RESUMO O tamanduá-bandeira (Myrmecophaga tridactyla) está classificado como vulnerável quanto ao risco de extinção. O objetivo deste trabalho é reportar a ocorrência de ancilostomíase em um macho jovem da espécie. Trata-se de um indivíduo que foi criado desde filhote em cativeiro, com manejo direcionado para a reabilitação e a soltura branda. Durante o monitoramento, cinco meses após a soltura, observou-se que o animal havia perdido peso, por isso ele foi capturado para avaliação médica veterinária, e constatou-se parasitismo por Ancylostoma sp. no exame coproparasitológico. Apesar de apresentar ocorrência comum em carnívoros domésticos, este é o primeiro relato de ancilostomíase em tamanduá-bandeira em vida livre. Devido ao estresse de adaptação, juntamente com os desafios do novo ambiente, a monitoração pós-soltura a longo prazo é de extrema importância para aumentar a chance de sobrevivência dos animais. O indivíduo foi solto após tratamento com vermifugação com a associação de fembendazol, pamoato de pirantel e praziquantel. tamanduábandeira tamanduá bandeira Myrmecophaga tridactyla extinção espécie Tratase Trata se cativeiro branda monitoramento observouse observou peso veterinária constatouse constatou sp coproparasitológico domésticos livre adaptação ambiente póssoltura pós animais fembendazol praziquantel

ABSTRACT The giant anteater (Myrmecophaga tridactyla) is classified as vulnerable to extinction. Here, we report the occurrence of ancylostomiasis in a young male Myrmecophaga tridactyla. The animal was raised from a puppy in captivity with management directed toward rehabilitation and monitored soft release. Five months after release, significant weight loss was noted in the individual, who was captured for examinations, with detection of Ancylostoma sp. in coproparasitological analysis. Although common in domestic carnivores, this is the first report of hookworm disease in free-ranging giant anteaters. Due to the stress factor arising from adapting to the challenges in the new environment, long-term post-release monitoring of animals undergoing rehabilitation is extremely important to increase the chance of survival of individuals. The giant anteater was released after treatment with vermifuge composed of fenbendazole, pyrantel pamoate, and praziquantel. tridactyla extinction Here release individual examinations sp analysis carnivores freeranging free ranging anteaters environment longterm long term postrelease post individuals fenbendazole pamoate praziquantel

Resumo O parasitismo intestinal é a principal causa de doença em todo o mundo e descrito como um importante problema de saúde comunitária. O presente estudo buscou descobrir a ocorrência e identificação de fatores de risco relacionados a infecções parasitárias intestinais (IPIs) entre crianças em idade escolar de 4 a 12 anos residentes no distrito de Lower Dir, Paquistão durante 2019-2020. Um estudo transversal baseado em escola foi realizado usando uma pesquisa preestabelecida e pré-testada. Dados antropométricos e coleta de fezes foram feitos para obtenção dos achados. A preparação de montagem úmida direta em solução salina/iodo/métodos foi usada para exame de fezes. Os dados foram investigados usando o GraphPad Prism 5. Em um total de 400 crianças estudadas (idade média de 8,6±3,6 anos), a taxa de incidência total da parasitose intestinal foi estabelecida em 71,75%. Das 400 crianças estudadas, a taxa de prevalência global de infecções parasitárias intestinais foi de 71,75%. Ascaris lumbricoides (33,1%), Trichuris trichiura (1,04%), E. vermicularis (1,39%), Ancilostomíase (19,86%) foram identificados em crianças morando na área de estudo. Concluímos que há necessidade de campanhas em massa para gerar alerta sobre saúde e saneamento nas crianças, e a necessidade do desenvolvimento de programas efetivos de controle da pobreza, pois a desparasitação por si só não é adequada para controlar as infecções parasitárias.

Abstract Intestinal parasitism is the main cause of disease all over the world and described as a significant community health problem. The current study intended to find out the occurrence and identification of hazard factors linked with IPIs among 4-12 years aged shool-age children residing in Lower Dir district, Pakistan during 2019 - 2020. A cross-sectional school-based study was conducted using a pre-arranged pre-tested survey. Anthropometric data and stool collection were done to obtain the findings. The direct wet mount preparation in saline/iodine/methods was used for stool examination. Data were investigated using the GraphPad Prism 5. A total of 400 children studied (mean age of 8.6±3.6 years) the total incidence rate for the intestinal parasitic disease was established to be 71.75%. Of the 400 children studied, the overall prevalence rate for intestinal parasitic infections was found to 71.75% Ascaris lumbricoides (33.1%), Trichuris trichiura (1.04%), E. vermicularis (1.39%), Hookworm (19.86%) were identified in children living in the study area. We concluded that there is a mass scale campaigns were required to generate alertness about health and sanitation in children and the need for the development of effective poverty control programs because deworming (killing of worm with drugs) alone is not adequate to control parasitic infections.

