The aim of the present study was to evaluate polymerase chain reaction (PCR) as an alternative tool for diagnosing schistosomiasis in individuals with low-level parasite burden from areas of low endemicity or under occasional risk of infection by Schistosoma mansoni. A total of 102 samples were tested in this study using 2 PCR assays utilizing distinct primer pairs. One of the primer pairs was targeted to a highly repeated 121-base pair sequence of S. mansoni, and the other was targeted to Schistosoma 28S rDNA. The samples were divided into 4 groups according to parasite burden of the individual as follows: 16 individuals with schistosomiasis excreting less than 10 eggs per gram of feces (EPG), 18 individuals excreting higher than 10 EPG, 22 individuals with reactive IgG-ELISA against S. mansoni soluble membrane antigen and negative coproscopy, and 46 controls samples including 25 individuals with other intestinal parasites and 21 individuals with negative parasitologic examination. The results obtained with stool samples from individuals with schistosomiasis showed a high sensitivity for PCR as S. mansoni DNA was detected in 91% (31/34) of the samples analyzed. No amplification was observed in 3 stool samples from individuals excreting below 10 EPG. The specificity of the test for both pairs of primers was 100%. In the group of seropositive individuals, S. mansoni DNA was detected in 59% (13/22) of fecal samples, corroborating the serologic results. Overall, PCR can be an important tool for detecting S. mansoni infection in individuals excreting few eggs in feces. Moreover, the determination of the infection through the detection of S. mansoni DNA in stool samples from seropositive individuals represents a new means of confirming the results of IgG-ELISA for schistosomiasis. Therefore, studies in this direction should be encouraged and extended.

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Small mammals are found naturally infected by Schistosoma mansoni, becoming a confounding factor for control programs of schistosomiasis in endemic areas. The aims of this study were: to investigate the infection rates by S. mansoni on the water-rat Nectomys squamipes during four years in endemic areas of Sumidouro, state of Rio de Janeiro, using mark-recapture technique; to compare two diagnostic methods for schistosomiasis; and to evaluate the effects of the chemotherapy in the human infected population on the rodent infection rates. The rodent infection rates of S. mansoni increased when rodent population sizes were lower. Coprology and serology results presented the same trends along time and were correlated. Serology could detect recent infection, including the false negatives in the coprology. The chemotherapy in the humans could not interrupt the rodent infection. Rodents can increase the schistosomiaisis transmission where it already exists, they probably maintain the transmission cycle in the nature and can be considered as biological indicators of the transmission sites of this parasite since they are highly susceptible to infection. The water-rats may present different levels of importance in the transmission dynamics of S. mansoni infection cycle for each area, and can be considered important wild-reservoirs of this human disease.Key words: diagnostic methods -population ecology -rodents -schistosomiasis Small mammals are found naturally infected by Schistosoma mansoni, becoming a confounding factor for control programs of schistosomiasis in endemic areas (Barbosa et al. 1958, Antunes et al. 1971, Rey 1993. Among the extra-human definitive hosts of this parasite, rodents of the genera Nectomys and Holochilus are the most probable wild reservoirs taking into account: (1) their semiaquatic habits (Ernest & Mares 1986), which make them highly exposed to infection; (2) their wide geographic distribution (Bonvicino 1994) coincident with the distribution of schistosomiasis in Brazil; (3) presence of infected individuals in most of the endemic areas where they were investigated, despite of the low human prevalence -rodents frequently showing higher infection rates in relation to human populations (Rey 1993); (4) rodent tolerance to human presence, occurring near human dwellings. Several experimental studies also support the hypothesis that water-rats are probable wild reservoirs of S. mansoni, showing high susceptibility to infection (Borda 1972, Souza et al. 1992, Maldonado Jr. et al. 1994, Ribeiro et al. 1998, somatic development hypertrophy of adult worms , elimination of viable eggs with high infectivity potential (Picot 1992), high infection persistence , low pathogenicity with efficient peri-ovular modulation and low tissue aggression (Silva & Andrade 1989), and ability to close the transmission cycle in semi-natural conditions (Antunes et al. 1973, Carvalho et al. 1976, Kawazoe & Pinto 1983. Infection of small mammals other than Nectomys and Holochilus by S. mansoni occurs only occasionally, especial...

