Socioeconomic determinants of schistosomiasis in a poor rural area in Brazil.

The objective of this paper is to identify and quantify socioeconomic determinants of Schistosoma mansoni infection in the rural area of Virgem das Graças in Minas Gerais State of Brazil. A cross-sectional study was carried out to examine the prevalence and intensity of schistosomiasis in relation to socioeconomic characteristics of the households. Log-binomial regression analysis was used to examine the data on both the household and individual levels, analyzing the prevalence ratios for the association of schistosomiasis and socioeconomic variables related to the head of the household. Multiple comparisons through mixed effect modeling were used to examine the relationship between intensity of infection (geometric mean egg counts) and different levels of socioeconomic variables, respectively. In the univariate analysis, place of residence, number of persons per room, and lack of motorized transport were associated with schistosomiasis at the household level and age and unsafe water contact at the individual level. Age, unsafe water contact, number of persons per room, household possessions and lack of education of head of household remained significant predictors of schistosomiasis in the multivariable analysis. Only age was significantly associated with intensity of infection of individuals. It is concluded that widespread poverty, the rural environment, and weak socioeconomic differentiation that result in intense contact with infective water appear to minimize the protective effect of piped water supply and other socioeconomic parameters on schistosomiasis found in other studies. The potential role of socioeconomic development in conjunction with schistosomiasis control is described and areas for further studies are identified.