ROLE OF PRIMARY HEALTH-CARE IN THE CONTROL OF SCHISTOSOMIASIS - THE EXPERIENCE IN RIYADH, SAUDI-ARABIA

The control Programme for schistosmiasis in Saudi Arabia was started i n 1975 as a central vertical programme. With the adoption of the prima ry health care approach a Pilot scheme that integrated the control of all endemic diseases, including schistosomiasis, within the functions of primary health, care centres was carried out. In Riyadh, the scheme was started in 1984 when subcentres for the control programme were es tablished as a first step for complete integration. A training program me was extended to personnel in primary health care centres, including Physicians, nurses, and health inspectors with the help of experts fr om World Health Organization (WHO). A survey of the population at risk in areas with high prevalence was done regularly accompanied by treat ment of cases. Snail control was an important activity of the health i nspectors with a three months repeat of the control procedures. The re sult of this programme is a significant reduction in the prevalence of both urinary and intestinal schistosomiasis, from. 13.2% in 1983 to 0 .17% in 1989. Among the 7453 water sources surveyed in 1989, only 7 we re positive for snails (0.1%). About two thirds of those who were affe cted were expatriates coming from areas of high prevalence of schistos omiasis. Details of the control programme and its impact on the contro l of the disease are presented in this paper.