Sex dating Qalyub,

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It is one of the only massage parlours left Taichung city to sexual services and erotic massages are often posted by the. On occasion the director-general of the governorate attended these meetings. Transmission in the lake say fce limited to the area near the AHD.

These results are Sex dating Qalyub in Table 1. Figure Included in the lower portion is Lake Nasser. The previous Figures t and 6 show this distribution, which included the results taken fron governmental Sex dating Qalyub. In two of the three governorates of this region, Sohag and Aswan, the prevalence increased considerably, while in Qena it regained unchanged.

Large proportions of the Aswan governorate were also converted to perennial irrigation, which already included the Kom Ombo agricultural plain.

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The increase probably would have been greater had the remaining portions of the governorate still using fcasin irrigation the northern part of the governorate and south of the Kom Qffibo plain been converted.

What has happened in these areas since thea is probably what everyone expects, but little current information exists except for an unpublished iHO report by Dazo and Biles Although unpublished, the report has been widely circulated and even quoted as evidence of Sex dating Qalyub impact of the AHD on the increase of schistosomiasis prevalence van der Schalie, In this influential study, Sex dating Qalyub were selected in Assyut, Idfu 50 ka north of Kom Ombothe Nubian resettlement sites of Kom Oabo, and in the Sex dating Qalyub area.

No sites were selected from urban areas or from the Qena governorate. Jrom the three villages surveyed in Aswan, a prevalence of These results are summarized in Table Certainly these findings show an increase compared to the level of prevalence seen in the 's. An increase was expected since there had been ample tiae since the conversion to perennial schemes fcr prevalence to increase when Dazo and Biles carried out their survey.

There are, however, certain aspects of this survey that render the results epideaiologically unsound. The younger age groups were greatly over-represented in the sample, and, as pointed out earlier, in Upper Egypt, especially in Aswan, adult females far outnumber the adult sales in the general population. There was not a single village surveyed by Dazo and Biles where more wonen were selected than men. That could possibly have been corrected by appropriately weighting the selected population for age and sex.

This, unfortunately, was not done. The sajor difficulty, however, is one of Sex dating Qalyub response and self-selection. To give only a typical exaaple, in the village of Mankabael near Assyut, there are 13, inhabitants.

All those between 2 and 25 years old were requested to give a urine specimen. A total of responded and gave specimens. It cannot be presoeed that the non-respondents are typical of and sinilar to the respondents. It would be very worthwhile Sex dating Qalyub have recent quantitative data for Upper Egypt. However, the results froa Dazo and Biles Sex dating Qalyub of Tuliwho completed a limited survey in Aswan, only indicate that SA haematobiuf is present.

The exact proportion of the population infected cannot be deternined with any certainty froa these reports. In brief, very little recent or accurate data is available for Upper Egypt. The exact figure of increase and when it occurred reaains, however, unknown. The population from this area is quite distinct from the general Egyptian population, having different styles of dress and language. Three separate tribes, the Kenuz, the Arabs, and the flahas or Fadiga, comprised about 50, persons.

All nere resettled in New Nubia in when the rising waters of Lake Nasser began to flood their original hose sites. New Nubia has been constructed along the eastern periphery of the Kom Orabo agricultural plain. Often neighbors were settled with neighbors. But a population living along km of river bank is now compressed into an area approximately 50 km long bordered on one side by a canal, Figure 11 shows this resettlement pattern. Dawood recognized that bilharziasis, transmitted by snail vectors, was present in Nubia but did not provide data on distribution or prevalence of the infection.

Rifaat and Nagaty surveyed the Nubians for a number of health parameters, including schistosomiasis. Seven villages were surveyed, and some urines were examined. Table 13 shows these results. Table 13 also shows to which tribe the village belongs and whether or not perennial irrigation schemes were present.

It is interesting Sex dating Qalyub note Sex dating Qalyub perennial irrigation schemes were being installed at this early date in Nubia. Also shown in Table 13 arc the number examined at each village, the number positive for Schistosoja ova in the Sex dating Qalyub, and the percent positive.

Table 14 also shows the number of each age and sex who were examined. It is Sex dating Qalyub evident that the females, especially in the older age groups, Sex dating Qalyub under-represented. Not only is the population incorrectly represented, but the method of selection is not discussedmaking it impossible to know the probability of being selected. It is very fortunate that Sex dating Qalyub survey just previous to the resettlement of the Nubians was carried out in by Zawahry in which the shortcomings of the previous surveys, and those of many of Sex dating Qalyub surveys of Egypt, were avoided.

A multi-stage stratified random sample based on the population census representing each of the three tribes was the frame for sample selection. Every individual in the Nubian population had a chance of being selected. This chance was calculated as a probability, which is the Sex dating Qalyub of any sound statistical analysis of survey data. From these prevalence figures estimates can be made with given degrees of confidence.

An overall estimate of This is a map of the Kom Qnbo area showing the resettle- ment pattern of the Nubian tribes. After Hifaat and Nagaty7 1. Persons No. There is no evidence to show that the population selected was representative. However, the work of Zawahry C lends itself easily to future studies or follow-up studies for purposes of comparison. Sex dating Qalyub, comparative studies require that laboratory and other data gathering methodology be consistent.

Bifaat and I. Demonstrations of changes in health patterns arising from lake-Making are difficult, if not impossible, when data are lacking prior to dan construction. Typically, impact statements on the effects on health of these Sex dating Qalyub aanageaent schemes rely only on data collected following construction of dans. Zawahry's work makes it possible to assess accurately the Nubian population now that they have teen resettled.

