Human Schistosomiasis in the Middle East and North Africa Region

Human schistosomiasis is one of the most common Neglected Tropical Diseases (NTDs); it is an intravascular parasite caused by the trematode blood fluke (Schistosoma). Most human infections are caused by S. haematobium, S. mansoni, and S. japonicum. An estimated total of 237 people are infected worldwide, and 732 million people are at risk of being infected. In the Middle East and North Africa (MENA) Region alone, 12.7 million individuals are infected. The link between poverty and high prevalence is evident, where approximately ten million of infected individuals are clustered in Egypt and Yemen. However, during the past 20 years significant changes had occurred in the region. Schistosomiasis was eliminated from Islamic Republic of Iran, Oman, Lebanon, and Tunisia. Transmission has been greatly reduced in Egypt, Morocco, Saudi Arabia, Iraq, Jordan, and Syria. Evidence from the Egyptian experience indicated that a nonintegrated intervention strategy, Author was deceased at the time of publication. R. Barakat • A. Farghaly High Institute of Public Health, Alexandria University, Alexandria, Egypt e-mail: [email protected]; [email protected] H. El Morshedy (*) Faculty of Medicine, Princess Nora Bint Abdul Rahman University, Riyadh, KSA e-mail: [email protected] M.A. McDowell and S. Rafati (eds.), Neglected Tropical Diseases Middle East and North Africa, Neglected Tropical Diseases, DOI 10.1007/978-3-7091-1613-5_2, © Springer-Verlag Wien 2014 23 such as annual drug delivery for morbidity control, did not succeed to alter transmission. Large-scale mass chemotherapy is the first step to reducing the burden of Schistosoma-related disease; yet, such programs may not significantly alter parasite transmission in high-risk areas. Snail control, integrated with drug treatment proved to be most efficacious in preventing and controlling schistosomiasis in Saudi Arabia, Morocco, and Egypt. Intersectoral collaboration between health, agriculture, and education is an extremely important part of advocacy in any program and is an essential part of any successful program in countries which achieved elimination or near elimination progress. This necessitates political commitments for decades. Despite the notable success in schistosomiasis control in the region, achievements are jeopardized by the current political instability, therefore resurgence of high prevalence, high intensity of infection, and severe morbidity might ensue. Yemen is the only country in the Middle East not to have eliminated the disease. The significant World Bank funds being allocated to the 6-year control program in Yemen will continue provided the political situation there returns to a level that allows drug distribution.