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The borough of Ocholo, on the western side of the Ethiopian Rift Valley, is an endemic focus for Leishmania aethiopica infection and has been surveyed thrice between 1987 and 1990. In 1989, 3022 inhabitants (> 95% of the population) were interviewed and examined. The overall prevalence of localized cutaneous leishmaniasis (LCL) was 3.6-4.0%, with a peak value of 8.5% in the 0-10 years old age group. In half of the patients the active disease was estimated to last for 9.6 +/- 6 months; in 10%, it exceeded 3 years. Scars of LCL were present in 34.3% of the residents. Leishmanin skin tests were positive in 54% of 120 school-children without signs of the disease. Therefore, in Ocholo a minimum of 71.6% of the population has been exposed to L. aethiopica infection. Two cases of the diffuse form of cutaneous leishmaniasis were observed. In this highland biotope, Phlebotomus pedifer was found to be the major, and possibly the only, vector for L. aethiopica.

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The endod (Phytolacca dodecandra)-based schistosomiasis mansoni control project was implemented in Ethiopia between 1994 and 1999. The aim was to develop an effective, cheap and sustainable method of controlling schistosomiasis. First, different formulations of the Ethiopian endod strain 44 (E-44) were compared for potency in the laboratory. Secondly, spray and drip-feeding methods were compared for simplicity and effectiveness in the field. Lastly, the efficacy of endod powder soap was compared with the endod spray method. In Bati stream, endod powder soap was distributed to the residents every weekend at laundry sites. In Worke stream, endod was sprayed along a 1-km stretch of the stream at 3-month intervals. No endod was applied in Harbu stream. The immediate and long-term effects of endod application on the snail population and schistosomal infection were determined. Using the spray method, 100% snail mortality could be obtained, and it was simpler and more effective than the drip-feeding method. Snail mortality ranged from 20 to 100% using endod soap. There was a progressive decline in the snail population and infection in Bati stream compared with Worke stream, mainly due to sustained use of endod soap. The advantages and disadvantages of the different endod delivery systems are discussed.

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