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https://www.arca.fiocruz.br/handle/icict/39489
THE CHANGING PROFILE OF SCHISTOSOMIASIS IN A CHANGING URBAN LANDSCAPE
Genética populacional
Eliminação
Tratamento em toda a comunidade-
Saneamento
Diferenciação
População
Population genetics
Elimination
Community-wide treatment
Sanitation
Differentiation
Effective population size
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Bahiana School of Medicine and Public Health. Salvador, BA, Brazil.
Case Western Reserve University. Department of Pathology. Cleveland, OH, USA.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Regional University of Bahia. Salvador, BA, Brazil.
Regional University of Bahia. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Salvador, BA, Brazil / Yale University. Yale School of Public Health. New Haven, CT, USA.
Case Western Reserve University. Department of Pathology. Cleveland, OH, USA.
Bahiana School of Medicine and Public Health. Salvador, BA, Brazil.
Case Western Reserve University. Department of Pathology. Cleveland, OH, USA.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Municipal Secretariate of Health. Salvador, BA, Brazil.
Regional University of Bahia. Salvador, BA, Brazil.
Regional University of Bahia. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. School of Medicine. Salvador, BA, Brazil / Yale University. Yale School of Public Health. New Haven, CT, USA.
Case Western Reserve University. Department of Pathology. Cleveland, OH, USA.
Abstract
Since 2007, most of humanity resides in urban areas, a trend which continues worldwide. Diseases usually associated with rural contexts are now emerging or newly recognised in cities. In the neighbourhood of São Bartolomeu in Salvador, Brazil, the prevalence of Schistosoma mansoni infection in 2011 was >20%. Following enrollment and treatment of a portion of the community, ~25% of the area underwent urban renewal. In 2015, we returned to enrol individuals who had previously participated and a cohort that had not taken part in 2011. Thus, infected individuals in one group experienced specific drug treatment plus improved living conditions and the second group only improved living conditions. Between 2011 and 2015 there were no organised treatment programs, but adequate sanitation increased from 69% to 92% coverage, household flooding decreased, and the presence of indoor toilets increased to 99% of households. Ownership of household appliances also increased significantly. The overall prevalence of schistosome infections was 6.2%. In 2015, the cohort first seen in 2011 had a higher prevalence (8.7%) than those first seen in 2015 (4.8%) and showed a few demographic differences. The 2011 cohort was older, more likely born in Salvador, less likely to have lived outside of Salvador, spent a greater percentage of their lifetime in Salvador, but more likely to have travelled. The population structure of the parasites from both cohorts underwent a marked change with similar increased component and infrapopulation differentiation and >10 fold decrease in effective population size. There was a 4-5 year shift in age-specific prevalence in 2015 for all compared with 2011. While praziquantel may have helped reduce prevalence, our evidence suggests that the structural changes and improvements in living conditions had the biggest impact on schistosomiasis in this community.
Keywords in Portuguese
UrbanizaçãoGenética populacional
Eliminação
Tratamento em toda a comunidade-
Saneamento
Diferenciação
População
Keywords
UrbanisationPopulation genetics
Elimination
Community-wide treatment
Sanitation
Differentiation
Effective population size
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