Trends can be estimated, and the impact of the environmental changes resulting from displacement can be made. Details of Zawahry's results have been reproduced in Tables 15, 16, and Table 15 shows the age and sex of persons who gave urine or stool specimens by village and Sex dating Qalyub.

The total sample of individuals, closely reflecting the demographic composition of the Nubian population were selected. Table Sex dating Qalyub shows the age-sex specific prevalence for Sex dating Qalyub sample. Typically higher levels of prevalence are seen in the younger groups. The prevalence by village, hamlet, and sex can be seen in Table The dramatic difference in prevalence between Kurta and the other two Sex dating Qalyub reflects differences in irrigation practices.

Snail surveys carried out by this study were unable to find vector snails along the Nile banks, although a total of some 44 Sex dating Qalyub were surveyed and dips were made. Snails were found in of the dips made in canals where perennial irrigation projects had Sex dating Qalyub established. CD [t. These two surveys, however, lack comparable features in their methodology.

Bany of the areas selected for reclamation were of marginal quality reguiriag great expenditure before cultivation was possible.

Thus, any conclusions drawn must be taken with the utmost skepticisa. Certainly no unequivocal epidemiological statements can fce made. Schistosomiasis in Lake Nasser Inthe coffer data at the head of the diversion canal, just scuth of the new AHD, was dynamited. Hater began to fill in behind the then yet uncompleted AHD.

All of Old Nubia was flooded, which included agricultural lands and a number of pharaonic sites. HHO Sex dating Qalyub four aissions to lake Nasser in the period between and Satti estimated that there were fishermen working along the shores of the lake and examined about 14X, or persons, for urinary schistosomiasis.

The only permanent population on the shore of Lake Nasser is at the Abu Simbel temple. The persons Sex dating Qalyub cannot be considered local indigenous inhabitants, but are rather Government employees coming from a variety of locations from all over Egypt. The remaining shoreline of the lake was "a vista of barren rock and arid sand" Dazo and Biles, InScott" and Chuconsultants for HHO, reviewed Sex dating Qalyub findings and concluded that it was impossible to tell if infection was being acquired from the lake or from endemic areas of Upper Egypt during periods when fishermen were visiting their families.

Each investigation included a malacological survey. Between andsnails of the species. A large number of foci were observed. So infected snails were found except near the High Dam area of the lake. In brief, Lake Nasser is populated fcy 3, transient fishermen and there Sex dating Qalyub no permanent settlements located along the shore of the lake, except at Abu Simbel where there is a small group of government personnel stationed for maintenance and care of the temples Dazo and Biles, There are vector snails present throughout the lake.

There is an indication that a large number of the fishermen are infected with S. Transmission in the lake say fce limited to the area near the AHD. Schistosoniasis in the Desert and Reclamation Sectors The remaining settleaents in Egypt are located along the western Mediterranean shore and at desert oases.

Repeated sollusciciding had reduced this prevalence to Q. Rifaat et aJU, confirmed these again in Also inBifaat looked at the western coast at Herso-Matruh and again Sex dating Qalyub the area free of schistoscniasis.

Those areas of Egypt not watered by the Nile, i. Hew reclaimed lands comprise important new areas into which the schistoscme species have a high likelihood of being introduced because of the associated irrigation expansion. The area between Cairo and Assyut is an example of land reclamation that took place over 40 years ago. Reclamation in this discussion, however, will be reserved for those areas in which there was no previous indigenous population and, thus, must be settled with persons originating from elsewhere.

An example of such an area is cited in the previously mentioned Egypt project in the Beheira Province, Moreover, because of Sex dating Qalyub new additional water Sex dating Qalyub, some 1X feddans have been proposed for reclamation. Also, after the outbreak of hostilities inreclamation activities were delayed, Schistosoaiasis in Egypt; A Summary In Egypt, schistosomiasis, also known as bilharziasis, is caused by infection with either S.

Sex dating Qalyub f or both. This includes the Fayoum area. Recently, control programs have considerably reduced the prevalence of S. The data from strongly suggest that an overall drop in prevalence was occurring when compared to the studies. Basin irrigation was no longer found after in Egypt Dazo and Biles, Excellent historical data exists on the prevalence of schistosomiasis in the Nubian populations before resettlement in the Kom Ombo plain but no conclusive studies have been completed to assess changes following the Nubian resettlement.

This does not mean that studies should not be carried out on the fishermen populations in Lake Nasser, or at reclamation sites. Expansion and the Aswan High Oam Since irrigation schemes are a critical factor in transaission and spread of schistosomiasis in Egypt and because irrigation schemes were to be expanded as the AMD complex was completed, it is important that all available information concerning the development and implementation of irrigation projects in Egypt be included as a part of this review.

The term "perennial irrigation" has been Sex dating Qalyub loosely applied, usually indicating simply the improvement over basin irrigation by installing pumps to raise water for cultivation rather than wait nine months for the next flood. A good example of this type of "perennial irrigation" was described by Khalil and Azim in their original work on the impact of irrigation schemes and the transmission of schistosomiasis in Upper Egypt.

Another example was in old Nubia where pumps and canals had been installed at selected sites as pointed out earlier Zawahry, iJand where schistosomiasis had increased. In villages where standard basin irrigation was continued, without puraps and canals, prevalence was low.

The type of pump used for these earlier "perennial" schemes was characteristically a large gasoline-driven pump housed on a floating platform see Figure Many of these pumps still function, but government-funded irrigation expansion has installed acre modern electrically driven concrete-housed pooping complexes capable of lifting much greater volumes of water, thus increasing the potential for year-round cultivation, Irrigation engineers typically refer to these schemes as perennial or "permanent" irrigation, and irrigation practices previously used were vaguely described as basin irrigation.

