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Abstract - 117 - ~!:!!!~~!:>:_L_9!?2S!!:!!!!!?2!! -a-r-d--R-e-c-o-m-m-e-n-d-a-t-i-o-n-s This work has been planned and conducted as an analytical case-control study in which 200 persons from Qalyub a were screened for HBsAq using reversed passive haemagglu ination test • Of these # 100 cases were hepatosplenic pati nts with a presumptive evidence of schistosomiasis , 50 case ’.were professional blood donors and 50 persons were chose as normal controls • The~e cases were subjected to his ory taking and physical examinatjon # urine and stool analysis # intradermal test for schistosomiasis and HBsAq screening • The neat conclusions of the present study are ,_ (1) The prevalence rate of HBsAq among normal ,ontrols was 2% conforming with other studies carried out in different parts of Egypt • (2) The prevalence rate of HBSAq among hepatosJ lenic ~ patients was 10% with no statistically significant I Lfference from controls’ ( p ,>0.05 ) , agreeing with populatiol -based morbidity s~udies • (3) The frequency of HBSAq could be statistica: Ly correlated with decompensated hepatosplenic disease (p.:0.05) and it was proved that whenever the two conditions f ~e present together , a rrore advanced hepatocellular ff llure is anticipated • (4) Statistical 6nalysis of our results stresSE I tha~ - 118 - the biological credib5.lity for these correlations ••mLd be more acceptable if based upon an ”exposure-risk con :ept” rather than a ”predisuosi tion-risk concept H • (5) Xn terms of nrevention of severe liver dis ’ase in Egypt • the advisability of using an effective oral treatment is more likely to be rewarding medically and econo” .cally than vaccinating hepatosplenic schistosomal patient I against hepatitis B • (6) The ”expecteo attack rate” of pos~-transfu lion hepatitis B in recipignts of commercial blood in Oa .yubia is estimated to approximate 3% • (7) from the point of view of preventive medic .ne • the exclusion of both commercial and HBsAg-positive ble ’d is the most reasonable and promising approach • The present study also recommends the followin I .hI (1) A large-scale population-based study in wh .ch both HBsAg and anti-HBs are detected using a sensitive t ,chnique like radio-immunoassaY (RrA) is necessary to settle the question of the presumed association between hepati .is Band schistosomiasis • (2) A large-scale cohort-study in which SChist ’somal patients are followed up for the evolution of morbi lity parametres is required to evaluate the relative rol ,played by viral hepatitis • :nalnutrition and gastrointesti al haemo- ,’” - 119 - rrhaqe in the production of decompensated hepatospl. lie schistosomiasis • (3) ~e immunological response of schistosomal lepatosplenic patients to hepatitis B vaccine has to be s1 Jdied to evaluate the protection offered by active immuni~ !tion in these immunoloqically compromised patients • (4) A comparative cost/effectiveness study of 1 Ie ,~’ suggested measures to reduce the incidence of advanc !d liver disease in Egypt is needed to ground the choice bet~ ~en vaccinating hepatosplenic sChistosomal patients agaj 1st hepatitis B or the large scale application of prazic lantel therapy for schistoso~iasis • (5) The risk of post-transfusion hepatitis neec I further studies to elucidate the most effective risk-reducin measures • • |