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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060
EISSN: 1678-8060
Vol. 90, No. 2, 1995, pp. 155-159
Bioline Code: oc95033
Full paper language: English
Document type: Research Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 90, No. 2, 1995, pp. 155-159

 en Determination and Control of Schistosomiasis
Frederico Sim es Barbosa

Abstract

The subject of this conference reflects the scientific
community's interest in seeking to understand the complex
causal web whose various social, economic, and biological
components interact in the production and reproduction of
schistosomiasis and its control in relation to community 
participation.

From the onset, the author stresses the impossibility of dealing separately with community participation, as if social components were just one more "weapon" in the arsenal for schistosomiasis control.

This study begins with a brief historical review of the 71 years of control activities with this endemic disease, stressing the enormous efforts and huge expenditures in this field vis-a-vis the limited results, despite the extraordinary technological development of specific, classical control inputs such as new treatment drugs and molluscicides.

The article then discusses the various strategies used in control programs, emphasizing ideological consistencies and contradictions. Interactions at the macro and micro levels are discussed, as are the determinants and risk factors involved in producing the disease's endemicity.

Unequal occupation of space leaves the segregated portion of the population exposed to extremely favorable conditions for transmission of the discase. This raises the issue of how to control an endemic disease which is so closely linked to the way of life imposed on the population. The study challenges the classical control model and suggests an alternative model now undergoing medium-term investigation in the States of Espirito Santo, and Pernambuco, Brazil.

The author concludes that we do not need new strategies, but a new control model, contrary to the prevailing classical model in both concept and practice. From the conceptual point of view, the new model mentioned above is different from others in that schistosomiasis control is seen from a social perspective stressing the population's accumulated knowledge in addition to the building of shared knowledge. The model's praxis has the following characteristics: (1) it is integrated with and financed by research agencies and health services; (2) it operates at the local health services level; (3) use of molluscicides has been eliminated; (4) emphasis is given to individual medical treatment and improvement of sanitary conditions.

Keywords
schistosomiasis control - alternative model for control - Brazil

 
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