Resumen Este artículo analiza las prácticas de tratamiento de la campaña contra la anemia tropical en Colombia, que fue llevada a cabo a través de un acuerdo de cooperación entre la Junta Internacional de Salud (IHB) de la Fundación Rockefeller y el gobierno colombiano entre 1920 y 1934. Particularmente, se analizan los procesos que llevaron a cambios en los métodos de tratamiento y las variaciones en las dosis de vermífugos y purgantes, que en muchos casos desencadenaron en intoxicaciones y muertes en la población campesina de la región cafetera, principal foco de la campaña. La revisión de fuentes documentales, locales e internacionales, sobre la campaña para combatir la anemia tropical en Colombia durante el periodo 1920 y 1934 permitió reflexionar y comprender cómo tales prácticas de tratamiento hicieron parte de un proceso de medicalización experimental en terreno sobre la población, donde las directrices tiempo y costo guiaron, en gran parte, las decisiones sobre qué método y qué tratamiento seguir.

Abstract This article analyses the treatment practices of the campaign against hookworm disease in Colombia, which was carried out through a cooperation agreement between the International Health Board (IHB) of the Rockefeller Foundation and the Colombian government between 1920 and 1934. Particularly, the processes that led to changes in treatment methods are analysed, as well as the variations in the doses of vermifuges and laxatives, that in many cases caused poisoning and deaths in the farmer population of the coffee region, which was the focal point of the campaign. The review of documentary sources, both local and international, on the campaign to fight hookworm disease in Colombia during the period 1920 and 1934, allowed for a reflection and understanding of how such treatment practices were part of an in situ experimental medicalisation process on the population, where the guidelines of time and cost directed, to a great extent, the decisions on what method and what treatment to follow.

Résumé Cet article revient sur les pratiques de traitement de la campagne contre l'anémie tropicale en Colombie menée suite à un accord de coopération entre le Conseil International de Santé (IHB) de la Fondation Rockefeller et le gouvernement colombien entre 1920 et 1934. On analyse particulièrement les processus ayant induit des changements sur les méthodes de traitement et les variations dans les doses de vermifuges et des purgatifs, ce qui a souvent produit des intoxications et même des décès chez la population paysanne de la région productrice du café, lieu par excellence où la campagne a été mise en œuvre. L'étude des sources documentaires relatives à cette campagne, aussi bien locales qu'internationales, permet de comprendre comment des telles pratiques de traitement ont fait partie d'un processus de médicalisation expérimentale sur la population, processus guidé par les critères de temps et de coût qui, à leur tour, déterminaient quel méthode ou quel traitement adopter.

Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).

Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation’s efforts to control hookworm disease (1909-c.1930), the World Health Organization’s pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).

Introducción. El Salvador no cuenta con datos actualizados de prevalencia en menores de 15 años de la infección por helmintos transmitidos por contacto con el suelo. Además, al ser uno de los países en las Américas que reporta un número bajo de casos de malaria, se considera que su eliminación allí es factible. Objetivo. Determinar la prevalencia y la intensidad de la infección por geohelmintos y la prevalencia de Plasmodium spp. en escolares de 8 a 10 años de El Salvador. Materiales y métodos. Se hizo un estudio de corte transversal en las cinco zonas eco-epidemiológicas del país (planicie costera, depresión central, cadena volcánica, cadena costera y zona montañosa). La presencia de geohelmintiasis se estudió en 1.325 estudiantes y, la de malaria, en 152. Se utilizó la técnica de Kato-Katz para la detección de geohelmintos, y para el diagnóstico de la malaria, una prueba rápida, el estudio mediante microscopía y la prueba de reacción en cadena de la polimerasa. Resultados. La prevalencia total de geohelmintiasis fue de 7,9 % (IC 95% 6,6-9,5). En la planicie costera fue de 14,9 % (IC 95% 10,9-19,7); en la depresión central, de 9,4 % (IC 95% 6,5-13,3); en la cadena volcánica, de 6,6 % (IC 95% 4,2-10,5); en la cadena costera, de 5,9 % (IC 95% 3,8-9,4), y en la cadena montañosa, de 2,6 % (IC 95% 1,4-5,7). La proporción de infección de gran intensidad debida a cualquiera de las especies de geohelmintos fue de 0,3 %. No se encontraron escolares infectados con Plasmodium spp. Conclusión. La prevalencia de geohelmintos fue baja y la especie más prevalente fue Trichuris trichiura . La intensidad de la infección debida a cualquiera de las especies de geohelmintos fue leve (<1 %). Los factores de riesgo asociados a la infección por geohelmintos fueron la defecación al aire libre, no usar calzado y vivir en la planicie costera.

