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Factors Associated with Schistosoma mansoni Infestation in Northeast Brazil: A Need to Revisit Individual and Community Risk Factors

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  • 1 Institute of Tropical Medicine of Rio Grande do Norte, Natal, Brazil;
  • 2 Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil;
  • 3 Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil;
  • 4 Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, Brazil;
  • 5 Departament of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil;
  • 6 Institute of Science and Technology of Tropical Diseases, INCT-DT, Salvador, Brazil

ABSTRACT

In Brazil, schistosomiasis continues to be an important health issue. The aim of this study was to identify factors associated with Schistosoma mansoni infestation. A cross-sectional study was performed to assess factors associated with S. mansoni endemicity in a municipality in Northeast Brazil with a history of reporting schistosomiasis. Participants were divided into four groups: 1) new S. mansoni cases (n = 44), 2) past history of S. mansoni treatment (n = 78), 3) immediate neighbors (n = 158), and 4) nearby controls (n = 35). Multiple comparisons analysis was performed. Subjects had a mean of 6.6 ± 3.9 years of education, and no difference was observed regarding family income (one-way analysis of variance, P = 0.215). A total of 95.9% of the individuals had rudimentary cesspit as sanitary wastewater. The mean body mass index was 28.3 ± 5.1, with 41.0% and 24.1% overweight and obesity, respectively. Of note, 28.9% of adults had hypertension. Hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin were higher in the recent S. mansoni treated group (Wilks’ lambda, P < 0.001). Male gender was more prevalent in new S. mansoni cases (likelihood ratio, P < 0.001), close proximity to water collections was a risk for S. mansoni infestation (likelihood ratio, P < 0.001), and a better hematological status was observed in individuals recently treated with praziquantel. This study indicates the need to maintain surveillance for S. mansoni in low-transmission areas and the need to establish community-based interventions to control transmission.

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Author Notes

Address correspondence to Selma M. B. Jerônimo, Institute of Tropical Medicine of Rio Grande do Norte, Av Senador Salgado Filho 3000, Lagoa Nova, Natal 59078900, Brazil. E-mail: smbj@cb.ufrn.br

Financial support: This study was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil (Finance Code 001) and CNPq (440893/2016-0).

Authors’ addresses: Danielle V. F. Bezerra, Institute of Tropical Medicine of Rio Grande do Norte, Brazil and Postgraduate in Health Sciences of Federal University of Rio Grande do Norte, Natal, Brazil, E-mail: danielleviviannefb@gmail.com. José W. Queiroz, Institute of Tropical Medicine of Rio Grande do Norte, Natal, Brazil, E-mail: jwq.wil@gmail.com. Victor A. V. Câmara, Institute of Tropical Medicine of Rio Grande do Norte, Natal, Brazil, E-mail: victorcamara.rn@gmail.com. Bruna L. L. Maciel, Nutrition Department of Federal University of Rio Grande do Norte, Natal, Brazil, E-mail: brunalimamaciel@gmail.com. Eliana L. T. Nascimento, Institute of Tropical Medicine of Rio Grande do Norte and Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, Brazil, E-mail: eltomaz@gmail.com. Selma M. B. Jerônimo, Institute of Tropical Medicine of Rio Grande do Norte, Natal, Brazil, Postgraduate in Health Sciences of Federal University of Rio Grande do Norte, Natal, Brazil, Departament of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil, and Institute of Science and Technology of Tropical Diseases, INCT-DT, Salvador, Brazil, E-mail: smbj@cb.ufrn.br.

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