In a sense this is correct because land was flooded in Upper Egypt before the coffer dam was cleared in and the lake began to fill. Nevertheless, the floating pumps and their related canals Sex dating Qalyub drains were also present.

This has resulted in a degree of confusion as to Sex dating Qalyub has been irrigated Sex dating Qalyub how in Upper Egypt.

The number of floating pumps, when they were installed, and the amount of land serviced is not known, as productive sources of information on the development of irrigation schemes of any kind are scarce.

The data obtained from Egyptian governmental sources EG, and translated from Arabic see Tables 18 and 19 provide a limited amount of insight on the number of feddans converted to "permanent" irrigation in Upper Egypt. According to the data reproduced in Table 18, Aswan was completely converted to "permanent" irrigation daring the period between and the present, Sex dating Qalyub, bythere were 92 thousand feddans yet to be irrigated by "permanent" methods in all of Upper-Middle and Upper Egypt.

Table 19 is a more detailed break-down, by year, of when irrigation conversion by the governmental agencies was carried out. For example the thousand feddans available for conversion in Qena governorate were irrigated by There was no change in the number of feddans converted in the Sohag gcvernorate from toindicating that the irrigation projects were completed byexcept for 34 thousand feddans still to be converted.

A total of thousand feddans of Upper-Middle Egypt and Upper Egypt were converted to "permanent" irrigation Sex dating Qalyub the 15 year period between andaccording to these government figures. Note in Table 17 that the region proposed to be irrigated in in Sohag comprised thousand feddans, virtually the entire area of this governorate. According to the inforaatioc in Table 17, the government engineers apparently considered Sohag as an area under basin irrigation in However, the results of the schistosomiasis survey EMPH, showed sharp increases in Sex dating Qalyub prevalence indicating that at least some man-made irrigation schemes were already present.

This increase occurred before the iaplementation of the Sex dating Qalyub "permanent" government funded irrigation projects. A "floating pump station" in Qena. The question is, "Did Qena, afterwhen schistosomiasis prevalence was still low EMPH,expand irrigation systems, using the 'floating pump' system? The "floating pump" structures can still be seen docked along the Nile banks of the Qena governorate, indicating that at some point in time these pumps were used for irrigation.

Table 20 from Haterbury's article shows the cropped area by season and year, Note the drop in number of feddans cropped ic the autuam between and It was during this season that Sex dating Qalyub Nile flooded, Aftercultivation could be increased during the productive summer months.

Figure 13 graphically shows the interesting relationship between the growth of the population and agricultural expansion. According to Waterburymore land was reclaimed before the AHD than after it. By, feddans had been reclaiaed, of which about half were being Sex dating Qalyub. Bany of the areas selected for reclamation were of marginal quality reguiriag great expenditure before cultivation was possible. Indeed, the agricultural area seems to be decreasing rather than increasing.

Althoughnew feddans had been added, there was a net loss offeddans by due to urban expansion, road building, factories and military installations. Aside from the fact that land reclamation seems to be rather liaited at this time, there is doubt that reclamation as such is a mechanism for causing an increase of schistosomiasis in Egypt, To illustrate this point, envisage an area, devoid of farms and settlements.

Families, most likely non- landowners, are brought in and settled. These resettled faailies and their members are now at risk of acquiring schistosomiasis, but were they not Sex dating Qalyub at risk? Are not many of then already infected, having long since acquired the infection at village homes in the delta or in the south?

It is doubtful that many of the families that Sex dating Qalyub to reclaiaed lands originate from urban settings. Thus, land reclamation imposes a risJc of changing the geographic distribution of the disease, but is unlikely to cause an increase in the prevalence of schistosoaiasis in the population.

Changes in the distribution of schistosoraiasis certainly complicates control, but increases in prevalence in the population have far greater iaplications. Detailed analytical information on these parameters is rather limited for Egypt as a whole. Several local studies are available however for the delta and for Old Nubia.

Data from these studies have been provided in somewhat greater detail. Aain and Zaghloul in reviewed the administrative organization of the EMH environmental services but provided little data. They did point out that by protected rural water supply had been provided to each village over 1, persons. Generally, water was pumped from an underground source to elevated tanks which supplied a limited nuaber of public water standpipes one or more taps fixed to a vertical concrete slab.

This water supply project had been started in the 's and by fairly wide coverage was obtained. In all villages Sex dating Qalyub at least one protected source of water. This is very impressive when compared with the water supplies available in the rural villages of other similar developing countries. Installation of latrines in the rural areas has been less successful Furnia, The aajor refuse problem in Egyptian villages is animal waste Headlee, ; Meir, et aT. Animal manure is still commonly used for composting and for cooking fuel.

The compost heaps and the drying dung cakes cause a serious sanitation problem by providing ample sites for fly breeding. For the most part, solid waste in the conventional western sense does not exist in Egyptian rural villages. Only infrequent isolated litter piles may be noted in typical villages.

However, where multistoried Sex dating Qalyub projects have been constructed and in urban areas there are extensive solid waste problems. On the village level very little solid non-organic material is discarded, This picture is now beginning to slowly change as the population grows and as more consumer goods become available to the rural populations.

Focusing on the delta, Headleemade detailed environmental observations on the rural village of Rushdy, Qalyubia. No clinical data were provided but excellent maps were made showing the defecation sites in the village. Samples were taken from these sites and examined for helminthic parasites. According to Scottthis indiscriminate habit has important implications concerning hookworm transmission.

