Prevalence of intestinal parasitic infections versus knowledge, attitudes and practices of male residents in Brazilian urban slums: a cross-sectional study.

Intestinal parasitic infections (IPIs) are neglected diseases caused by helminths and protozoa, with the relationships between parasite, host and environment having the potential to produce high morbidity and incapacity to work and mortality in vulnerable areas. This study assessed the prevalence of IPIs concerning socio-environmental conditions and analyzed the knowledge, attitudes and practices related to these diseases among men living in the slums of Rio de Janeiro city, Rio de Janeiro State, Brazil. A cross-sectional study was conducted in an agglomeration of urban slums between 2018 and 2019, with men aged between 20 and 59 years. A socioeconomic status questionnaire and an IPIs knowledge, attitudes and practices questionnaire (KAPQ) were applied. Coproparasitological diagnoses (n=454) were performed using four methods and samples of water for household consumption (n=392) were subjected to microbiological and physicochemical analysis. A total of 624 participants were enrolled. About 40% of the households had "water unsuitable for consumption". Only one Major Area, MA 3 was not statistically significant for IPIs (AOR=0.75; 95% CI: 0.30-1.88; p=0.55). The overall prevalence of IPIs was 23.8%. Endolimax nana (n=65, 14.3%) and hookworm (n=8, 1.7%) were the most frequently identified parasites. The analysis of the frequency of responses to the KAPQ has shown that men reported to seeking medical care if they were suspicious of IPIs, and around 35% would self-medicate. The results have shown the need to adopt integrated health education practices targeting male residents in urban slums to qualify the care with water for human consumption and promote self-care about IPIs. The household can be considered strategic for Primary Health Care activities for men.

Socioenvironmental conditions and intestinal parasitic infections in Brazilian urban slums: a cross-sectional study.

METHODS: A cross-sectional study covering an agglomeration of urban slums was conducted between 2015 and 2016 using participants observation, a socioeconomic survey, and the spontaneous sedimentation method with three slides per sample to analyze fresh stool specimens ( n =595) searching for intestinal parasites. RESULTS: Endolimax nana ( n =95, 16.0%) and Entamoeba coli ( n =65, 10.9%) were the most frequently identified agents, followed by Giardia intestinalis ( n =24, 4.0%) and Ascaris lumbricoides ( n =11, 1.8%). Coinfections caused by E. nana and E. histolytica/dispar and by Entamoeba coli/A. lumbricoides were significant. The use of piped water as drinking water, the presence of A. lumbricoides , and contamination with coliform bacteria and Escherichia coli were more common in major area (MA) 1. Children (0-19 years) had a greater chance of living in poverty (OR 3.36; 95% CI: 2.50- 4.52; p <0.001) which was pervasive. The predominance of protozoa parasites suggests that a one-size-fits-all approach focusing on preventive chemotherapy for soil-transmitted helminths is not appropriate for all communities in developing countries. It is important that both residents and health professionals consider the socioenvironmental conditions of urban slums when assessing intestinal parasitic infections for disease control and health promotion initiatives.

Prevalence of intestinal parasitic infections versus knowledge, attitudes and practices of male residents in Brazilian urban slums: a cross-sectional study

ABSTRACT Intestinal parasitic infections (IPIs) are neglected diseases caused by helminths and protozoa, with the relationships between parasite, host and environment having the potential to produce high morbidity and incapacity to work and mortality in vulnerable areas. This study assessed the prevalence of IPIs concerning socio-environmental conditions and analyzed the knowledge, attitudes and practices related to these diseases among men living in the slums of Rio de Janeiro city, Rio de Janeiro State, Brazil. A cross-sectional study was conducted in an agglomeration of urban slums between 2018 and 2019, with men aged between 20 and 59 years. A socioeconomic status questionnaire and an IPIs knowledge, attitudes and practices questionnaire (KAPQ) were applied. Coproparasitological diagnoses (n=454) were performed using four methods and samples of water for household consumption (n=392) were subjected to microbiological and physicochemical analysis. A total of 624 participants were enrolled. About 40% of the households had "water unsuitable for consumption". Only one Major Area, MA 3 was not statistically significant for IPIs (AOR=0.75; 95% CI: 0.30-1.88; p=0.55). The overall prevalence of IPIs was 23.8%. Endolimax nana (n=65, 14.3%) and hookworm (n=8, 1.7%) were the most frequently identified parasites. The analysis of the frequency of responses to the KAPQ has shown that men reported to seeking medical care if they were suspicious of IPIs, and around 35% would self-medicate. The results have shown the need to adopt integrated health education practices targeting male residents in urban slums to qualify the care with water for human consumption and promote self-care about IPIs. The household can be considered strategic for Primary Health Care activities for men.

Parasitoses intestinais, no âmbito da saúde do homem, na comunidade do Parque Oswaldo Cruz, Manguinhos, Rio de Janeiro

As parasitoses intestinais (PI) são doenças negligenciadas, cuja importância não comporta contestação. Em contraste, as políticas visando o seu enfrentamento não contemplam a abordagem da determinação social da saúde e não estimulam metodologias participativas que assegurem a construção de práticas envolvendo populações negligenciadas, especialmente aquelas no âmbito da Saúde do Homem. Realizar inquérito educacional e parasitológico sobre as PI e seus determinantes na comunidade do Parque Oswaldo Cruz, Manguinhos, Rio de Janeiro, no âmbito da Política Nacional de Atenção Integral à Saúde do Homem (PNAISH). Foi realizado estudo transversal, com observação participante e amostragem não aleatória por conveniência (n=96). O cadastro dos participantes foi realizado mediante o Termo de Consentimento Livre e Esclarecido. Foram aplicados questionários socioeconômico e habitacional (QSH), e sobre conhecimentos, atitudes e práticas (CAP) dos moradores acerca das PI. O diagnóstico coproparasitológico foi realizado pelos métodos de Lutz (1919), Scheather (1923), Baermann & Moraes (1948) e Kato-Katz (1972). Foram realizadas análises colimétrica e microbiológica de amostras de água domiciliar. Os dados foram plotados em planilhas do MS-Access e analisados através do Software Epi-Info 7.2. O QSH revelou que os participantes possuíam nível médio completo (41,7%), renda familiar mensal de 2-4 salários mínimos (52,1%) e ocupação profissional (91,7%). No CAP, relataram que "os alimentos contaminados" são as principais fontes de infecção (28,7%) e como principal medida de prevenção "lavar as mãos" (54,5%), porém 61,2% desconhecem a sintomatologia. A prevalência geral foi 40,7% (33/81) e 54,6% (18/33) destas por infecções monoparasitárias. Os parasitas mais frequentes foram Endolimax nana (57,6% 19/33 p= 0,01) e Ascaris lumbricoides (15,2% 5/34 p= 0,00). Cerca de 20% das amostras de água domiciliar estavam insatisfatórias, conforme os padrões de potabilidade (MS/Portaria 2914/11). Os moradores possuem algum conhecimento sobre o tema, porém não o articulam com as práticas cotidianas, o que possivelmente promove a manutenção da transmissão das PI, cuja prevalência vem sendo subestimada. A dinamização das práticas de educação em saúde articulando saberes popular e acadêmico poderia ser contemplada na PNAISH, contribuindo para a efetividade das Redes Locais de Atenção à Saúde.