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Gomes ECDS, da Silva IEP, de Araújo HDA, Barbosa CS. Malacological, socio-environmental evaluation, and evidence of local transmission and maintenance of schistosomiasis in an urban area of Northeast Brazil. Acta Trop 2024; 252:107145. [PMID: 38336344 DOI: 10.1016/j.actatropica.2024.107145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/27/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
To present the current epidemiological scenario of schistosomiasis related to urban transmission through an epidemiological risk assessment in Porto de Galinhas, a coastal area of Pernambuco, Brazil. Malacological and parasitological surveys were performed between the years 2018 and 2020. Snails were identified taxonomically and examined to confirm infection by Schistosoma mansoni, and so to identify Schistosomiasis Transmission Foci (STF) by the artificial light exposure technique. Stool samples were examined using the Kato-Katz method to identify schistosomiasis cases. Socioeconomic, environmental, behavioural and health data were collected by a questionnaire applied to participates in the survey and used to predict the schistosomiasis risk occurrence by multivariate logistic regression. In all, a total of 6466 snails of Biomphalaria glabrata were collected and 36 breeding sites were identified, of which 25 % were STF. A total of 2236 individuals took part of the survey which identified 187 cases of schistosomiasis, registering a positivity percentage of 8.36 %. The surveys identified the neighbourhoods with the highest risk for transmission while the socioenvironmental analysis identifies other risk factors for disease occurrence, such as gender, age range, level of education and absence of water drainage. We found that areas with poor sanitation, flooding during winter periods and dwellings located near mangroves should be treated by health authorities as priority areas for health interventions to minimize disease transmission. In addition, efforts to improve the population's educational level could certainly contribute to the adoption of measures to prevent and control this neglected tropical disease.
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Affiliation(s)
- Elainne Christine de Souza Gomes
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil.
| | - Iris Edna Pereira da Silva
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil
| | - Hallysson Douglas Andrade de Araújo
- Health Department of Ipojuca County (PE) - Brazil, Rua Cel. João Souza Leão, CEP: 55.590-000, Ipojuca, PE, Brazil; Biotechnology and Drugs Laboratory and Biomaterials Technology Laboratory - Academic Center of Vitória de Santo Antão, Federal University of Pernambuco, Rua Alto do Reservatório, s/n - Bela Vista, CEP: 55.608-680, Vitória de Santo Antão, PE, Brazil; Keizo Asami Institute (iLIKA), Federal University of Pernambuco, Cidade Universitária, Av. Prof. Moraes Rego, 1235 CEP: 50670-901, Recife, PE, Brazil
| | - Constança Simões Barbosa
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil
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Menezes CA, Montresor LC, Jangola STG, de Mattos AC, Domingues ALC, Júnior AM, Silva CCM, Barbosa CS, de Mendonça CLF, Massara CL, Fonseca CT, de Oliveira EJ, Gomes ECDS, da Silva EF, Bezerra FSDM, Silva-Jr FP, de Siqueira IC, Silva JRME, Heller L, Farias LP, Beck LCNH, Santos MCS, Lima MG, Mourão MDM, Enk MJ, Fernandez MA, Katz N, Carvalho ODS, Parreiras PM, Neves RH, Gava SG, de Oliveira SA, Thiengo SC, Favre TC, Graeff-Teixeira C, Pieri OS, Caldeira RL, da Silva-Pereira RA, Rocha RS, Oliveira RR. FioSchisto's expert perspective on implementing WHO guidelines for schistosomiasis control and transmission elimination in Brazil. Front Immunol 2023; 14:1268998. [PMID: 38143743 PMCID: PMC10739458 DOI: 10.3389/fimmu.2023.1268998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
The World Health Organization (WHO) recognizes schistosomiasis as one of the Neglected Tropical Diseases targeted for global elimination in the 2030 Agenda of the Sustainable Development Goals. In Brazil, schistosomiasis mansoni is considered a public health problem, particularly prevalent among vulnerable populations living in areas with poor environmental and sanitary conditions. In 2022, the WHO published a Guideline encompassing recommendations to assist national programs in endemic countries in achieving morbidity control, eliminating schistosomiasis as a public health problem, and advancing towards interrupting transmission. The perspectives presented here, collectively prepared by members of the Oswaldo Cruz Foundation's (Fiocruz) Schistosomiasis Translational Program (FioSchisto), along with invited experts, examine the feasibility of the WHO recommendations for the Brazilian settings, providing appropriate recommendations for public health policies applicable to the epidemiological reality of Brazil, and suggests future research to address relevant issues. In Brazil, the provision of safe water and sanitation should be the key action to achieve schistosomiasis elimination goals. The agencies involved in measures implementation should act together with the Primary Care teams for planning, executing, monitoring, and evaluating actions in priority municipalities based on their epidemiological indicators. Host snails control should prioritize judicious ecological interventions at breeding sites. The Information, Education, and Communication (IEC) strategy should be associated with water and sanitation and other control actions, actively involving school community. To identify infected carriers, FioSchisto recommends a two-stage approach of immunological and molecular tests to verify transmission interruption during the intervention and beyond. Praziquantel administration should be done under medical supervision at the Primary Care level. MDA should be considered in exceptional settings, as a measure of initial attack strategy in locations presenting high endemicity, always integrated with water and sanitation, IEC, and snail control. To assist decision-making, as well as the monitoring and evaluation of strategic actions, there is a need for an Information System. FioSchisto considers this systematization essential to make investments in strategic research to support the improvement of schistosomiasis control actions. Efforts toward schistosomiasis elimination in Brazil will succeed with a paradigm shift from the vertical prescriptive framework to a community-centered approach involving intersectoral and interdisciplinary collaboration.
