Identification of factors and groups at risk of infection with Schistosoma mansoni: a strategy for the implementation of control measures? Identificação de fatores e grupos de risco de infecção com Schistosoma mansoni: uma estratégia para implementação de medidas de controle?

A fourteen year schistosomiasis control program in Peri-Peri (Capim Branco, MG) reduced prevalence from 43.5 to 4.4%; incidence from 19.0 to 2.9%, the geometric mean of the number of eggs from 281 to 87 and the level of the hepatoesplenic form cases from 5.9 to 0.0%. In 1991, three years after the i...

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Bibliographic Details
Published in:Revista do Instituto de Medicina Tropical de São Paulo
Main Authors: Pedro Coura-Filho, Roberto Sena Rocha, Marcio Willian Farah, Grace Carolina da Silva, Naftale Katz
Format: Article in Journal/Newspaper
Language:English
Published: Universidade de São Paulo (USP) 1994
Subjects:
Online Access:https://doi.org/10.1590/S0036-46651994000300009
https://doaj.org/article/51805659004944c98b67382fda036236
Description
Summary:A fourteen year schistosomiasis control program in Peri-Peri (Capim Branco, MG) reduced prevalence from 43.5 to 4.4%; incidence from 19.0 to 2.9%, the geometric mean of the number of eggs from 281 to 87 and the level of the hepatoesplenic form cases from 5.9 to 0.0%. In 1991, three years after the interruption of the program, the prevalence had risen to 19.6%. The district consists of Barbosa (a rural area) and Peri-Peri itself (an urban area). In 1991, the prevalence in the two areas was 28.4% and 16.0% respectively. A multivariate analysis of risk factors for schistosomiasis indicated the domestic agricultural activity with population attributive risk (PAR) of 29.82%, the distance (< 10 m) from home to water source (PAR = 25.93%) and weekly fishing (PAR = 17.21%) as being responsible for infections in the rural area. The recommended control measures for this area are non-manual irrigation and removal of homes to more than ten meters from irrigation ditches. In the urban area, it was observed that swimming at weekly intervals (PAR = 20.71%), daily domestic agricultural activity (PAR = 4.07%) and the absence of drinking water in the home (PAR=4.29%) were responsible for infections. Thus, in the urban area the recommended control measures are the substitution of manual irrigation with an irrigation method that avoids contact with water, the creation of leisure options of the population and the provision of a domestic water supply. The authors call attention to the need for the efficacy of multivariate analysis of risk factors to be evaluated for schistosomiasis prior to its large scale use as a indicator of the control measures to be implemented. Um programa de controle da esquistossomose mansoni em Peri-Peri, (Capim Branco, MG), durante catorze anos reduziu a prevalência de 43,5 para 4,4%; a incidência de 19,0 para 2,9%: a média geométrica do número de ovos de 281 para 87 e o índice da forma hepatoesplênica de 5,9 para 0,0%. Em 1991, após três anos de interrupção do programa, a prevalência subiu para 19,6%. ...