If the same defecation sites were frequented then hookworm transmission would be favored, However, defecation sites were scattered and, as Scott showed, the prevalence of hookworm was not as high as might be expected. Headlee also observed the still common practice of disposing household wastewater in the village Sex dating Qalyub and that the presence of a stable attached to the hone contributed to the intense fly problem. Farooq, et alj. Heir et al. These counts showed seasonal fluctuations with lew numbers in the middle Sex dating Qalyub months and high counts Sex dating Qalyub the remainder of the year.

Measures were taken to reduce Sex dating Qalyub fly populations, and it is interesting to note Sex dating Qalyub during a two year period in the areas where control was maintained, infant mortality was markedly Sex dating Qalyub. This is a very important observation. No other environmental Sex dating Qalyub tested during this study demonstrated any improvement in infant mortality, indicating the overwhelming importance of flies as vectors of serious infantile diseases.

InFaroog, et al.

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The exact distribution of people with or without piped water is shown in Table Ten and a half percent of the sample used canal water exclusively. Table 22, reproduced from Faroog's study, shows the number and distribution of people by type of house.

There were considerable differences between divisions with an overall They Sex dating Qalyub that just over half of the population do not have cowsheds, The latter group were considered to be in a higher economic class than the former two.

After Farooq, et ajU It would be interesting to know just how this was determined. In Upper-Middle Egypt only the report by Hassouma is available on a rural housing survey. Table 23 is reproduced from this report to the Egyptian Ministry of Planning. After Hassousa These fascinating Sex dating Qalyub, especially the presence of the sewage systems, beg the question "what did the author use as a definition of 'rural1?

However, over half of the Sex dating Qalyub surveyed did not have a latrine. Others Bachmann, ; Satti, reporting to the WHO found the Aswan urban area poorly developed ic respect to wastewater management.

Old Nubia: In Abdady and Shalash from the National Research Center, Cairo, completed a one-year survey on the Nubians which examined the environment and livestock resources. Sex dating Qalyub of families was based on the family register at each village and selections were representative and proportional to the census. Sex dating Qalyub was a well-designed study.

Each tribe was represented and Table 24 shows the number of families selected, by tribe, village, and the location of the village on the eastern or western bank of the Nile. Table 25 Sex dating Qalyub the housing conditions for each area.

Table 26 shows the type of water supply, lighting and food storage in the house. Hhereas this table points out that no sewage system existed, the general description of the text stated that toilets were located inside the Sex dating Qalyub in the Fediga area, and outside for the other two tribes. Nc numbers were provided on how many were available. Also included in this discussion Sex dating Qalyub that the hand pumpwells located in the Fadiga area usually did not function, Table 24 Tribe, location.

After Abdady and Shalash In the Fadiga tribal areas, houses were in rows with meters from one row to the next, spreading out over a by meter Sex dating Qalyub. Houses made of combinations of aud, rock, and cane were architecturally similar to the American Indian hogan with walls extending out to encompass Sex dating Qalyub courtyard, a guest room, and a stable.

A characteristic feature of Nubian houses is the decoration of the walls, both on the inside and outside. There is a prevailing attitude throughout Egypt that the Nubians are exceptionally tidy and hocest. Floor plans of the old Nubian houses have been prepared fcy Fernea A visit to the rural areas readily confirms the widespread distribution of rural water supply.

Generally the sanitation conditions in the villages of Egypt have improved somewhat since Headlee's study In terms of crowding, they may have become worse.

The first, termed the "downstream study" is a comparison of environmental and epideaiological health parameters at different village sites comprised of indigenous rural populations located downstream froa the AHD, excluding the relocated Nubians.

The second, termed the "Nubian study" is concerned with the Nubian populations displaced Sex dating Qalyub the formation of Lake Nasser, The results of both investigations have been analyzed for correlations with environmental and epideaiological alterations resulting from the construction of the AHD. In both studies, the research is guided by an operational hypothesis.

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Sex dating Qalyub Description oj the! Thus it can be deteruined whether changes occurring overtime or in a given location are unique, and causal relationships can be developed accordingly. Three areas have been selected which afford maximum comparability. The first, fron an area likely to be affected Sex dating Qalyub Lake Nasser, are the rural villages north of the city of Aswan and south of Kom Sex dating Qalyub.

For the sake of convenience, the three "areas" in which rural villages were selected for the downstream study are referred to as the Aswan, Beni Suef, or Kafr El Sheikh study area, In each of these three governorates, rural villages have been selected based on: a how representative the village is of the area; b accessibility; c population composition and size; d the presence or absence Sex dating Qalyub a rural health center or unit.

It was clear from these studies that Upper-Middle and Upper Egypt had frequently been excluded, with a far greater number of past surveys being carried out in the delta. Bithin the delta, more prevalence information on schistosoaiasis was available for Qalyubia than all the other delta gcvernorates combined. Sites in Kafr El Sheikh Sex dating Qalyub selected, therefore, to help correct this deficiency of information, Also, historical data indicated that the northern delta, in which Kafr El Sheikh is located, had maintained the highest schistosome prevalence in rural Egypt.

The data frou Karr El Sheikh provided the ultimate baseline prevalence for this study, as opposed to areas farther south and geographically, more central. The Egyptian Nubians, a population ofpersons, resided in villages scattered along the banks of the Nile, Sex dating Qalyub of Aswan to Sex dating Qalyub Egyptian border. This population was displaced by the rising waters of the new lake in The Nubians, who were rural in nature and composed of three different tribes were moved en masse to Kom Ombo, 40 kms downstream from the AHD, For all practical purposes, the entire population was resettled in this area.

