of Human/Water Contact in Schistoaomisis Transmission and Control. WHO Document, 1979; TDR/SER/HWC/1979.3. Geneva. 2.UNDP/World Bank/WHO. Sixth programme report: social and economic research. WHO Document, 1983; TDR/PR-6/83.12- SER. Geneva. 3.Herrin AN., Rosenfield, P.L. The economic. of tropical diseases. In Economics, Health and Tropical Diseases. Edited by Herrin, AN. and Rosenfield, P.L. Manila: University of the Philippines, School of Economics, 1988; pp.3-16. 4.Dunn FL. Human behaviors factors in the epidemiology and control of Wuchereria and Bn4gia infections. Bull. Publ. Hlth. Soc. Malaysia, 1976; 10:34-44. 5.K1oos H. Health education in schistoaomi-sis: a review. Ethiop. I. Hlth. Dev., 1993; in press. 6.Dunn FL. Behaviorsl aspects of the control of p-rssitic diseases. Bull. Wld. Hlth. Org., 1979; 57:499-507. 7. World Health Organization. New approaches to health education in primary health care. Tech. Repl. Series, 1983; No.690. Geneva. 8.Taylor PA. proposed evaluation on a primary health care approach to control schiatoaomiasis in Zimbabwe. Trop. Med. Parasit, 1986; 37:160-163. 9.Solomon Ayalew. The Social Cotext of Health Care planning in Africa: Ethiopian Caoe Studiea and Penpectivea. Stockholm: Karolinaka lnatitutel, 1991 . 10.Chee.mond AK., Fenwick A. Human excretion behaviour in a Shistosomiasis endemic area in the Gezin, Sudan. J. Trop. Med. HyB., 1981; 84:101-107. 11.Dalton PR., Pole, D. Water contact patterns in relation to Schistosome haematobium infection BuU. WId. H/1h. OrB., 1978; 56:417-428. 12.Kloos H. and Aklilu Lemma. The epidemiology of Schistosome monsoni infeclion in Tenaae Berhan, Ethiopia. 2. Human water contaclpattem.. Elhiop. Med. I., 1981; 17:91-98. 13.Brinkmann U., el .1. Scbialoaomia.i. control in Africa: organizalional aapecta of GTZ-a..iated bilatenl prognmmea in Madagascar, Malawi, Mali and the people'a Republic of the Congo. WHO Documenll989 WHO/SCHISTO/89.100. Geneva. 14.Chen MF .programme and problems in schistomiasis control in China. Trop. Med. Parasit., 1989; 40:177-185. 15.Kloos H. Developmenl, droughl and famine in the Awalil Valley of Ethiopia. Aft. Stud. Rev., 1982; 25,21-48. 16.Fi.oeha Haile Me.kal, el .1. Di.ruption of bilharzia transmission in the Kortume flood plain. Elhiop. Med. J., 1981; 19:117-121. 17.Bekele Mamo, el .1. Intestinal pansiti.m in Akaki town, with opecial emphaaia on Schislo.some mansoni. Elhiop. Med. I., 1989; 27:183-191. 18.Firdu Zewde, personal communication. 19.Elias Gebre-Egziabher. Diagnosis before action:a KAP survey .s baseline for a schisloaomiasis pilol conlrol project in Kemise, Wollo Administrative Region. Ethiop. I. Hlth. Dev., 1987; 2:1-19. 20.Polderman AM. The lnnamission of intestinal schistoaomiaaia in Begemder province, Ethiopia. Acto Leidensio, 1975; 72:1-193. 21.Kloos H. et al. Schialoaomiasis haemalobium among semi-nomadic agricultural and Afar in Ethiopia. Trop. Geo Br. Med., 1977; 29:399-406. 22.Kloos H., el .1. The control of schiatoaomiasis in Jig. town, Ethiopia. 2. The impact of piped water supply and environmental control measures on human water contact patterns. Rivista parassiol., 1991; 8(52):156-160. 23.Kloos H, el al. Human behaviour and schisloaomiasis in an Upper Egyptian village. Sac. Sci. Med., 1983; 17.545-562. 24.Jondan P. Schistoaomiasis can be prevented. Wld Hlth. Forum 1988; 9:104-106. 25 .Fekade Shewakena, et al. Socioeconomic and water uae pattema in Schistosome mansonl infection in Jiga. Ethiop. J. Hlth. Dev. , in PIe"". 26. Yayehirad Kitaw. Water supply in a .mall village in Ethiopia: Kidame Gebaya. Ethiop. Med. I., 1980; 18:165-169. 