Intervention to prevent intestinal parasitic reinfections among Tarahumara indigenous schoolchildren in northern Mexico Intervención para prevenir las reinfecciones parasitarias intestinales en niños indígenas tarahumara en edad escolar en el norte de México

• Main Authors: Joel Monárrez-Espino, Cristina Rocío Pérez-Espejo, Guillermo Vázquez-Mendoza, Andrés Balleza-Carreón, Ramiro Caballero-Hoyos
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2011
• Subjects: Enfermedades parasitarias; ascariasis; giardiasis; población indígena; salud indígena; estudios de intervención; saneamiento de escuelas; México; Parasitic diseases; indigenous population; indigenous health; intervention studies; school sanitation; Mexico; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/d1923372d45c4dbcaee9361c855643ea

OBJECTIVE: To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico. METHODS: A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical infrastructure: intervention school (IS), modern; control school (CS), deprived. After initial diagnosis, children with positive stool samples received supervised treatment with oral nitazoxanide. Diagnoses were made with at least one positive microscopic result from two serial samples using the Faust technique, as reported by the independent observations of two trained, laboratory technicians. Post-treatment samples were taken, and only those with negative results were followed-up. The intervention included infrastructure improvements/maintenance and an educational preventive program for children, parents, and school personnel; no activities were undertaken in the CS. RESULTS: Baseline prevalence for AL was 37.5% at the IS versus 16.6% at the CS (P < 0.01); and for GL, 51.7% versus 37.8%, respectively. At the IS, 35.7% did not speak Spanish, compared to 6.7% in the CS (P < 0.01). Cure rates were similar in both schools for AL (~ 98%) and GL (~ 80%). Final prevalence and reinfection rates for GL were 10.4% versus 10.8%, and 17.2% versus 21% at the IS and CS, respectively. No children were infected/reinfected with AL in either school. Follow-up rates were 80%-83% at the CS and 90%-95% at the IS. CONCLUSIONS: Infection/reinfection rates were similar at the schools after 20 weeks. Supervised treatment alone every semester could effectively control AL/GL infections in this indigenous setting. OBJETIVO: Evaluar la eficacia de una intervención amplia de 20 semanas de duración para prevenir la reinfección por Ascaris lumbricoides y Giardia lamblia en niños indígenas en edad escolar del norte de México. MÉTODOS: Estudio prospectivo, de comparación y ...