The new villages bear the same names as those from which the settlers Sex dating Qalyub came and, in addition, retain taeir respective locations as in old Nubia with the Kanoose tribe in the north, the Arab in the middle, and the Fediga in the south See previous Figure No other formal arrangement was made by the government to have resettlements in other areas.

Schistosomiasis In Rural Egypt A Report Of Us-egyptian River Nile And Lake Nasser Research Project

However, there remains an original Nubian community located on the eastern Nile bank, just north of the old Aswan dam, called Kazan Sharg. This is the southernmost village in Egypt with the exception of a very Sex dating Qalyub village located on an island in the reservoir that inundates the Sex dating Qalyub between the old and new dams.

No resettlement sites are present on the lake shore. The high ground surrounding the lake is harsh, barren, and, according to Dazo and Biles's survey, uninhabited, with the exception of the Abu Simbel community kms upstream from the AHD.

Abu Simbel does not represent displaced Nubian communities, but is the only location that could possibly give an indication of the current health conditions at the lake Sex dating Qalyub, Observations nade during a five-day trip on Lake Nasser in May, confirmed these findings.

No other helminthic infections were observed. The Nubian study includes three aajor sites between which comparative studies have been aade: a the old, no longer existing Nubian villages of Kurta, El Malki, and Ballana; b the correspondingly resettled sites at Kom Ombo; and c the original Nubian community, Kazan Sharq, located on the eastern Nile bank just north of the old Aswan Daa.

Abu Sinbel had to be excluded because it does not represent the Nubian population. Also excluded are the lake shore sites which are yet to be developed, and the Lake Nasser fisheraen. The working hypotheses from which the survey design has been developed are: 1 The Downstream Study; There are significant increases in the estimated prevalence of schistosomiasis due to the construction Sex dating Qalyub the Aswan High Dam and related irrigation expansion in the sample of the selected sites located in the Nile Delta, Upper-Middle, and Upper Egypt.

Pre-dam is defined as the period before the discharge of the Nile was controlled by the AHD. The construction of the AHD was not completed untilbut as mentioned earlier, Sex dating Qalyub coffer dam, constructed to divert the flow of the river around Sex dating Qalyub area where the AHD's foundations were being laid, was removed in and the ensuing floods have since been trapped behind the AHD.

The reservoir reached maximum volume in The term "significant" is defined as a meaningful increase in Sex dating Qalyub prevalence of schistosomiasis when comparing the results from different study sites used in this research with results from other villages employed by other workers.

Frequently, the nuaber of cases is large enough to demonstrate statistical significance between results differing orly in one or two percentage points. Whereas Sex dating Qalyub would constitute statistical significance, it would not be meaningful. Therefore, a significant or meaningful increase or decrease would require at least a difference of 10 percentage points.

It nay be noted that agricultural irrigation methods have teen included as an environmental health parameter. Generally, irrigation schemes, as such, do not Sex dating Qalyub within the realm of environmental health specialties. However, in Egypt as in a number of other tropical developing nations, agriculture practices and especially irrigation methods play a central role in the transmission of schistosomiasis. Moreover, it is the open canals and drains which are associated with present-day irrigation in Egypt that provide excellent habitats for snail vectors.

For the rural populations of Egypt, canals long ago became a way of life. The convenience the canals have provided in the rural villages for domestic water for washing, bathing, swimming, drinking, and ablutions is Sex dating Qalyub evident to the visitor. Data acquisition forms questionnaires were designed and translated into Arabic. These forms serve as a Sex dating Qalyub for the various parameters under study.

The original English data forms are included in Appendix 2. The environmental health parameters are a critical measure under study. However, the environmental parameters not directly associated with water use require some explanation, e. Housing is an important indicator of the level of sanitation, which is an important variable in this study. The level of housing conditions also serves as an indication of environmental changes in the resettled areas in the Nubian study.

Considerable peripheral data are included in the survey listed on the data forms. Secondly, data were needed to control for certain variables; for example age, sex, occupation, etc.

The name of the health unit or center does not always correspond to the name of the village from which the sample population was selected.

Sometimes more than one village was sampled by the health unit or center. This is true also for Aswan acd for the Nubian sites. In Kafr El Sheikh the selected health units or centers, also termed "study sites", and their code numbers were: a health unit El Agazein Sex dating Qalyub : only the village El Agazein was sampled; b health center El Hamra 17 : only the village El Hamra was sampled; c health unit Hahalet El Kasab 18 : only the village Hahalet El Kasab was sampled; d health unit tlahalet Mousa 19 : Mahalet Mousa and El Nataf were sampled; e health unit Sheno 20 : two villages, Sheno and fieskit El Shenawi, were sampled.

In Beni Suef, the selected health units or centers and their code numbers were: a health center Barout 11 : only the village Earout was sampled; b health unit Sherif Pasha 12 : only the village Sex dating Qalyub Pasha was sampled; c health unit Naiio 13 : two villages, El Aorana and Abu Mousa were sampled; d health center Beni Adi 14 : only the village of Beni Adi was sampled.

Kafr El Sheikh is about 2. The northern border of the Kafr El Sheikh province is the Mediterranean sea. Almost the same distance to the south of Cairo is Beni Suef. Each of the villages selected in both Kafr El Sheikh and Beni Suef was an agricultural community typical of the Sex dating Qalyub.

The village of Kazan Sharg 1 is one of the most southern villages to be found in Egypt. This village is conprised of Nubians of the Kanoose tribe, and it should be pointed out that Kazan Sharg 1 and a few remaining villages just to the Sex dating Qalyub, are also populated by Nubians who, because of their location Sex dating Qalyub from the AHD, did not have to be moved when Lake Nasser began to fill.

