Epidemiologia da giardíase e de geohelmintoses como doenças tropicais negligenciadas em três municípios da Zona da Mata Mineira

Abstract

Neglected tropical diseases (NTDs), so classified by the World Health Organization, are a group of infections that have been eliminated in the developed world, but still persist in poor areas of low-income countries. Among them, ascariasis, trichuriasis, and hookworm infection are soil-transmitted helminthiasis. Recently, and despite its worldwide distribution, giardiasis was also included in the WHO list, due to its way of transmission, which can be associated with lack of sanitation. This population-based cross-sectional survey aimed at investigating the occurrence of such infections in three municipalities of southeastern Minas Gerais state. A total of 2,367 individuals randomly chosen provided one single fecal sample. The baseline data consisted of a questionnaire and parasitological coproscopy using the HPJ method. Five slides were examined from each fecal sample, allowing us to conclude that, regarding this method, the examination of three slides per sample presented a satisfactory sensitivity and the best cost-effectiveness for the SUS. The results showed that 6.1% (n=145) of the population sample was infected with either one or two NTDs, of which the prevalences observed for hookworms, G. lamblia, T. trichiura, and A. lumbricoides were 47.3%, 27.3%, 16.0% e 9.3%, respectively. In the bivariate analysis (p<0.05; CI 95%), Pearson Qui-square tests were used to assess the strength of the associations. Multivariate analysis was run with all significant variables. Four variables remained significant in the logistic regression, as the possible risk factors for the installation and spread of the infections in the municipalities: inadequate sewage discharge (p<0.001), the habit of drinking unsafe water (p<0.001), lack of adequate sanitary infrastructure in the household (p=0.015), and masculine sex of the individual (p<0.001). Our findings allow us to conclude that NTDs occur even in more developed areas of Brazil. Our numbers confirm the study area as low endemic for giardiasis and soil-transmitted helminthiasis, and justify surveys in order to get more information on the epidemiological profile of the Zona da Mata Mineira region, aiming at giving support to the development of local health policies.