In this study, the results obtained in a control programme of schistosomiasis in Ravena (Sabará, Minas Gerais) between 1980 and 1992 are evaluated. Control measures used in this programme were: specific treatment of the people infected with Schistosoma mansoni at four year-intervals (1980/84/88) and the supply of tap water to 90% of the residences in 1980. A significant reduction of the prevalence (36.7% to 11.5%, p < 0.05) and of the intensity of the infection (228.9 eggs per gram of feces (epg), s = 3.7 to 60.3 epg, s = 3.5, p < 0.05) was observed. No cases of the severe form of the disease were diagnosed in the area. Factors independently associated with the infection were in 1980 daily sand extraction and the lack of tap water in residences and in 1992 daily sand extraction and fishing and weekly swimming. Concluding, the supply of tap water together with quadrennial treatments significantly diminished both the prevalence and intensity of the S. mansoni infection, with the additional gain of persistent low indices even after four-year intervals between the treatments.

Neste estudo foram identificados os determinantes biológicos e sociais na transmissão da esquistossomose em Ravena, Sabará, Minas Gerais, Brasil, em 1980, visando a caracterizar o perfil clínico-epidemiológico da endemia na população para posterior avaliação da eficácia do fornecimento de água potável intradomiciliar e o tratamento específico quadrianual dos infectados pelo Schistosoma mansoni. O distrito é formado por três localidades: Ravenópolis, Ravena e Lavapés, cujas prevalências da endemia foram 20,1%; 42,6% e 63,9%, respectivamente. A prevalência da endemia no distrito foi estatisticamente maior nos homens. As faixas etárias que apresentaram diferenças por sexo foram as de 10-14 e 15-19 anos. A intensidade da infecção só foi diferente estatisticamente entre indivíduos com idade entre 10 e 14 anos nas três localidades, e de 15 a 19 anos entre indivíduos de Ravenópolis e Ravena. A forma hepatointestinal estava associada à idade: menores de 15 anos apresentaram risco 8,85 vezes maior do que os adultos. A análise multivariada dos fatores determinantes da transmissão da endemia evidenciou que a localidade de Lavapés esteve independentemente associada à infecção pelo S. mansoni. Era onde estavam ocorrendo os maiores riscos de infecção por falta de saneamento, maior proximidade das casas a córregos infestados por cercárias de S. mansoni, o que facilitava a infeccção das donas-de-casa em atividades domésticas e dos homens na prática de tirar areia. Esses resultados apontam o carater focal da transmissão da endemia, exigindo medidas específicas.

This study identified the role of biological and social determinants in the transmission of schistosomiasis mansoni in Ravena, Minas Gerais, Brazil, in 1980. This data was used to characterize the clinical and epidemiological profiles of the endemic desease in the population, allowing for the determination of the efficacy of the potable water supply and the specific treatment of those infected with S. mansoni. The district contains three locations, Ravenopolis, Ravena and Lavapes, where the prevalence of the endemic disease was, 20.1%, 42.6% and 63.9%, respectively. The prevalence in the district was statistically higher in men. The age brackets that displayed differences by gender were 10-14 and 15-19 years. Severity of infection was statistically different among individuals within the 10-14 year bracket in ali three locations, and in the 15-19 year bracket among individuals from Ravenopolis and Ravena. The hepatointestinal form was associated with age, and individuals under 15 years of age presented risk of infection 8.85 times higher than adults. Multivariable analysis of the factors involved in transmission of the disease showed that Lavapes was independently associated with infection. In that area, poor sanitary conditions and the proximity of houses to streams infested with S. marsoni cercariae facilitated infection of neighborhood women while performing domestic activities, as well as men digging sand from the streams for construction. These results show the focal nature of transmission of the endemic requiring specific intervention for effective control of disease.

Neste estudo foram identificados os determinantes biológicos e sociais na transmissão da esquistossomose em Ravena, Sabará, Minas Gerais, Brasil, em 1980, visando a caracterizar o perfil clínico-epidemiológico da endemia na população para posterior avaliação da eficácia do fornecimento de água potável intradomiciliar e o tratamento específico quadrianual dos infectados pelo Schistosoma mansoni. O distrito é formado por três localidades: Ravenópolis, Ravena e Lavapés, cujas prevalências da endemia foram 20,1%; 42,6% e 63,9%, respectivamente. A prevalência da endemia no distrito foi estatisticamente maior nos homens. As faixas etárias que apresentaram diferenças por sexo foram as de 10-14 e 15-19 anos. A intensidade da infecção só foi diferente estatisticamente entre indivíduos com idade entre 10 e 14 anos nas três localidades, e de 15 a 19 anos entre indivíduos de Ravenópolis e Ravena. A forma hepatointestinal estava associada à idade: menores de 15 anos apresentaram risco 8,85 vezes maior do que os adultos. A análise multivariada dos fatores determinantes da transmissão da endemia evidenciou que a localidade de Lavapés esteve independentemente associada à infecção pelo S. mansoni. Era onde estavam ocorrendo os maiores riscos de infecção por falta de saneamento, maior proximidade das casas a córregos infestados por cercárias de S. mansoni, o que facilitava a infeccção das donas-de-casa em atividades domésticas e dos homens na prática de tirar areia. Esses resultados apontam o carater focal da transmissão da endemia, exigindo medidas específicas.

This study identified the role of biological and social determinants in the transmission of schistosomiasis mansoni in Ravena, Minas Gerais, Brazil, in 1980. This data was used to characterize the clinical and epidemiological profiles of the endemic desease in the population, allowing for the determination of the efficacy of the potable water supply and the specific treatment of those infected with S. mansoni. The district contains three locations, Ravenopolis, Ravena and Lavapes, where the prevalence of the endemic disease was, 20.1%, 42.6% and 63.9%, respectively. The prevalence in the district was statistically higher in men. The age brackets that displayed differences by gender were 10-14 and 15-19 years. Severity of infection was statistically different among individuals within the 10-14 year bracket in ali three locations, and in the 15-19 year bracket among individuals from Ravenopolis and Ravena. The hepatointestinal form was associated with age, and individuals under 15 years of age presented risk of infection 8.85 times higher than adults. Multivariable analysis of the factors involved in transmission of the disease showed that Lavapes was independently associated with infection. In that area, poor sanitary conditions and the proximity of houses to streams infested with S. marsoni cercariae facilitated infection of neighborhood women while performing domestic activities, as well as men digging sand from the streams for construction. These results show the focal nature of transmission of the endemic requiring specific intervention for effective control of disease.