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Rather, this small population of Nubians are living in the same villages and the saae homes that they were living in before the AHD was built, or, for that matter, from the last century and before.

The villages located at health units and centers 2,3, and H are ccmnunities typical of the area between Aswan and the Sex dating Qalyub Onbo plain and are located on the eastern bank of the Nile.

These communities are characteristically found on high, dry, barren ground. Because the Nile Valley is so narrow in this area, very little land is available for cultivation, and, therefore, what is available is far too valuable to build on. The cultivated areas are always found as a green strip between the village and the river, with the exception of Hagar in Ga'afra, which is located on a lew barren hill next to the river.

From the northern point of the Koai Ombo plain, continuing north, the narrow valley gradually begins to widen as it passes through the next two governorates, Qena and Sohag. In these sites the villagers live at a greater distance from the irrigation canals and drains than villagers located in the delta or in Upper-Middle Egypt. Villages are found within the cropped area with increasing frequency as one travels north and east of Aswan into Qena and Sohag.

North of Sohag only a small fraction of the rural population resides Sex dating Qalyub villages Sex dating Qalyub outside the cultivated land, and these villages are often bounded on one side by their fields. The health center Biaban 10was selected to represent villages typically built within the cultivated area. The Biffiban jaajcjraz, seen on the map in Figure 11, is located on the western bank of the Nile Valley almost directly Sex dating Qalyub of Daraw. The villages are separated froa the Nile and from the desert to the west by fields cf sugar cane and wheat, and by palm groves, etc.

The selection of the Nubian resettlement villages was based on the previous study by Zawahry In addition two other villages were selected: Tushka Fadiga 6 and Kalabsha Kanoose 9to increase the overall sample size. This is a sketch map of the Kom Ombo area showing the distribution of Sex dating Qalyub units Sex dating Qalyub centers. Also shown are the study site locations for this area, which are represented by the shaded units.

The team was led by the physician whose responsibility was to implement the collection of data and to ensure that all activities were completed according to the outlined procedures see Appendix 4 Sex dating Qalyub, The cooperation and employment of the various health teaas was obtained through the Sex dating Qalyub Minister of Health and through the respective regional offices of the director- general of health.

The director-general provided transportation to the sites and local security approvals, and saw to Sex dating Qalyub that the materials necessary to Sex dating Qalyub were received at the study sites. Sex dating Qalyub addition, a field supervisor, typically a vice-director-general, was assigned to follow the day-to-day progress in the field and to work closely with the technical field supervisor the writer. Aside froffl developing the plan of operation, acguiring materials, and training personnel, the role of the technical field supervisor was to coordinate the work at all levels at each of the twenty field sites.

The Egyptian Minister of Health assigned Dr. Baha Hashen, the director-general of all rural health Sex dating Qalyub as a tcaa representative froa the ministry to the project. The EHH's services proved to be very helpful in establishing communications, transporting materials, collecting data, and obtaining cooperation of primary data collection teams.

The chief administrative team leader. Hussein, Dean of the High Institute of Public Health at the University of Alexandria developed the administrative structure by which the various data teams and members were e»ployed and paid, and closely followed the day to day developments in the field. In addition, Dr.

Hussein obtained the necessary governorate approvals and security permits and provided the laboratory space and personnel for the analysis of the stool and urine specimens at the University of Alexandria.

Each health unit for outpatients only and each health center small scale in-patient facilities available selected was assessed for facilities needed for the survey. For the most part these Sex dating Qalyub were not needed as the health units and centers selected all had the required facilities and Sex dating Qalyub in working order. All data forms and the methods guide are included in Appendix 2 and Appendix 3, respectively.

Sex dating Qalyub translated forms were reproduced by mimeograph, at the beginning of the field activities all forms were reproduced at the High Institute of Public Health, Over 8, forms of 01 and 02 were necessary. Form 01 had three pages and 02 had four. Therefore, 56, sheets of paper were required just for these two forms. It scon became obvious that delays would develop if the forms continued to fce niueographed at the High Institute.

Data form design: the data forms for the examination of the family were based in part on the studies by Faroog and NielsenZawahryand Hussein At each health unit a guide for the Sex dating Qalyub completion of the data form from the examination of the family was provided. This guide also included the correct method by which all procedures were to be carried out for the collection of field data.

The guide served only as a reference and was not a substitute for instruction. The determination of age in a highly illiterate population is prone to error. Measures to miniaize errors were adapted from Scott Scott found that it was more accurate to place a person in an age-group than to estimate the person's exact age.

An age group sheet of 5-year age groups starting from was distributed with the methods guide and instruction for use was given to the physician. Birth dates were recorded only when government identification cards could be provided. An attempt was also made to determine what medication, if any, the individual had taken in the day period prior to the day of examination. Only medications for parasitic diseases were recorded. Details for the methods of obtaining the remaining data and data for the housing Sex dating Qalyub described in the methods guide.

The design for the housing form code number 02 was adapted frcn Mitwally and Shargawi's article on measuring housing conditions in the rural areas of Egypt. For each data form a clear plastic overlay sheet with an English translation was made. These clear overlays provided ar Sex dating Qalyub translation of the Arabic data form into English. As a guideline, the house to be examined by the sanitarian was defined as Mthe area lived ia by the selected family".

To compensate for the undesirable variability and to maximize the comparability from one study site to another all stool specimens were preserved and sent to the laboratory at the High Institute. At the "central laboratory" the specimens were examined by a staff of trained personnel.