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Affiliation(s)
| | | | | | | | - Ana Lúcia Coutinho Domingues
- Centro de Ciências da Saúde, Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Leo Heller
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, Brazil
| | | | | | | | - Mariana Gomes Lima
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, Brazil
| | | | | | | | - Naftale Katz
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, Brazil
| | | | | | - Renata Heisler Neves
- Faculdade de Ciências Médicas, Universidade Estatual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Grossi Gava
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, Brazil
| | | | | | | | - Carlos Graeff-Teixeira
- Centro de Ciências da Saúde, Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | | | | | - Roberto Sena Rocha
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, Brazil
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Rodrigues ML, da Luz TPSR, Pereira CLD, Batista AD, Domingues ALC, Silva RO, Lopes EP. Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models. World J Hepatol 2022; 14:719-728. [PMID: 35646266 PMCID: PMC9099102 DOI: 10.4254/wjh.v14.i4.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/20/2021] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The evaluation of periportal fibrosis (PPF) is essential for a prognostic assessment of patients with Schistosomiasis mansoni. The WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography, 1H-nuclear magnetic resonance (NMR)-based metabonomics has been employed to assess liver fibrosis in some diseases. AIM To build 1H-NMR-based metabonomics models (MM) to discriminate mild from significant periportal PPF and identify differences in the metabolite profiles. METHODS A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern Brazil. We evaluated 41 serum samples from 10 patients with mild PPF (C Niamey pattern) and 31 patients with significant PPF (D/E/F Niamey patterns). MM were built using partial least squares-discriminant analysis (PLS-DA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA) formalisms. RESULTS PLS-DA and OPLS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model, respectively. The OPLS-DA model presented accuracy, sensitivity, and specificity values of 92.7%, 90.3%, and 100% to discriminate significant PPF. The metabolites identified as responsible by discrimination were: N-acetylglucosamines, alanine, glycolaldehyde, carbohydrates, and valine. CONCLUSION MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.
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Affiliation(s)
- Milena Lima Rodrigues
- Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | | | - Caroline Louise Diniz Pereira
- Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Andrea Dória Batista
- Hospital das Clínicas, Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Ana Lúcia Coutinho Domingues
- Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
- Hospital das Clínicas, Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Ricardo Oliveira Silva
- Programa de Pós-Graduação em Química, Centro de Ciências Exatas e da Natureza, Universidade Federal de Pernambuco, Recife 50670-740, Pernambuco, Brazil
| | - Edmundo Pessoa Lopes
- Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
- Hospital das Clínicas, Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil.
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Persistence of Schistosomiasis-Related Morbidity in Northeast Brazil: An Integrated Spatio-Temporal Analysis. Trop Med Infect Dis 2021; 6:tropicalmed6040193. [PMID: 34842851 PMCID: PMC8628971 DOI: 10.3390/tropicalmed6040193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: To analyze the temporal trend and spatial patterns of schistosomiasis-related morbidity in Northeast Brazil, 2001–2017. Methods: Ecological study, of time series and spatial analysis, based on case notifications and hospital admission data, as provided by the Ministry of Health. Results: Of a total of 15,574,392 parasitological stool examinations, 941,961 (6.0%) were positive, mainly on the coastline of Pernambuco, Alagoas and Sergipe states. There was a reduction from 7.4% (2002) to 3.9% (2017) of positive samples and in the temporal trend of the detection rate (APC—11.6*; Confidence Interval 95%—13.9 to −9.1). There was a total of 5879 hospital admissions, with 40.4% in Pernambuco state. The hospitalization rate reduced from 0.82 (2001) to 0.02 (2017) per 100,000 inhabitants. Conclusion: Despite the reduction in case detection and hospitalizations, the persistence of focal areas of the disease in coastal areas is recognized. This reduction may indicate a possible positive impact of control on epidemiological patterns, but also operational issues related to access to healthcare and the development of surveillance and control actions in the Unified Health System.
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Wanderley FSO, Montarroyos U, Bonfim C, Cunha-Correia C. Effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable areas of a state in northeastern Brazil, 2011-2014. ACTA ACUST UNITED AC 2021; 79:30. [PMID: 33750474 PMCID: PMC7941929 DOI: 10.1186/s13690-021-00549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022]
Abstract
Background To assess the effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable endemic areas in northeastern Brazil. Method An ecological study was conducted, in which 118 localities in 30 municipalities in the state of Pernambuco were screened before 2011 and in 2014 (after mass treatment). Information on the endemic baseline index, mass treatment coverage, socio-environmental conditions and social vulnerability index were used in the multiple correspondence analysis. One hundred fourteen thousand nine hundred eighty-seven people in 118 locations were examined. Results The first two dimensions of the multiple correspondence analysis represented 55.3% of the variability between locations. The human capital component of the social vulnerability index showed an association with the baseline endemicity index. There was a significant reduction in positivity for schistosomes. For two rounds, for every extra 1% of initial endemicity index, the fixed effect of 13.62% increased by 0.0003%, achieving at most 15.94%. Conclusions The mass treatment intervention helped to reduce transmission of schistosomiasis in areas of high endemicity. Thus, it can be recommended that application of mass treatment should be accompanied by other control actions, such as basic sanitation, monitoring of intermediate vectors and case surveillance. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00549-9.
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Affiliation(s)
- Flávia Silvestre Outtes Wanderley
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil
| | - Ulisses Montarroyos
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil
| | - Cristine Bonfim
- Social Research Department, Joaquim Nabuco Foundation, Recife, PE, Brazil
| | - Carolina Cunha-Correia
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil.
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