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      Mass treatment for intestinal helminthisis control in an Amazonian endemic area in Brazil Translated title: Tratamento em massa para controle das helmintíases intestinais em área endêmica na Amazônia Brasileira

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          Abstract

          The objective of the present study was to estimate the prevalence of soil-transmitted helminthiasis and evaluate the sanitary conditions and the role of a mass treatment campaign for control of these infections in Santa Isabel do Rio Negro. A cross-sectional survey was carried out in 2002, to obtain data related to the sanitary conditions of the population and fecal samples for parasitological examination in 308 individuals, followed by a mass treatment with albendazole or mebendazole with coverage of 83% of the city population in 2003. A new survey was carried out in 2004, involving 214 individuals, for comparison of the prevalences of intestinal parasitosis before and after the mass treatment. The prevalences of ascariasis, trichuriasis and hookworm infection were 48%; 27% and 21% respectively in 2002. There was a significant decrease for the frequency of infections by Ascaris lumbricoides (p < 0.05; OR / 95% CI = 0.44 / 0.30 - 0.65), Trichuris trichiura (p < 0.05; OR / 95% CI = 0.37 / 0.22 - 0.62), hookworm (p < 0.05; OR / 95% CI = 0.03 / 0.01 - 0.15) and helminth poliparasitism (p < 0.05; OR / 95% CI = 0.16 / 0.08 - 0.32). It was also noticed a decrease of prevalence of infection by Entamoeba histolytica / dispar (p < 0.05; OR / 95% CI = 0.30 / 0.19 - 0.49) and non-pathogenic amoebas. It was inferred that a mass treatment can contribute to the control of soil-transmitted helminthiasis as a practicable short-dated measure. However, governmental plans for public health, education and urban infrastructure are essential for the sustained reduction of prevalences of those infections.

          Translated abstract

          O presente trabalho objetivou avaliar a prevalência e o papel de um tratamento em massa das helmintíases intestinais em Santa Isabel do Rio Negro, Estado do Amazonas, Brasil. Foi realizado em 2002 um estudo seccional, incluindo inquérito copro-parasitológico, objetivando a obtenção das prevalências das parasitoses intestinais e dados sobre as condições sanitárias do local, estudando-se uma amostra de 308 indivíduos. Em 2003 foi realizada intervenção para tratamento em massa das helmintíases intestinais com administração de albendazol (ou mebendazol para crianças entre 12 e 24 meses) na sede do município, alcançando-se 83% de cobertura. Novo inquérito copro-parasitológico foi realizado em 2004, para comparação das prevalências antes a após o tratamento. As prevalências das infecções por Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos foram 48%, 27% e 21%, respectivamente em 2002. Em 2004 observou-se redução significativa das infecções por Ascaris lumbricoides (p < 0,05; OR / 95% IC = 0,44 / 0,30 - 0,65), Trichuris trichiura (p < 0,05; OR / 95% IC = 0,37 / 0,22 - 0,62), ancilostomídeos (p < 0,05; OR / 95% IC = 0,03 / 0,01 - 0,15) e poliparasitismo por helmintos intestinais (p < 0,05; OR / 95% IC = 0,16 / 0,08 - 0,32). Foi também observada redução da prevalência de infecção por Entamoeba histolytica/dispar (p < 0,05; OR / 95% CI = 0,30 / 0,19 - 0,49). Concluiu-se que o tratamento em massa pode auxiliar o controle das helmintíases intestinais, porém ações governamentais em infraestrutura urbana e educação são essenciais para uma redução sustentada das prevalências destas infecções.

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          The global burden of intestinal nematode infections--fifty years on.

          M S Chan (1997)
          Fifty years after Stoll published his 'This Wormy World' article, the global prevalence of infections with intestinal nematodes remains virtually unchanged. The main species involved are Ascaris lumbricoides, Trichuris trichiura and hookworms, and there are now approximately one billion infections with each of these, worldwide. Given these large numbers, Man-Suen Chan here focuses on attempting to quantify the disease burden caused by these infections, using a recently formulated method of calculating disability-adjusted life years (DALYs). Using a mathematical model, it is estimated that approximately 70% of this burden can be prevented in high-prevalence communities by treating schoolchildren alone. Programmes targeted at schoolchildren have been shown to be extremely cost-effective, and hence this provides a realistic approach for combating these infections in the future.
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            Soil-transmitted helminth infections: updating the global picture

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              Mode of action of benzimidazoles.

              Benzimidazoles represent the only class of truly broad-spectrum anthelmintics, however, they also show activity against fungi and mammalian cells. This raises the question as to why benzimidazoles can selectively kill helminths and yet exhibit little or no mammalian toxicity. In this paper, Ernest Lacey examines this example of selectivity of drug action to the ubiquitous target of these drugs, the structural protein, tubulin.
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                Author and article information

                Journal
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Rev. Inst. Med. trop. S. Paulo
                Instituto de Medicina Tropical (São Paulo, SP, Brazil )
                1678-9946
                August 2006
                : 48
                : 4
                : 189-195
                Affiliations
                [04] RJ orgnameUniversidade do Estado do Rio de Janeiro orgdiv1FCM Brasil
                [02] RJ orgnameFiocruz orgdiv1IOC Brasil
                [03] RJ orgnameUniversidade Federal Fluminense orgdiv1Departamento de Patologia Brasil
                [01] RJ orgnameFiocruz orgdiv1IOC orgdiv2Departamento de Medicina Tropical Brasil
                Article
                S0036-46652006000400003 S0036-4665(06)04800403
                10.1590/S0036-46652006000400003
                083c9344-4ed3-40b9-bff6-118cd5e63018

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 04 November 2005
                : 13 April 2006
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 7
                Product

                SciELO Brazil

                Categories
                Parasitology

                Parasitology
                Amazon,Intestinal helminthiasis,Control,Mass Treatment
                Parasitology
                Amazon, Intestinal helminthiasis, Control, Mass Treatment

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