The aim of the present study was to use an integrated approach for the identification of risk areas for Schistosoma mansoni transmission in an area of low endemicity in Minas Gerais, Brazil. For that, areas of distribution of Biomphalaria glabrata were identified and were related to environmental variables and communities with reported schistosomiasis cases, in order to determine the risk of infection by spatial analyses with predictive models. The research was carried out in the municipality of Alvorada de Minas, with data obtained between the years 2017 and 2019 inclusive. The Google Earth Engine was used to obtain geo-climatic variables (temperature, precipitation, vegetation index and digital elevation model), R software to determine Pearson's correlation and MaxEnt software to obtain an ecological model. ArcGis Software was used to create maps with data spatialization and risk maps, using buffer models (diameters: 500, 1,000 and 1,500 m) and CoKriging. Throughout the municipality, 46 collection points were evaluated. Of these, 14 presented snails of the genus Biomphalaria. Molecular analyses identified the presence of different species of Biomphalaria, including B. glabrata. None of the snails eliminated S. mansoni cercariae. The distribution of B. glabrata was more abundant in areas of natural vegetation (forest and cerrado) and, for spatial analysis (Buffer), the main risk areas were identified especially in the main urban area and toward the northern and eastern extensions of the municipality. The distribution of snails correlated with temperature and precipitation, with the latter being the main variable for the ecological model. In addition, the integration of data from malacological surveys, environmental characterization, fecal contamination, and data from communities with confirmed human cases, revealed areas of potential risk for infection in the northern and eastern regions of the municipality. In the present study, information was integrated on epidemiological aspects, transmission and risk areas for schistosomiasis in a small, rural municipality with low endemicity. Such integrated methods have been proposed as important tools for the creation of schistosomiasis transmission risk maps, serve as an example for other communities and can be used for control actions by local health authorities, e.g., indicate priority sectors for sanitation measures.
Introduction: In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. Methods: E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. Results: MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD 100 as observed under laboratory conditions. Conclusions: MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.
The present work aimed to study ecological aspects related to the distribution pattern of medically important and native freshwater mollusks, found in a rural municipality in the state of Minas Gerais, Brazil. Malacological captures were carried out in aquatic environments (lentic and lotic) from 46 locations between October 2018 and September 2019. The collected specimens were subjected to taxonomic identification and evaluation for infection with trematode larvae. Qualitative data were used to analyze the similarity and the odds ratios between the environmental variables. In total, 1125 specimens were sampled, belonging to the following species: Biomphalaria glabrata, B. tenagophila, B. straminea, B. kuhniana, B. cousini, Biomphalaria sp., and Drepanotrema cimex (Planorbidae), Stenophysa marmorata (Physidae), Omalonyx sp. (Succineidae), Pseudosuccinea columella (Lymnaeidae), and Pomacea sp. (Ampullaridae). Echinostome, strigeocercaria, and xiphidiocercaria types of larval trematodes were detected in S. marmorata and D. cimex. Of note was the similarity in the distribution of S. marmorata, a supposedly endangered species, with that of the medically important Biomphalaria species, with the two sharing environments. This complex scenario led us to reflect on and discuss the need for the control of important intermediate hosts, as well as the conservation of endangered species. This relevant issue has not yet been discussed in detail, in Brazil or in other countries that recommend snail control.
Uma das maiores preocupações da área de saúde pública são causadas pelos parasitos intestinais humanos, que são encontrados em grande parte nos países tropicais. O diagnóstico dessas doenças parasitárias se dá por meio de sintomas fisiológicos e exame fecal. Frequentemente, poucos profissionais estão disponíveis e aptos a realizarem esse tipo de exame, que é considerado lento, difícil, propenso a erros e pode causar fadiga ocular no especialista. Portanto, o objetivo desse trabalho é utilizar redes neurais convolucionais para classificar ovos de parasitos intestinais, sendo um sistema de auxílio a tomada de decisão no diagnóstico de um exame de fezes. Foram realizados experimentos empíricos de modo a definir uma arquitetura da rede específica para cada problema. Os resultados obtidos demonstraram uma taxa de reconhecimento de 99.9%, para todas as métricas avaliadas. A aplicação desenvolvida será parte essencial de um futuro sistema totalmente automatizado.
Objective: To identify priority areas for schistosomiasis control, we analysed the epidemiological characteristics, temporal trends and spatial patterns of schistosomiasisrelated mortality in the state of Minas Gerais from 2000 to 2019. Methods: Ecological and time-series study with spatial analysis techniques on deaths from Schistosomiasis mansoni. A log-linear regression model was used to identify changes in mortality rates. Moran's global index, local indicators of spatial association and a retrospective spatio-temporal permutation model were applied to identify the spatial and temporal distribution of mortality rates and assist in identifying priority areas for interventions. Results: A total of 1290 deaths from schistosomiasis were recorded between 2000 and 2019, with an average mortality rate of 0.33 deaths/100,000. Although the overall mortality rate in the state of Minas Gerais decreased significantly over time (average annual percentage change = À9.6; 95% confidence interval = À14.4 to À4.6; p < 0.001), it increased in the mesoregions of Jequitinhonha, Mucuri Valley, and Rio Doce Valley. Spatial analysis identified the displacement and emergence of high-risk clusters from the central region of the state to the mesoregion of Rio Doce Valley. Conclusion: Temporal changes and shifting of high-risk areas from the central region to the mesoregion of Rio Doce Valley may indicate possible failures in early diagnosis and treatment of the schistosomiasis control program in these areas. Our research contributes to a better understanding of the spatio-temporal dynamics of death rates due to schistosomiasis infections and might help health authorities to direct resources most efficiently to avoid serious clinical outcomes in Minas Gerais.
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