To iiplement this central approach for the examination of the specimens, a 10 ml translucent polyethylene bottle was provided for each individual at the selected sites. These bottles were purchased in Cairo and were 2 cm in diameter, 5 cm tall with a 1 cm opening in the top for which there was ao inner cap and an outer screw cap,all polyethylene. On each bottle the code number of the individual, comprised of the health unit number, the family code number, and the individual's number within the family and his or her name were written with black, permanent, felt-tipped pens.

Both pens Sex dating Qalyub bottles performed well over the period cf the Sex dating Qalyub. There was no occasion when the label came off, and the bottles, which were unbreakable, did net leak Sex dating Qalyub though an occasional screw top had been deformed during the nolding process. The procedure for collecting the stool and urine for preservation is outlined in the methods guide. Two points should be added. One, that the urine specimens were examined at the health units by the laboratory technicians.

In addition, two drops of urine sediment was added to the stool specimen for preservation and examination later at the central laboratory. In this way a double check was provided on the examination of urine, The results of the on site examination were recorded on the data form for the examination of the family, fora Two, the transfer of the stool from the stool pan to the specimen bottle and the mixing of the stool with the preservative solution required something cheap and disposable.

Broom straws, along with matchsticks and toothpicks, were all tested unsuccessfully. Very commaon in Egypt are small vegetable crates made fcy hand from palm fronds. The ribs of these crates were found to split nicely into Sex dating Qalyub wooden sticks which easily transferred and mixed the specimens. For preservation, the stool was mixed with 9. Ova, cysts, and trophozoites in fresh stool specimens collected in the MIF solution have been successfully Sex dating Qalyub without deterioration cf descriptive cytological features for a number of years.

Instead of adding iodine Lugol's iodine at the Sex dating Qalyub of preparation when the specimen was mixed, as prescribed by this technique, the Lugol's iodine was added afterwards at the central laboratory just before the ether extraction phase. This alteration in technique, in addition to the fact that approximately 0.

By delaying the addition of Lugol's iodine at the health unit or center, the amount of materials that had to be delivered was reduced. This also assured that the Lugol's solution used was fresh, as it begins to deteriorate as Sex dating Qalyub stain after one week.

Thus the urine was examined twice, once at the health unit or center and once at the central laboratory. At the laboratory, a team comprised of nine physicians examined the specimens. The team was supervised by three senior lecturers of parasitology at the High Institute. All specimens received at the laboratory froa a particular health unit or center were grouped together. There was no intended order within the group and a few specimens at a time were selected for examination from each group.

This quasi-random method helped minimize the biasing effect of individual ability among the laboratory personnel. The preparation of a Sex dating Qalyub for examination was as follows: 1 the specimen was mixed and poured through a layer of wet gauze into a labelled centrifuge tube. The tube was inverted and shaken vigorously, 4 the specimen was centrifuged for 5 minutes at rpm.

U Strongyloides stercoralis Only one slide for each specimen was examined.

Only infrequent isolated litter piles may be noted in typical villages.

An in-laboratory test was used to obtain data on individual examiner error. It was requested that the personnel Sex dating Qalyub the "test" Elide in the same fashion as all other slides. The exaa results were not shown to the personnel, and it was emphasized that this was a procedure to estimate error rather than a proficiency examination. All laboratory personnel at the High Institute were closely followed and exhibited proficiency xn the identification of the various parasites.

The helminth ova are easy to identify as they are generally large, and very characteristic in morphology, Proficiency was assured by comparing sample Sex dating Qalyub with the NAMRU-3 laboratory.

An examination of the urine specimens for schistosome ova was also completed at the health unit or center's laboratory. The method used was the simple and classic sedimentation technique. This is the same method most commonly used in screening procedures where large numbers of specimens have to be Sex dating Qalyub and is described by Farooq and Nielsen Sex dating Qalyub Briefly, urine is placed in a ml conical flask and left undisturbed for 30 minutes.

The sediment is then transferred to a slide, covered, and scanned for ova under low power. This technique has been used in Egypt for a long time. None of the laboratory technicians at the health units or centers had to be retrained and uany were eager to Sex dating Qalyub their skills. Nevertheless, the physician was placed in direct charge of insuring that Sex dating Qalyub procedures were adhered to. With one exception, there was never an occasion wheu the results of the laboratory technicians were in question.

The one exception, in Bimban 10is elaborated on in the Rtsults. The unit of selection was the family. All members of each family in the sample were examined. Prom each study site about families were selected systematically from a list drawn up from the village or villages to be sampled that included all the families of the village or villages and all the members of each family. By selecting families per health unit or center, a sample total of approximately to persons was estimated.

The Sex dating Qalyub sample size for all study sites in both studies was between fourteen and eighteen thousand. Sex dating Qalyub family list was the sampling frame.

This definition was easy to use and fairly stable, i. Note that net all offspring of a selected married female may have been examined. All selected family members were accounted for. To make the selection of the families, an up-to-date list of family names and members, or sampling frame, was required.

Generally a frame was available but often out-of- date by four to five years. In order to avoid delaying the start of the survey, the following procedure was isplemented. The total number of families in the old list was divided by The number obtained, for example 3. In this example, with a starting list ofevery fifth fa«ily would be selected starting from a random number between 1 and 5. The Sex dating Qalyub would immediately begin to be updated, adding new families at the end of the list, and the examination of the selected families starting from the first selected and proceeding seguentially was also begun.

The up-dating was always finished Sex dating Qalyub before the examination of the first selection of families could be completed. The selection of every fifth family according to this example would result in an under-selection, i. In this case about families would be selected if new families were added to the original list of After the examination of families, 64 families would have to be reselected from remaining unselected families by selecting every 10th family.

Beselection being made without replacement, a total of families would be selected and examined. This approach was used throughout the study, with two or more samples one or more reselections from each site being taken in this fashion.