In low endemicity areas of schistosomiasis, the recommended diagnostic method of coprological examination results in an underestimation of infection cases. Alternative diagnostic methods have been developed, such as immunodiagnostic and molecular techniques. In this study we evaluated three methods used in the diagnosis of Schistosoma mansoni infection: parasitological (Kato-Katz), immunological (ELISA) and molecular (real time PCR), and also investigated the sensitivity of each technique in the cure determination after treatment with praziquantel using the water rat Nectomys squamipes, a natural reservoir for S. mansoni, as an experimental model. Two infection laboratory experiments were carried out. The first experiment aimed to observe the evolution of the immunological response in the first moments after infection and in the first months after treatment. The second experiment aimed to compare the efficacy of the three diagnostic techniques after infection and after treatment over a more extended time period. In the first experiment, 44% of the infected animals showed IgG reactivity after two weeks of infection, and 94% were positive based on serology 30 days after infection. The serological IgG titers increased just after infection but decreased gradually after treatment. In the second experiment, 89% of the animals showed positive IgG titers 22 days after infection. Only 68% of the animals showed positive results on the coproscopic diagnostic analysis and 79% did so by qPCR, 50 days after infection. Treated animals showed negative results on coproscopy one month after treatment but remained positive by serology even 12 months after treatment, although showing a decline in immunologic reaction after treatment. By qPCR analysis, all animals showed negative results three months after treatment, except for one animal. The parasitosis can be detected by coproscopy only six weeks after infection, and by serology 14 days after infection. The qPCR was a better diagnostic method for confirming the infection cure of S. mansoni. In early infection, this method was less efficient than serology but was slightly more efficient than the Kato-Katz method. We suggest that the methods should be used in low endemic areas as follows: serology should be used in the initial diagnosis in a population with potential positive cases; subsequently, coproscopy should be used in IgG positive cases to confirm the current infection; and qPCR should be used to evaluate the infection cure after treatment and is also a very valuable tool when there are cases showing positive IgG and negative coproscopy.

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OBJETIVOS: Investigar a distribuição espacial, a abundância e os índices de infecção natural de Biomphalaria glabrata, hospedeiro intermediário do Schistosoma mansoni, em localidade do Estado do Rio de Janeiro, RJ, Brasil. MÉTODOS: Na localidade de Pamparrão, município de Sumidouro, RJ, as coletas de moluscos foram realizadas bimestralmente no período de junho de 1991 a novembro de 1995. Foram estabelecidos 23 pontos de coleta ao longo do córrego Pamparrão e três de seus afluentes. Os moluscos capturados foram levados ao laboratório para diagnóstico da infecção. Para a análise dos dados, foram usados o coeficiente de Spearman (nível de 0,5% de significância) e o teste de qui-quadrado. RESULTADOS: A abundância populacional de B. glabrata foi bastante variável ao longo do tempo e entre os ambientes amostrados. A maioria dos pontos de coleta apresentou correlação negativa com a pluviosidade. O afluente B destacou-se dos demais corpos d'água por apresentar taxas de infecção de B. glabrata elevadas (acima dos 25% em alguns pontos de coleta) e persistentes. Foram encontrados mais moluscos infectados na estação seca do que na chuvosa (chi²=20,08; p=0,001). CONCLUSÕES: A população de moluscos foi influenciada negativamente pelo regime de chuvas, principalmente no córrego Pamparrão. A época de estiagem também parece ter favorecido a ocorrência de infecção, provavelmente devido ao menor volume de água dos córregos, o que aumentaria as chances de encontro do parasita com seu hospedeiro intermediário.

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Fifteen years after our first investigation, a follow-up study was carried out with the purpose of assessing the evolution of schistosomiasis in the locality of Sabugo, Paracambi, state of Rio de Janeiro, Brazil, an area with low prevalence of the disease. The coprological techniques adopted were spontaneous sedimentation and Kato-Katz. Out of the 1356 individuals assessed, 13 (1%) were infected with Schistosoma mansoni. From those, 10 were males, 12 were over 15 years old, and at least 11 had been infected in Sabugo. All patients presented either the intestinal or the hepato-intestinal form of the disease, and 8 (61.5%) harboured light parasitic loads. In 1990, there were 27 (2.7%) infected individuals; less than half harboured light parasitic loads, with the predominance of moderate and heavy forms. Although our results indicate an improvement in the epidemiological situation of schistosomiasis in Sabugo, transmission of the disease in the locality is still active, especially among young males, and tends to be acquired during leisure activities.