Factors involved in Schistosoma mansoni infection in rural areas of northeast Brazil.

Two contiguous villages in Tracunhaém county (State of Pernambuco), endemic for schistosomiasis, were studied: Itapinassu (138 inhabitants) and São Joaquim (91 inhabitants). Agriculture predominates in the former region while ceramics is the main activity in the latter. Although no statistical difference was found regarding prevalence, severe infection (> 400 epg) predominated in Itapinassu, probably related to the kind of occupation. No association was found between parasite burden and severity of disease, in spite of the high infection rates for Schistosoma mansoni in both communities (approx. 60%). Typical epidemiological features of schistosomiasis such as age-related prevalences and intensities of infection (high in children, low in adults) were also mutual characteristics. Nutritional status determined through anthropometric evaluation was carried out by measuring specific anthropometric indicators. A deficit of energy intake, as well as vitamin A and riboflavin deficiencies were detected. The prevalence of moderate or severe undernutrition in patients under 18 years old was 21.9% in Itapinassu and 24.1% in São Joaquim. In this group an association was found between prevalence of schistosomiasis and chronic undernutrition. Similarly, for patients over 18 year old the prevalence of undernutrition was higher than 20%. However, in this case no association between nutritional status and either prevalence of schistosomiasis or parasite burden could be detected. The two communities had not been treated for eight years.

PIP: Patterns of schistosomiasis infection were compared in two contiguous endemic villages in Northeast Brazil's Tracunhaem County (Pernambuco State): Itapinassu (138 inhabitants) and Sao Joaquim (91 inhabitants). The overall prevalence of schistosomiasis in Tracunhaem State was 58.7%; this rate was 61.6% in Itapinassu and 54.2% in Sao Joaquim. Severe infection (400 epg) was more prevalent in Itapinassu (35.1%) than Sao Joaquim (13.3%) and ultrasound revealed more severe pathologic changes (e.g., periportal fibrosis, right liver lobe shrinkage, left lobe and spleen enlargement) in the former village. The higher prevalence of severe infection in Itapinassu is likely related to the predominance of agricultural occupations; in Sao Joaquim, most residents are engaged in ceramics. Schistosomiasis prevalence was significantly positively associated with increasing age, male sex, residence in the village for more than 5 years, daily water contact, fishing, laundering, less than a 10 m distance from an infected stream, lack of cesspools, and chronic undernutrition. A deficit of energy intake, as well as vitamin A and riboflavin deficiencies, was detected in both villages. The role of each of these factors (especially nutritional status) will be analyzed further in order to develop an integrated model for local control of the disease.

A regional basic diet from northeast Brazil as a dietary model of experimental malnutrition.

The nutritional potentiality of the "Regional Basic Diet" (RBD) was assessed in albino rats. The diet, which was prepared according to data from food consumption surveys and was similar--in terms of quality and quantity--to those consumed by human populations in Northeast Brazil, was compared to a balanced diet (22% casein). The centesimal composition, aminogram, minerals content, NDpCal% and GCal%/PCal% ratio were determined. Vitamin contents were calculated from data in the literature. The RBD was shown to be imbalanced and poor in certain nutrients, mainly protein (7.8%). The growth curve of the RBD group was severely impaired; the naturally occurring sex-related differences in body weight were not detected. For fetuses and suckling pups, the weights of the liver and diaphragm paralleled body weight; brain weights were about 20% lower than those of controls, and its ratio was higher. RBD pregnant females presented, despite their higher food and energy intakes, lower weight gain as compared to the controls. During lactation food and energy intakes of RBD dams were lower than those of controls. The mortality rate among RBD pups was 24%. Our data indicate that RBD produces in the rat a type of malnutrition similar to that prevalent among children from Northeast Brazil, namely an association to nutritional dwarfism with some clinical signs of marasmus. RBD is considered to be a useful experimental model for studies on human malnutrition in countries where basic food patterns are similar to those in RBD-consuming regions.

Desnutricao recente, cronica e pregressa em quatro localidades do Estado de Pernambuco, Brasil. / Recent, chronic and past malnutrition in 4 districts of the State of Pernambuco, Brazil

Foram estudadas 1.712 criancas menores de 6 anos, residentes nas cidades de Recife (Zona Litoranea), Ferreiros (Zona da Mata),Brejo da Madre de Deus (Zona do Agreste) e Afogados da Ingazeira (Zona do Sertao) - Estado de Pernambuco (Brasil) - com o proposito de comparar a prevalencia da desnutricao proteico-energetica (DPE) nas quatro localidades e contribuir para o mapeamento nosografico da desnutricao do Estado. A situacao nutricional das criancas foi determinada atraves dos criterios de Gomez, Ariza-Macias e Seoane-Lathan modificado. A relacao peso/altura nao discrimina muito bem a situacao de tres das comunidades estudadas. Segundo o criterio de Seoane Lathan modificado, sao comprovadas diferencas significativas na prevalencia de desnutricao dos tres tipos (recente, cronica e pregressa) entre o Recife e as cidades do interior, com excecao da situacao na Zona do Agreste (Brejo da Madre de Deus)