Morbidade da esquistossomose mansoni no Brasil: III Estudo evolutivo em uma área endêmica no período de dez anos

Abstract

Four cross sectional studies on morbidity of schistosomiasis mansoni were carried out respectively in 1973, 1974, 1979 and 1983 in the Village of Capitão Andrade, District of Itanhomi, State of Minas Gerais, Brazil, through clinical and fecal examination of the population. In addition a comparison was made of the dinamic and infection rate of the snails and the man-water contact between 1973-1974. The present study compares the prevalence of the human infection by S. mansoni and the evolutive pattern of the disease in the area from 1973 to 1983. Besides 190 persons infected with S. mansoni and 134 non-infected, were followed-up during this period. The infection rate was 60.8% among 1,234 persons examined in 1973, decreasing to 36.2% of the 1,269 examined in 1983. However, the intense migration of the population in the area and the specific treatment of 7% of persons by their own decision may be partially responsible for this reduction. Although there was a decrease of more than 50% in the mean egg output of S. mansoni, there was no change in the morbidity of the disease and in the proportion of the different clinical forms. The incidence of S. mansoni infection among 134 persons followed-up during the ten years was 40.3% (annual average of 4%), with 61.9% in males. The incidence of the clinical forms was 51.8% for type I (intestinal form), 38.9% for type II (hepatointestinal) and 9.3% for type III (hepatoesplenic). The clinical evolutive pattern of 190 patients followed-up during the mentioned period showed that 75.3% had no change, 12.1% deteriorated and 12.6% improved. Two thirds of those which improved (8.4%) had received specific treatment.

Specific schistosomiasis treatment as a strategy for disease control

“…Unfortunately, the results from these campaigns could not be properly investigated, although such evaluations would have been extremely important for disease control efforts. In experimental field studies conducted on a smaller scale, Prata (1970, 1974) in Bahia, Katz et al (1977Katz et al ( , 1980 in Minas Gerais (MG) and Coura et al ( , 1984Coura et al ( , 1992, Conceição and Borges-Pereira (2002) and Conceição et al (2007) in other areas of MG have demonstrated the possibility of reducing the rates and intensities of infection among treated individuals who remained in the endemic area. Furthermore, they have shown a reduction in the progression of the disease to severe forms.…”

A thirty years follow-up study on Schistosomiasis mansoni in a community of Minas Gerais, Brazil

“…Table shows Between 1973 and 1983, there was a spontaneous decrease in the prevalence registered in the area without any measures of mass treatment (Coura et al 1984). The reason for this finding may be the improvement of hygiene habits resulted from the development of health education in the region of MG. Amaral et al (2006) and Guimarães et al (2006) have described the impact of the schistosomiasis control program in Brazil, especially in MG.…”

“…Consequently, a longitudinal study of the infection in this population was started in 1984. Despite the limitations of following-up the case due to the marked migratory flow of inhabitants to and out of the area (Coura et al 1984), the evaluation was continued in 1993 (Conceição & Borges-Pereira 2002), and in 2003, accomplishing the 30 years follow-up that is presented in this article.…”

Formas hepatosplênicas da esquistossomose mansônica no interior do Nordeste do Brasil

“…O tratamento específico no controle da morbidade da esquistossomose foi revisto com bastante propriedade e abrangência por vários autores, entre eles, Katz (1980), Coura (1984), Coutinho & Domingues (1991), Gryseels (1992). Este assunto não será discutido no presente trabalho, fazendo-se, entretanto, referências a duas monografias recentemente publicadas (Chen & Mott, 1988;WHO, 1993).…”