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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. 257-260
Bioline Code: oc95051
Full paper language: English
Document type: Research Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 90, No. 2, 1995, pp. 257-260

 en Control of Schistosomiasis in Brazil: Perspectives and Proposals
Jose Rodrigues Coura

Abstract

Attempts to control schistosomiasis have hitherto involved
the use of one or more of the following methods, either in isolation 
or in combination: (1) control of the intermediate host using 
molluscicides or biological methods; (2) basic sanitation and clean 
water supply; (3) health education; (4) individual or mass treatment; (5)
protection of individuals in such a way as to prevent cercariae from 
penetrating the skin; (6) vaccine-based strategies against 
schistosomiasis.

None of these methods is capable, on its own, of bringing about effective control of schistosomiasis, except in populations of a very limited size or under very special conditions. Molluscicides, besides expensive and toxic, have only a temporary effect. As for biological control, there is no effective method yet. Basic sanitation and clean water supply combined with health education potentially constitute the most effective approach, but only in the mid-to-long term. Mass treatment reduces morbidity, but does not control transmission. Protection of individuals has proved to be impraticable on a large scale. Vaccine-based strategies against schistosomiasis are still in the experimental stage.

Experiments carried out in Brazil in the last 20 years have shown that mass treatment with single doses of oxamniquine or praziquantel can rapidly reduce levels of Shistosoma mansoni infection and morbidity in endemic areas. They have also shown that subsequent transmission and reinfection frequently occur in defined foci or "clusters", due to human contact with water, and in inverse proportion to the number and frequency of treatments carried out. On the basis of these experiments, the author suggests a multidisciplinary strategy for schistosomiasis control.

Keywords
schistosomiasis control - multidisciplinary strategy

 
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