Determination and control of schistosomiasis

Abstract

The subject of this conference reflects the scientific community's interest in seeking to understand the complex causal web whose various social, economic, and biological components interact in the production and reproduction of schistosomiasis and its control in relation to community participation. From the onset, the author stresses the impossibility of dealing separately with community participation, as if social components were just one more "weapon" in the arsenal for schistosomiasis control. This study begins with a brief historical review of the 71 years of control activities with this endemic disease, stressing the enormous efforts and huge expenditures in this field vis-à-vis the limited results, despite the extraordinary technological development of specific, classical control inputs such as new treatment drugs and molluscicides. The article then discusses the various strategies used in control programs, emphasizing ideological consistencies and contradictions. Interactions at the macro and micro levels are discussed, as are the determinants and risk factors involved in producing the disease's endemicity. Unequal occupation of space leaves the segregated portion of the population exposed to extremely favorable conditions for transmission of the disease. This raises the issue of how to control an endemic disease which is so closely linked to the way of life imposed on the population. The study challenges the classical control model and suggests an alternative model now undergoing medium-term investigation in the States of Espirito Santo, and Pernambuco, Brazil. The author concludes that we do not need new strategies, but a new control model, contrary to the prevailing classical model in both concept and practice. From the conceptual point of view, the new model mentioned above is different from others in that schistosomiasis control is seen from a social perspective stressing the population's accumulated knowledge in addition to the building of shared knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)

Epidemiological and control aspects of schistosomiasis in Brazilian endemic areas

“…More recently, Katz (1992, 1998) Coura et al (1992, Bina (1992) Barbosa and Coimbra Jr. (1992), Kloetzel (1992), Barbosa (1995), and Coura (1995) reviewed the epidemiological situation and suggested controlling actions for disease in Brazil, while Hiroshi Kano (1992) and Amaral and Porto (1994) analyzed the controlling actions adopted by National Health Foundation (Fundação Nacional de Saúde -Funasa).…”

Distribuição da esquistossomose no espaço urbano. 2. Aproximação teórica sobre a acumulação, concentração, centralização do capital e a produção de doenças

“…Assim, o desenvolvimento de abordagens, incluíndo-se aspectos das especificidades da dinâmica de transmissão conforme modo de produção econômica e, conseqüentemente, conforme modo de vida dos expostos à infecção pelo S. mansoni (Barbosa, 1995), torna-se uma meta e um duplo desafio, por falta de metodologias de intervenção além do enfoque biológico e por não fazer parte da hegemonia bio-tecnológica já estabelecida no país por interesses médico-institucionais em que o ato médico legitima a medicalização da doença e o papel interventivo do Estado.…”

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

“…However, the prevention of reinfection, the infection of others, and the reduction in the incidence of infection require that attention be given to socioeconomic, cognitive, behavioral, and other factors (Kloos 1995, Barbosa 1998, Uchôa et al 2000, Asaolu & Ofoezie 2003. Health education in conjunction with environmental sanitation and safe water supplies has been described as a potentially effective strategy in schistosomiasis control (Barbosa 1995, Coura 1995, Dias et al 1995, Kloos 1995, Schall 1998, 2002, Funasa 2002.…”

“…However, the prevention of reinfection, the infection of others, and the reduction in the incidence of infection require that attention be given to socioeconomic, cognitive, behavioral, and other factors (Kloos 1995, Barbosa 1998, Uchôa et al 2000, Asaolu & Ofoezie 2003. Health education in conjunction with environmental sanitation and safe water supplies has been described as a potentially effective strategy in schistosomiasis control (Barbosa 1995, Coura 1995, Dias et al 1995, Kloos 1995, Schall 1998, 2002, Funasa 2002.Developing health education programs requires that their design, administration, and outcomes be adapted to different socioeconomic and cultural settings (Kloos 1995, Parker et al 2004. Since the institutionalization of health education in the national disease control programs in Brazil in the early 1920s (Levy et al 2003) theoretical and methodological improvements have been made in the development and operationalization of health education programs.…”