Perspectivas de controle da esquistossomose mansoni com especial referência ao tratamento em massa

Epidemiological and control aspects of schistosomiasis in Brazilian endemic areas

“…Finally, we confirm the conclusions and recommendations of Coura and Camillo-Coura (1980) and Amaral and Porto (1994), as for the perspectives of schistosomiasis control in Brazil: (a) no method is able, in an isolated way, to control schistosomiasis and every control program should consider the need of multidisciplinary application of existing methods; (b) the main methods for long term control of infection are the implementation of basic sanitation conditions, potable water supply, as well as sanitary education and community participation; (c) specific treatment in endemic areas associated to intermediary hosts control in "epidemiological important" foci is extremely relevant regarding short term morbidity control, though not sufficient to interrupt disease transmission; (d) although schistosomiasis control, in a country like Brazil, with great vectors dissemination and population mobilization, is a difficult process, it is possible through intensification, adjustment, and continuity of programs in long term; (e) it is necessary to develop a critical analysis of schistosomiasis control experience in Brazil, in order to redirect the program in an effective way, aiming to achieve only residual levels of infection for the next 20 or 30 years or, even better, its full control.…”

“…During the decades of 50 and 60, many pioneering works were developed by Pessoa et al (1953Pessoa et al ( , 1955Pessoa et al ( , 1957 in Brazilian Northeast, Brener and Mourão (1956), Rodrigues da Silva (1957), Klotzel (1962Klotzel ( , 1963 Katz and Brener (1966), Barbosa (1966Barbosa ( , 1968, Prata and Schroeder (1967), and Prata and Bina (1968), about morbidity and disease evolution, in areas of Minas Gerais, Alagoas, Pernambuco, and Bahia and many others cited by Coura et al (1980Coura et al ( -1992, which resume epidemiological, laboratorial and clinical studies about the disease until that time.…”

“…These drugs proved to be particularly effective in controlling morbidity by reducing parasite load and reinfection rates, when repeatedly used at endemic areas (Coura et al 1980, Katz et al 1980, Coura 1986). However, all of them show a reinfection trend and an increase of parasite load after a time, when there is therapeutic interruption, being more intense in children than in adults, indicating that therapy alone is not able to interrupt transmission.…”

Specific schistosomiasis treatment as a strategy for disease control

“…On the other hand, the hepatosplenic form, which was 5.8% in 1973 when the prevalence was 60.8%, went down to 1.3% in 2003. We conclude that treatment alone reduces the prevalence of infection and the morbidity due to schistosomiasis, but does not control its transmission (Coura & Camillo-Coura 1980, Coura 1995. Such transmission control is only possible through integrated measures over the short, medium and long terms; while this would seem to be an obvious protocol to implement, it has never been put into continuous practice in Brazil.…”

A comparative cross-sectional study on the prevalence and morbidity of schistosomiasis in a community in northeastern Brazil (1979-2010)

“… Coura and Camillo-Coura (1980) and Coura et al ( 1983 , 1984 , 1987 , 1992 ) conducted studies on the morbidity, evolution and control of schistosomiasis in areas of MG, SE and PB. Following the master’s degree dissertations and PhD thesis of Conceição ( 1976 , 1985 ) in Capitão Andrade, MG, and of Mendonça (1982) in Alhan- dra, PB, several studies were conducted by Conceição and Borges-Pereira (2002) , Conceição et al (2007) and Conceição and Coura (2012) on the prevalence of morbidity, evolution and the response to specific treatment of schistosomiasis in rural areas in MG.…”