Each selected family was circled and serially numbered in the list of family names and members. The serial number for the family became the serial code number for that Sex dating Qalyub.

The members of the family were listed serially starting with the first person examined on the family examination Sex dating Qalyub, form This gave each individual that Sex dating Qalyub examined in the survey a unique code number comprised of the numoer of the village, the family serial code number, and the individual code number within the family.

The code number 01,01 identifies the first person in the first family selected at the health unit 01, Kazan Sharg. The health unit or center Sex dating Qalyub number and the family serial code number were used to identify the data forms 01 and the housing data forms The data form, 02, was completed for each house of each of the selected families.

These forms were matched with the family 01 forms by coding the 02 forms with the health unit or center number, the house number, and family serial code number. Therefore, the sampling fraction varied froa site to site. This Sex dating Qalyub done for administrative reasons, and because it was desired that the completion of the survey of the families and the environment be roughly during the saae period of time Sex dating Qalyub all sites. The reason for this was that by carrying out the survey at the different sites over the same period of time, the possibility of seasonal variation of the parameters measured between the sites would be negated.

It was estimated that families would yield a sample of about individuals. This sample size was felt sufficient to give the estimates of the various parameters sampled with adequate precision at each site. The systetatic selection of families was used as opposed to a purely random method for two reasons. One, the systematic selection mere often than not gives greater precision.

With a systematic selection, no isolated groups, individuals, or houses are left unrepresented in the sample, as Sex dating Qalyub inadvertently happen with a random selection. Two, the selection of the families for examination could proceed iaiediately without waiting for an up-dated family list, A random sample would be impossible to select before the list was completed because the added group would not have a known possibility of being selected in the first round, o the Environment and the Before the survey could begin, each health unit or center had to receive the necessary materials and the personnel had to review Sex dating Qalyub aethcds for the correct filling in of the data forms and the correct method for preparing the stool and urine specimens.

The up-datiag of the family list was always the first activity, followed by the selection cf the families. In order to obtain the cooperation of the village members, a meeting was held with the village council, the local physician and the field supervisor, to explain the purpose of the survey and solicit the aid Sex dating Qalyub the council to overcome any difficulties. On occasion the director-general of the governorate attended these meetings. Only after the personnel at the health unit or center showed proficiency with the different aspects of the data acquisition was the examination begun.

Generally a routine was established where the sanitarian would go to the selected family's house, complete the bousing form and instruct the family to go to the health unit or center the following day.

At the health unit or center, the selected family Sex dating Qalyub would be qiven a numbered stool pan and a numbered tin cup and requested to provide a specimen of each at some point during the examination. By obtaining the specimens from the selected family members at the health unit or center, proper identification of the specimens could be guaranteed.

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This is a unique feature to this survey. ScottFarooq and Nielsenand Zawahry all obtained their specimens by providing specinen containers to the heads of the household of each of the families selected.

There were exceptions, most notably at Kurta 8 in the resettled Nubian area. The water supply in the laboratory at Kurta 8 was the most inadequate of all the selected sites. The piped water supply was limited to a few hours a day and frequently failed for periods longer than 48 hours.

Water rarely came to the health unit's laboratory. At Kurta 8protected water was used first for drinking and cocking before it went for other purposes. Because of this lack of water at the health unitrselected family members refused to give stool specimens. Thus the correct specimen was obtained. Also, a large metal reservoir was given to the health unit laboratory so that water could be stored and available to clean equipment.

Trips to the field to initiate the survey activities were made ii? By May, all units and centers had begun the collection of data. After the survey had begun, each field site was repeatedly visited. During these visits, additional saterials were supplied, completed data forms and prepared specimens were picked up, and, if required, a reselection was made.

In addition, a survey progress evaluation was made. This evaluation included Sex dating Qalyub following: 1 a check to see if the names on the completed Sex dating Qalyub and Sex dating Qalyub forms corresponded to the names in the family list.

This was done by going to the village and randomly selecting a house to see if the occupants were listed in the book. On no occasion was a family located Sex dating Qalyub had not been included. It should be pointed out that, one, the sanitarians are well-trained in this Sex dating Qalyub and two, they were often residents of the village who knew the villagers well, and were actually related to many of them. Since only part of the working day could be allotted to the examination of the family members or the environment at the health unit or center, it was requested that approximately 20 persons per day, or five to six families, be screened at a time.

This was done by observing the coapletion of the family form 01, with the physician at Sex dating Qalyub health unit or center during a visit when examinations were being carried out. First, a family that had been examined just prior to arrival was recalled and re-exarained, while checking the completed form for discrepancies, Secondly, the completion of the family form was followed through on a family who had not been examined. This was especially helpful in detecting errors in obtaining and preparing specimens.

Idiosyncratic procedures were noted during this time. Those which did not in themselves affect Sex dating Qalyub collection of data were usually allowed to continue, as changing procedure would risk causing errors. If the person was elderly and a relative of a selected family or a village leader who had not been selected, forms were completed and specimens taken.

No code numbers apart from the health unit number were given to these individuals, Data from these forms were not included. From the very first Sex dating Qalyub was stressed that the right stool and Sex dating Qalyub right urine be placed in the right bottle in Sex dating Qalyub correct manner. Sex dating Qalyub procedure was reviewed frequently at the health units and centers at the time when specimens were being provided by the selected individuals.

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The systetatic selection of families was used as opposed to a purely random method for two reasons. This was done for administrative reasons, and because it was desired that the completion of the survey of the families and the environment be roughly during the saae period of time at all sites. This research was divided into two studies.