Modelo alternativo para o controle da esquistossomose: estado atual do projeto no Estado do Espírito Santo, Brasil

Abstract

An intervention study for schistosomiasis control is being carried out in the county of Afonso Cláudio, state of Espírito Santo, Brazil, having begun in February 1992. This study is an alternative response to classical control methods. The project is being developed using an interdisciplinary approach and involves both research and service institutions. The organization of health services at the primary care level is part of the project. Participant observation is seen as the methodological point of departure for guiding data collection and analysis and the intervention process in local reality. Control methods are restricted to the medical treatment given to all infected individuals and to improvements in the sanitation facilities available in the area. These methods are obviously integrated with the above-mentioned social actions. Consisting of three phases - pre-control, control (intervention), and final evaluation - the project is now in its intervention phase, lasting approximately three years.

Environmental intervention as a tool for control of schistosomiasis: suggestions from a field study in Northeast Brazil

“…In addition to the present study, past data (Kloetzel & Schuster, 1987;Kloetzel & Vergetti, 1988;Kloetzel et al, 1990) demonstrate that environmental intervention in Northeast Brazil, as well as elsewhere (Barbosa et al, 1993), does not require major engineering projects nor a sophisticated water supply system, and that the bulk of transmission takes place within small, selfcontained and usually temporary collections of water, the answer has to be affirmative.…”

“…We thus are forced to conclude that any reasonable degree of control demands a multidisciplinary approach, based upon chemotherapy plus intervention upon the environment (Barbosa & Coimbra Jr., 1992). Evidence from the five areas hitherto investigated suggest that a selective policy, targeted towards areas at greatest risk will prove sufficiently effective (Kloetzel, 1967;Kloetzel & Schuster, 1987;Kloetzel & Vergetti, 1988;Kloetzel et al, 1990;Barbosa et al, 1993).…”

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

“…As an alternative to this situation, Coura-Filho (1996) suggests a standardization of information to be the subject-matter of special courses, which should include the integral participation of all personnel, aiming at improving one's achievements as a citizen. Using a model set forth by Barbosa et al (1993) in the municipality of Afonso Cláudio, State of Espírito Santo, Brazil, a joint control program was implemented with the local Health Care Office and an active participation of the community. During this study, mass specific treatment and the use of moluscicides were excluded from the program.…”

“…Only on a few occasions the local residents took any part in the works, as demonstrated by Barbosa et al (1971), Barreto & Prata (1969) and Coura-Filho et al (1992). A holistic approach to the problem of individuals, taking into account their symboliccultural universe, their historical instruction, their weltanschauung and their attitude towards health/disease situations was suggested by Barbosa and Coimbra Jr (1992), Barbosa et al (1993), Tognoni (1993) and Valla et al (1993) to implement a practical approach aiming at reducing the local process of disease production. According to this line of argument, from the 1980's to the present time Acioli and Carvalho (1998) observed a dominance of proposals for community participation in programs aimed at controlling endemic diseases.…”

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

“…Em um modelo proposto por Barbosa et al (1993), no Município de Afonso Cláudio, ES, um programa de controle foi desenvolvido juntamente com o serviço de saúde local e com a participação ativa da comunidade. Neste estudo, o tratamento medicamentoso em massa e o uso de moluscicidas foram medidas excluídas do programa.…”