Flávia Silvestre Outtes Wanderley1, Ulisses Montarroyos1, Cristine Bonfim2, Carolina Cunha-Correia3. 1. Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil. 2. Social Research Department, Joaquim Nabuco Foundation, Recife, PE, Brazil. 3. Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil. carolina.cunha@upe.br.
Abstract
BACKGROUND: To assess the effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable endemic areas in northeastern Brazil. METHOD: An ecological study was conducted, in which 118 localities in 30 municipalities in the state of Pernambuco were screened before 2011 and in 2014 (after mass treatment). Information on the endemic baseline index, mass treatment coverage, socio-environmental conditions and social vulnerability index were used in the multiple correspondence analysis. One hundred fourteen thousand nine hundred eighty-seven people in 118 locations were examined. RESULTS: The first two dimensions of the multiple correspondence analysis represented 55.3% of the variability between locations. The human capital component of the social vulnerability index showed an association with the baseline endemicity index. There was a significant reduction in positivity for schistosomes. For two rounds, for every extra 1% of initial endemicity index, the fixed effect of 13.62% increased by 0.0003%, achieving at most 15.94%. CONCLUSIONS: The mass treatment intervention helped to reduce transmission of schistosomiasis in areas of high endemicity. Thus, it can be recommended that application of mass treatment should be accompanied by other control actions, such as basic sanitation, monitoring of intermediate vectors and case surveillance.
BACKGROUND: To assess the effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable endemic areas in northeastern Brazil. METHOD: An ecological study was conducted, in which 118 localities in 30 municipalities in the state of Pernambuco were screened before 2011 and in 2014 (after mass treatment). Information on the endemic baseline index, mass treatment coverage, socio-environmental conditions and social vulnerability index were used in the multiple correspondence analysis. One hundred fourteen thousand nine hundred eighty-seven people in 118 locations were examined. RESULTS: The first two dimensions of the multiple correspondence analysis represented 55.3% of the variability between locations. The human capital component of the social vulnerability index showed an association with the baseline endemicity index. There was a significant reduction in positivity for schistosomes. For two rounds, for every extra 1% of initial endemicity index, the fixed effect of 13.62% increased by 0.0003%, achieving at most 15.94%. CONCLUSIONS: The mass treatment intervention helped to reduce transmission of schistosomiasis in areas of high endemicity. Thus, it can be recommended that application of mass treatment should be accompanied by other control actions, such as basic sanitation, monitoring of intermediate vectors and case surveillance.
Entities:
Keywords:
Mass drug administration; Schistosoma mansoni; Social vulnerability
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