Interactions between malnutrition, soil-transmitted helminthiasis and poverty among children living in periurban communities in Maranhao State, Northeastern Brazil.

Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.

Triatomine dispersion rates and their association with socioeconomic and environmental conditions in Northeastern Brazil, from 2009 to 2013.

Triatomines are vectors of Trypanosoma cruzi , the etiological agent of Chagas disease, which affects between 6 and 12 million people in Latin America, with an incidence rate of 12 thousand cases per year. In the Ceara State, the predominance of the caatinga biome, coupled with a large rural area with precarious human habitations, provides several s shelters for these insects. In this study, we determined the spatiotemporal distribution of triatomine dispersion rates in the Cariri region, Southern Ceara and ascertained the possible association between these rates with socioeconomic and environmental factors. Dispersion rates (number of positive localities/number of searched localities × 100) were analyzed regarding 13 municipalities from the Ceara State, from 2009 to 2013. Socioeconomic and environmental variables collected from national research institutes were associated with the dispersion rates and their local empirical Bayesian estimates. All the municipalities recorded dispersion rates over 10% in all years, and 11 municipalities had average rates over 40% for the period of study. Significant differences were observed among the municipality means. The highest rates were observed in Antonina do Norte and Potengi. According to the correlation analysis, the proportion between the occupied population and the total population showed a significant negative correlation, as well as the percentage of the population who lives under adequate sanitary conditions. Both, the percentage of revenues from external sources and the percentage of urban households in reforested blocks had a significant positive correlation. Our results show that socioeconomic and environmental variables can be factors that contribute to both, the maintenance and the reduction of the elevated dispersion rates observed in the study area. Similar researches that encompass more municipalities from that region may reinforce Chagas disease surveillance and control in the Northeast of Brazil.