Attempts to Achieve Millennium Development Goals in a Rural Area of Rio de Janeiro: Deworming and Control of Schistosomiasis

Document Type : Original Article

Authors

1 Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

2 Lab. de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil

Abstract

Introduction: According to the World Health Organization (WHO), helminth control could contribute to achieving 7 Millennium Development Goals (MDGs). The present study evaluated the impact of deworming on the infection rate of schistosomiasis in Sumidouro, Brazil and the consequences for the MDGs.
Methods: The whole population of this area was invited to participate in the 2 stages of the study, the baseline from 2002 to 2003 and the follow-up from 2005 to 2006. Within this interval, no improvements to sanitation or access to safe water were undertaken. The statistical investigation was confined to the 164 people who were tested in both surveys. The diagnosis of parasitosis was based on coproscopy by Kato-Katz smears. Infected people were treated with a single oral dose of praziquantel.
Results: The infection rate of schistosomiasis dropped from 28.7% (n=47) to 6.7% (n=11). Among women of childbearing age, this rate decreased was from 27.8% (n=10) to 5.6% (n=2), and among children, it dropped from 14.6% (n=6) to 3.3% (n=1).
Conclusion: As there was no improvement in sanitation, deworming might have led to the reduced transmission of schistosomiasis. The drop in infection rate of schistosomiasis in children and women of childbearing age supports the argument that deworming would allow for the reduction of child mortality and the promotion of gender equality. A better future can also be foreseen, as no girl under 15 years of age was infected.

Keywords


  1. Cumming O. The sanitation imperative: A strategic response to a development crisis. Desalination. 2009;248(1):8-13. doi:10.1016/j.desal.2008.05.031.
  2. Barreto ML, Genser B, Strina A, et al. Effect of city-wide sanitation programme on reduction in rate of childhood diarrhoea in northeast Brazil: assessment by two cohort studies. Lancet. 2007;370(9599):1622-1628. doi:10.1016/s0140-6736(07)61638- 9.
  3. World Health Organization. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: report of a WHO expert committee. WHO Technical Report Series 912. Geneva, Switzerland: WHO; 2002.
  4. Igreja RP, Gusmao MF, Barreto MG, et al. A 15-year follow-up study on schistosomiasis in a low-endemic area in Rio de Janeiro State, Brazil. J Helminthol. 2010;84(3):229-233. doi:10.1017/S0022149X09990575.
  5. World Health Organization. The Millenium Development Goals. The evidence is in: deworming helps meet the Millenium Development Goals. http://whqlibdoc.who.int/hq/2005/WHO_ CDS_CPE_PVC_2005.12.pdf. Published 2005.
  6. Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14(6):397-400.
  7. Siegel S. Estatística Não-paramétrica para as Ciências do Comportamento. 1st ed. São Paulo: McGraw–Hill; 1975.
  8. Ross AG, Bartley PB, Sleigh AC, et al. Schistosomiasis. N Engl J Med. 2002;346(16):1212-1220. doi:10.1056/NEJMra012396.
  9. Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521-1532. doi:10.1016/S0140-6736(07)61638-9.
  10. Thinking beyond deworming. Lancet. 2004;364(9450):1993- 1994. doi:10.1016/S0140-6736(04)17521-1.
  11. Davis A. Schistosomiasis. In: Cook GC, ed. Manson’s Tropical Diseases. 20th ed. London: W B Saunders; 1996:1413-1456.
  12. Raso G, N’Goran EK, Toty A, et al. Efficacy and side effects of praziquantel against Schistosoma mansoni in a community of western Cote d’Ivoire. Trans R Soc Trop Med Hyg. 2004;98(1):18- 27. doi:10.1016/S0035-9203(03)00003-8.
  13. Igreja RP, Matos JA, Goncalves MM, Barreto MM, Peralta JM. Schistosoma mansoni-related morbidity in a low-prevalence area of Brazil: a comparison between egg excretors and seropositive non-excretors. Ann Trop Med Parasitol. 2007;101(7):575-584. doi:10.1179/136485907X229086.
  14. King CH. Toward the elimination of schistosomiasis. N Engl J Med. 2009;360(2):106-109. doi:10.1056/NEJMp0808041