Spatial distribution of Schistosoma mansoni infection before and after chemotherapy with two praziquantel doses in a community of Pernambuco, Brazil

Praziquantel chemotherapy has been the focus of the Schistosomiasis Control Program in Brazil for the past two decades. Nevertheless, information on the impact of selective chemotherapy against Schistosoma mansoni infection under the conditions confronted by the health teams in endemic municipalities remains scarce. This paper compares the spatial pattern of infection before and after treatment with either a 40 mg/kg or 60 mg/kg dose of praziquantel by determining the intensity of spatial cluster among patients at 180 and 360 days after treatment. The spatial-temporal distribution of egg-positive patients was analysed in a Geographic Information System using the kernel smoothing technique. While all patients became egg-negative after 21 days, 17.9% and 30.9% reverted to an egg-positive condition after 180 and 360 days, respectively. Both the prevalence and intensity of infection after treatment were significantly lower in the 60 mg/kg than in the 40 mg/kg treatment group. The higher intensity of the kernel in the 40 mg/kg group compared to the 60 mg/kg group, at both 180 and 360 days, ref lects the higher number of reverted cases in the lower dose group. Auxiliary, preventive measures to control transmission should be integrated with chemotherapy to achieve a more enduring impact

Spatial distribution of Schistosoma mansoni infection before and after chemotherapy with two praziquantel doses in a community of Pernambuco, Brazil

Submitted by Nuzia Santos ([email protected]) on 2012-09-27T18:19:06Z No. of bitstreams: 1 45.2010.pdf: 1608014 bytes, checksum: 3945bce0dad3f73dfa5a3703f1dff122 (MD5)Made available in DSpace on 2012-09-27T18:19:06Z (GMT). No. of bitstreams: 1 45.2010.pdf: 1608014 bytes, checksum: 3945bce0dad3f73dfa5a3703f1dff122 (MD5) Previous issue date: 2010Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Helmintoses e Malacologia Médica Belo Horizonte, MG, Brasil / Santa Casa de Misericórdia de Belo Horizonte. Programa de Pós-Graduação. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz-Fiocruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, BrasilUniversidade Federal de Pernambuco. Departamento de Medicina Clínica, Centro de Ciências da Saúde. Recife, PE, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou- Laboratório de Helmintoses e Malacologia Médica. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisas Aggeu Magalhães. Departamento de Parasitologia. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Ecoepidemiologia e Controle da Esquistossomose e Geohelmintoses. Rio de Janeiro, RJ, Brasil.Praziquantel chemotherapy has been the focus of the Schistosomiasis Control Program in Brazil for the past two decades. Nevertheless, information on the impact of selective chemotherapy against Schistosoma mansoni infection under the conditions confronted by the health teams in endemic municipalities remains scarce. This paper compares the spatial pattern of infection before and after treatment with either a 40 mg/kg or 60 mg/kg dose of praziquantel by determining the intensity of spatial cluster among patients at 180 and 360 days after treatment. The spatial-temporal distribution of egg-positive patients was analysed in a Geographic Information System using the kernel smoothing technique. While all patients became egg-negative after 21 days, 17.9% and 30.9% reverted to an egg-positive condi¬tion after 180 and 360 days, respectively. Both the prevalence and intensity of infection after treatment were signifi-cantly lower in the 60 mg/kg than in the 40 mg/kg treatment group. The higher intensity of the kernel in the 40 mg/kg group compared to the 60 mg/kg group, at both 180 and 360 days, reflects the higher number of reverted cases in the lower dose group. Auxiliary, preventive measures to control transmission should be integrated with chemotherapy to achieve a more enduring impact