Schistosomiasis control program in the state of Minas Gerais in Brazil

The Schistosomiasis Control Program (PCE) was implemented in Minas Gerais (MG) in 1984. In 1999, the state started the investigation and control of schistosomiasis in 470 municipalities. The aim of the present paper is to report the evolution of this Program from 1984-2007. The program included a coproscopic survey carried out in the municipalities of known endemic areas using a quantitative method. Positives were treated with praziquantel and given a program of health education. The information for this study was obtained from data collected and stored by the Health State Department. From 2003-2007, 2,643,564 stool examinations resulted in 141,284 positive tests for Schistosoma mansoni (5.3%). In the first evaluation after treatment, a decrease in the number of municipalities with prevalence over 10% was documented. In one village, selected for a more detailed evaluation, the percentage of positive tests decreased from 14.9% in the baseline survey to 5.3% after treatment. A reference centre for patients with severe schistosomiasis was created in Belo Horizonte, MG. Based on our findings, we believe that the implementation of PCE in MG is on the right path and in due time these new initiatives will provide desirable results

Schistosoma Mansoni: avaliar se a plaquetopenia pode ser marcadora de Esquistossomose Hepatoesplênica em área endêmica do nordeste de Minas Gerais, Brasil

Exportado OPUSMade available in DSpace on 2019-08-14T01:13:10Z (GMT). No. of bitstreams: 1 projeto_top_zio__5_6_2014.pdf: 646785 bytes, checksum: 72b4458f9958ab0a4a94a483aa777ab8 (MD5) Previous issue date: 7Estudos realizados em hospitais brasileiros mostraram que a trombocitopenia poderia ser usada como marcador da forma hepatoesplênica da esquistossomose. O objetivo do presente estudo é o de avaliar se a plaquetopenia poderia identificar os pacientes com a forma hepatoesplênica da esquistossomose em área endêmica do nordeste de Minas Gerais. A população do distrito de Topázio em Teófilo Otoni (MG), composta de 1.543 indivíduos, com prevalência da esquistossomose de 23% foi selecionada para o estudo. Todos tiveram um exame parasitológico de fezes examinado pelo método de Kato-Katz. Quatrocentos indivíduos foram admitidos ao estudo. Assim, 384 responderam o questionário padronizado. Na última semana de julho de 2012, 384 voluntários foram examinados; 13 (3,3%) não completaram os exames e foram excluídos do estudo. Eles responderam a questionário padronizado e submeteram-se a exame clínico e ultrassonográfico do abdômen (US). Coletou-se sangue para a contagem de plaquetas. Os dados foram analisados no pacote estatístico SPSS, 18.0. A esquistossomose hepatoesplênica foi classificada em quatro grupos: (Grupo 1) baço >13cm e fibrose periportal ao US; (Grupo 2) baço palpável e >13cm ao US; (Grupo 3) baço>13cm ao US; e (Grupo 4) baço palpável. Vinte um pacientes tinham a forma hepatoesplênica da esquistossomose por todas as definições (5,5%). Havia 8 pacientes no Grupo 1 (2,1%), 21 no Grupo 2 (5,5%), oito no Grupo 3 (2,1%) e 18 no Grupo 4 (4,7%). Houve diferença significativa entre a média do número de plaquetas entre os hepatoesplênicos e os controles (152.952/mm³ versus 237.275/mm³; p<0,01). Utilizando-se a curva ROC para plaquetas <143.000/mm³ a sensibilidade e a especificidade foram de 92,3% e 75,0% para o Grupo 1; 93,4% e 47,6% para o Grupo 2; 92,4% e 75,0% para o Grupo 3; 93,0% e 44,4% para o Grupo 4,respectivamente. Considerando os nossos achados, concluo que em área endêmica para esquistossomose com prevalência da doença de 23%, as plaquetas no sangue <143.000/mm³ identificam, com boa sensibilidade e especificidade regular, os pacientes com esquistossomose hepatoesplênica. Nos casos de triagem, naturalmente, a escolha deverá valorizar a sensibilidade

IL-10 plays a role in modulation of human granulomatous hypersensitivity against Schistosoma mansoni eggs induced by immune complexes.

It has been demonstrated that the chronic intestinal form of schistosomiasis is associated with the establishment and maintenance of a variety of immunoregulatory mechanisms that lead to a diminished granulomatous reaction to parasite eggs. Using an in vitro model of granuloma reaction we showed that immune complexes (IC) isolated from the sera of chronic intestinal schistosomiasis patients were able to reduce the granulomatous hypersensitivity (developed by peripheral blood mononuclear cells (PBMC) from schistosomiasis patients) to soluble egg antigen (SEA)-conjugated polyacrylamide beads (PB–SEA). This inhibitory activity, mediated by IC, was also observed in the proliferative response of PBMC stimulated with SEA and soluble worm antigen preparation (SWAP). Furthermore, we observed a decrease in TNF-α and an increase in IL-10 production by PBMC treated with IC in an in vitro granuloma reaction. This phenomenon was also seen in a cell proliferation assay when PBMC were treated with IC and stimulated with S. mansoni antigens. These results demonstrate that circulating IC may down-regulate PBMC reactivity to S. mansoni antigens by changing the cytokine pattern produced by these cells

Thrombocytopenia as a surrogate marker of hepatosplenic schistosomiasis in endemic areas for Schistosomiasis mansoni

Introduction This study aimed to evaluate whether a low platelet count is a good surrogate marker of hepatosplenic schistosomiasis (HSS) in a rural area of Brazil. A small district in southeastern Brazil, with a population of 1,543 individuals and a 23% prevalence of schistosomiasis, was selected for this investigation. Methods In July 2012, 384 volunteers were subjected to clinical, ultrasonography (US), and laboratory examinations, including stool sample analysis. The HSS patients were classified into four groups: Group 1 consisted of patients with a spleen >13cm and liver fibrosis; Group 2 consisted of patients with a palpable spleen and spleen>13cm measured by US; Group 3 consisted of patients with a spleen >13cm measured by US; and Group 4 consisted of patients with a palpable spleen. Results Eight patients were in Group 1 (2.1%), twenty-one were in Group 2 (5.5%), eight were in Group 3 (2.1%), and eighteen were in Group 4 (4.7%). A significant difference in the mean platelet counts was observed between the patients with and without HSS (p<0.01). Based on the receiver operating characteristic (ROC) curve (platelet count <143,000/mm3), the sensitivity was greater than 92% in all groups, and the specificity varied from 44.4% to 75%. Conclusions We concluded that in endemic areas, thrombocytopenia demonstrates good sensitivity for detecting HSS and may be used as a screening tool to identify patients with HSS