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Eradicating schistosomiasis

Both intestinal and urinary human schistosomiasis have been prevalent in Saudi Arabia.' In 1971, a special unit for schistosomiasis was set up at the Ministry of Health (MOH) to carry out extensive regional surveys. This unit identified 12 foci of the disease (Figure 1). The prevalence rate of schistosomiasis ranged between 5% and 20%, and in some districts the prevalence reached 50%. In 1973-74, the MOH established seven regional Bilharzia centers to oversee operations of control programs.
Strategies of control programs were based on case-finding (using skin tests and stool and urine examination), treatment of cases with antischistosomal drugs, treatment of infested water bodies with mollusicides (niclosamide) and environmental modification. Initially antimonial drugs were used for treatment, but they were replaced in 1982 with oral oxaminquine and praziquantel; cure rates reached 95%.
In 1983-84, four new Bilharzia control units were established and the control program was extended to cover all endemic areas in the Kingdom. Intervention activities were strengthened. These included provision of safe water supply, mechanical weed control, removal of unnecessary water bodies by filling and drainage, health education and active community participation. In 1990, the control program was integrated within the primary health care program through primary health care centers.
In 1985, when the overall prevalence was 9.5%, about 80% of schoolchildren and inhabitants of infected districts were screened and diagnosed cases were treated. The prevalence of schistosomiasis dropped to less than 1% in 1993. After two decades of extensive effort, it seems that eradication of schistosomiasis in the Kingdom is feasible.
  1. Ashi J, Arafaa F, Jeffri M and Suwairy M. Progress achieved in the control of schistosomiasis in Saudi Arabia. J Trop Med Hyg 1989;92:27-31.