A Comparison of Helminthic and Protozoan Infections in Two Egyptian Villages Two Years After the Installation of Sanitary Improvements in One of Them

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Abstract
Summary and Conclusions Comparative surveys were made of helminth and protozoan infections in two Egyptian villages situated near together. One, Sindbis, had had bored hole latrines installed in the majority of the houses, and had had an unpolluted water supply made available for the entire population two years previously, while the other, Aghour El Kubra, had been left as it was. 1. In Aghour El Kubra the Ascaris incidence was 76 per cent and the average eggs per gram in the infected individuals 6,900, whereas in Sindbis the corresponding figures were 50 per cent and 4,200. The incidence in Sindbis in 1950 was 62 per cent. We believe these figures to indicate a definite lowering of exposure to Ascaris infection in Sindbis as a result of the sanitary improvements. Search for Ascaris eggs in soil samples and washings from vegetables confirmed that the dirt floors of the houses are a more important source of Ascaris infections than uncooked vegetables. There was also evidence of correlation between the degree of infection in members of an individual household and the amount of contamination on the floors of these houses, indicating some tendency towards family concentration of Ascaris infections. 2. In Aghour El Kubra the Ancylostoma incidence was 17 per cent for females and 42 per cent for males, whereas in Sindbis it was 7 per cent for females and 12 per cent for males, but in both villages the individual burdens were very low. The data on age and sex infections suggest that a certain number of very light hookworm infections are acquired in the villages themselves, and that there was more exposure to such infection in Aghour El Kubra than in Sindbis. 3. Light Trichostrongylus infections were very common, 29 per cent in Sindbis and 40 per cent in Aghour El Kubra, reflecting the close association with animals in the homes. 4. Trichuris infections were few, again confirming the exceptional susceptibility of this parasite to relatively dry environmental conditions. 5. Hymenolepis nana was found in 7 per cent of the people examined, and about twice as frequently in Sindbis as in Aghour el Kubra. This again supports the view that this parasite is commonly acquired from food contaminated by rodent droppings, since otherwise a higher incidence would have been expected in the village with poorer sanitation. All but 2 of the 36 infections were in individuals below the age of puberty. Hymenolepis diminuta was found in 9 cases, but unlike the H. nana cases, these were evenly distributed in all age groups. 6. Special techniques for detection of Enterobius and Schistosoma infections were not employed, so only a few of these were found. No other fluke eggs or Taenia eggs were observed. No difference in the incidence of the various species of Protozoa was found between the two villages, and the average number of different infections harbored per person (2.3) was identical in both places. This number was lower (1.8) in the 1–4 age group, but was fairly uniform (2.4 to 2.5) in all the higher age groups. The failure of the sanitary improvements in Sindbis to be reflected in a lower incidence of protozoan infections may be due to loss of very few of the infections that were in existence two years previously.