Participação popular no controle da esquistossomose através do Sistema Único de Saúde (SUS), em Taquaraçu de Minas, (Minas Gerais, Brasil), entre 1985-1995: construção de um modelo alternativo

Abstract

Foi avaliado o programa de controle da esquistossomose realizado em Taquaraçu de Minas, MG, entre 1985 e 1995. A medida de controle adotada foi a participação popular nas ações de controle: tratamento seletivo, saneamento e educação popular. A equipe de saúde local foi capacitada para gerenciar o programa, conforme proposta do SUS. O fornecimento de água potável foi oferecido a 97% das residências no núcleo do Município. Em 1995, foi realizada análise para identificação dos fatores de risco responsáveis pela manutenção da transmissão da esquistossomose. A prevalência da infecção entre 1985-1995 apresentou-se sete vezes menor, passando de 30,9% para 4,3%, respectivamente. A intensidade de infecção também sofreu significativa redução, passando de 91,2 ± 6,1 para 30,7 ± 2,5 (p = 0,00) no mesmo período. A municipalização desse programa de controle da esquistossomose através do SUS, usando-se um tratamento seletivo, fornecimento de água potável intradomiciliar com participação popular nas medidas de controle, seguido de atendimento da demanda espontânea, apresentou resultados duradouros, apontando a possibilidade de uso deste modelo para outras áreas endêmicas com características semelhantes.

Schistosomiasis mansoni in Bananal (State of São Paulo, Brazil): IV. Study on the public awareness of its risks in the Palha District

“…Their knowledge about cause, prevention and treatment of the infection, the importance of water contacts and socio-economical factors define a specific mode of transmission for distinct strata of individuals (Coura-Filho 1998). The importance of public schooling can not be denied: the better, the easier assimilation of new facts and concepts and practical attitudes compatible with the prophylaxis of an infection such as schistosomosis.…”

“…According to Barbosa (1995) and Coura-Filho (1998) a model for the control of schistosomiasis, or for that matter, any other endemic disease should be based upon a socio-cultural paradigm which could explain the various processes of endemic disease production, as individuals cannot be held responsible for the production of their own diseases.…”

“…Given the vector snails and a frequent contact of people with the contaminated water, another focus is in action. Coura-Filho (1998) emphasizes the existence of a close association of economical environmental and behavioral conditions and the transmission of schistosomiasis. More than 50% of the population of the the Palha District informed to have accasional occupation or underemployment, a situation which is almost always a determinant of substandard socio-economic conditions and considerable barrier to schooling.…”

“…The control of schistosomiasis is one of the most difficult public health tasks, by reason of the distribution of vector snails over large areas of many states of Brazil, the numerous human activities related to agricultural or domestic work, or leisure, the dynamic characteristics of different foci, lack of potable water and restrictions on individual and mass treatment, in addition to a generalized lack of adequade organization of preventive and curative medical services (Coura-Filho 1998).…”

The impact of two education methods on knowledge of schistosomiasis transmission and prevention among schoolchildren in a rural community in northern Minas Gerais, Brazil

“…Reasons for the persistence of schistosomiasis in spite of prolonged and intensive control and prevention efforts include migration patterns and residence, the wide distribution of the intermediate hosts, the dependence of many poor populations in both rural and urban areas on schistosome-infested water sources for their domestic, occupational, and recreational needs, lack of sanitation and potable water, and scarcity of and deficiencies in preventive and curative health services (Coura-Filho 1998, Ximenes et al 2000, WHO 2001, Funasa 2002. Chemotherapy is still the main means of managing morbidity from schistosomiasis.…”