Aspectos epidemiológicos da esquistossomose e coinfecções por enteroparasitas utilizando geoprocessamento

Abstract

Geospatial analysis was used to study the epidemiology of Schistosoma mansoni, intestinal parasites and co-infections in an area (Ilha das Flores) in Sergipe, Brazil. We collected individually georeferenced clinical, socioeconomic, educational, epidemiological and parasitological data from 500 subjects and analyzed them by conventional statistics and produced risk maps by Kernel estimation. The prevalence rates found were: S. mansoni (24.0%), Trichuris trichiura (54.8%), Ascaris lumbricoides (49.2%), Hookworm (17.6%) and Entamoeba histolytica/dispar (7.0%). Only 59/500 (11.8%) individuals did not present any of these infections, whereas 279/500 (55.8%) were simultaneous infected by three or more parasites. We observed associations between S. mansoni infection and various variables such as male gender (p = 0.003), farmer (p <0.001) fisherman (p <0.001), low educational level (p <0.001) low income (p = 0.0005), water contact (p <0.001) and drinking untreated water (p <0.001). We also noted an association between A. lumbricoides infection and low income (p=0.002), between hookworm infection and low income (p = 0.01). A. lumbricoides infection and T. trichiura infection were both correlated with drinking untreated water at the level of p = 0.02, while their correlation with residential open-air sewage was at p = 0.001 and p = 0.0005, respectively. The Kernel estimator maps show that high-risk areas coincide with the poorest regions of the villages as well as with the part of the villages without an adequate sewage system. These findings call for an integrated approach to effectively control multiple parasitic infections.