27.Alula Abate, et al. Evaluation of UNICEF assisted rural water supply projects in Harerge, Shewa, Welo and Bale Administrative Region. in 1980-83. Report to the UNICEF, Addis Ababa, 1986. 28.Mekonnen Biohaw. Some socio-economic factor related 10 rural water use. Report to the Institute of Development Reaearch,1983 Addis Ababa University, 2 vol.. 29.Sandbach, F .R. Preventing ochi81080mia.i.: a critical assessment of present policy. Soc. Sci. Med., 1975; 9:517-527. 30.Mohundwa EPY. Rural development and primary health care in le.. developed countries. Soc. Sci. Med., 1986;22: 1247-1256. 31.EI-Katsha S., et al. Women Water and Sanitation: Household Water Use in Two Egyptian Village.. Cairo Paper in Social Science. Cairo: American University in Cairo Press, 1989. 32.KIoos. H., et al. Coping with intestinal illness among the Kamba of Machakos, Kenya, and aspects of Schistomiasis control. Soc. Sci. Med., 1987; 24: 383-894. 33.Fekadu Abebe, et al., The control of ochi81080miasi. mansoni in Jiga town, Ethiopia. I. Community participation and inter sectorial collaboration. Rivista di parassitol., 1991; 8(52): 143-153. 34.Rosenfield PL. Social determinants of tropical diseases. In Tropical and Geographical Medicine. Edited by Warren, K.S. and Mahmoud, A.A.F. PP. 1989; 197-204. New York: McGraw-Hill. 35.World Health Organization. Health Education and the Control of Schisto80miasis. Geneva. WHO, 1990. 36.Khairy AEM. Domestic water supplies and community self-help in Siddi Ghazzi alea-Nile delta, a strategy for schistomiasis control. I. water supplies and the prevalence of schistomisasis. Bull. High Inst. Publ. Hlth., 1986; 16: 9-19. 37. Tesfamichael Tesfayohannes, et .1. Evaluation of multidiociplinary control measure. of ochisto80miasi. mansoni in a northern Ethiopia community. IPB (Institute of Pathobiology) Repo11, 1987; 3: 17-29. 38.Gebre Arnanuel Teka. Water supply and sanitation. In The Ecology of Health and Disease in Ethiopia. Edited by KIoos H. and Zein Ahmed Zein. Boulder, Colorado: Westview press, 1993; pp. 179-201. 39.Ephraim Assefa. Migration and health (refugees and returnees Ethiopia). Ethiop. I. Hlth. Dev., 1992; 6: 63-71. TRANSMISSION OF SCHISTOSOMA MANSONI IN THREE ECOLOGICAL SETTINGS IN ETHIOPIA. I. EPIDEMIOLOGICAL ASPECTS Hailu Birre, MSPH1, Teklemariam Ayele, MD,MPH2 Shibru Tedla, PhD1, Fekadu Abebe, MSc1 ABSl'RACT: The epidemiological indices of Schistosome mansoni for three communities in Ethiopia; Jigga (northwest), Metahara sugar estate (southeast) and Lake Zway (central), each representing the three major transmission ecologies in the country, the stream, irrigation scheme and lake, respectively were studied and compared. A totals of 2897 people (913, 1614 and 370 from the stream, irrigation scheme and lake, respectively) was examined for S. mansoni ova by the Kato's smear method. The highest human prevalence (58% ) and intensity of infection (geometric mean of 450 EPG) were recorded for the lake ecology, whereas the irrigation scheme and stream showed moderate (218 EPG) and light (172 EPG) intensities of infection, despite fairly high disease prevalences of 20% and 41% respectively. Age-specific analysis of prevalence, intensity of infection and relative index of potential contamination (RIPC) indicated that children in their second decade of life to be most responsible. Nevertheless, the decline of all indices with increasing age was less obvious in the lake area than others. The disparity between prevalence and intensity of infection in the stream ecology, inter- ecological differences in the indices of infection and their implication in disease control tactics are discussed. [Ethiop. J. Health Dev. 1993;7(2):63-69] |