Introduction: El Salvador does not have recent data on the prevalence of infection with soil-transmitted helminths among children aged under 15 years of age. As one of the countries in the Americas that reports few malaria cases, eradication of this disease from El Salvador is considered to be feasible. Objective: To determine the prevalence and intensity of infection by soil-transmitted helminths, as well as the prevalence of Plasmodium spp. in schoolchildren aged 8-10. Materials and methods: A cross-sectional study was carried out in each of the five eco-epidemiological zones of the country (coastal plain, central basin, volcanic range, coastal range and mountain zone). In all 1,325 students we studied the presence of geohelminthiasis, with 152 of them also being tested for malaria. The Kato-Katz technique was used to detect geohelminths while diagnosis of malaria was performed using the rapid diagnostic test, microscopy and polymerase chain reaction. Results: The overall prevalence of geohelminthiasis was 7.9% (95%CI 6.6-9.5%). Values for the five eco-epidemiological zones were as follows: coastal plain, 14.9% (95%CI 10.9-19.7%); central plateau, 9.4% (95%CI 6.5-13.3%); volcanic range, 6.6% (95%CI 4.2-10.5%); coastal range, 5.9% (95%CI 3.8-9.4%), and mountain zone, 2.6% (95%CI 1.4-5.7%). The overall rate of high intensity infection with any of the geohelminth species was 0.3%. No schoolchildren were found infected with Plasmodium spp. by any of the three diagnostic techniques used. Conclusion: Prevalence of geohelminths was low and Trichuris trichiura was the predominant species. Intensity of infection with any of the species of geohelminths was light (<1%). The risk factors associated with infection by soil-transmitted helminths were defecation in the open air, being barefoot and living in coastal areas.

Conforme las poblaciones humanas se expanden hacia los hábitats silvestres con sus mascotas y ganado, el potencial de transmisión de enfermedades hacia los animales silvestres -y viceversa- aumenta, y hace necesario identificar interacciones zoonóticas potenciales. Los cánidos domésticos y silvestres pueden funcionar como reservorios o diseminadores de enfermedades infecciosas (se incluyen parásitos), por lo que el coyote (Canis latrans) puede también servir como indicador de la salud ecológica. Asimismo, se estudiaron los parásitos de 209 muestras de heces de coyotes en una zona mixta de área silvestre protegida y campo agrícola del Parque Nacional Volcán Irazú (PNVI) en Costa Rica. La recolección fue realizada mensualmente durante un año en tres sub-áreas denominadas: Irazú (la más cercana al volcán), papales (por el cultivo de papas), y Prusia (un sector del PNVI). Entonces, se empleó examen directo y concentración mecánica, se obtuvo 36.84% de muestras positivas por al menos un helminto. La presencia de parásitos fue muy similar para ambos sectores boscosos del PNVI (33.3% en Prusia y 37.4% en Irazú), pero contrastó con el 63.63% observado en los papales. También, se identificaron uncinarias (probablemente Ancylostoma caninum), estrongilidios (posiblemente Strongyloides sp.), Toxocara canis, Trichuris sp. y Taenia pisiformis, así como Hymenolepis diminuta, probablemente un parásito espurio proveniente de roedores ingeridos por los coyotes. Se comenta la importancia de estos primeros hallazgos y se concluye que las estaciones seca y lluviosa influyen en la presencia de los parásitos.

As human populations expand into wild habitats with their pets and livestock, the potential spread of disease to wildlife or vice versa increases. Because, wild and domestic canids may pose as reservoirs or disseminators of infectious diseases (including parasites), coyotes (Canis latrans) may also serve as indicators of ecological health. In Costa Rica, little information exists on coyote parasites, making research necessary to identify potential zoonotic interactions. For this reason, a survey of the coyote parasites was performed in a mixed area of protected woodland and agricultural land, surrounding Irazu Volcano National Park (IVNP) in Cartago, Costa Rica. Over a one-year period, 209 fecal samples were collected directly from the ground. Collection took place on a monthly basis in a trail sectioned into three sub-areas named Irazú (closest to the volcano), potato fields (where potatoes were cultivated), and Prusia (a protected sector of IVNP). Sectioning the trail allowed separate collection and analysis of the samples, where 99 were obtained from Irazú, 11 from potato fields and 99 from Prusia. Using direct examination and mechanical concentration 36.84% positive samples containing at least one helminth were found. The presence of parasites was similar for both woodland areas (33.3% in Prusia and 37.4% in Irazú), but differed from the 63.6% observed in the potato fields. Hookworm parasites (probably Ancylostoma caninum), threadworms (possibly Strongyloides sp.), Toxocara canis, Trichuris sp. and Taenia pisiformis were identified, as well as Hymenolepis diminuta, possible spurious parasite resulting from the ingestion of rodents by coyotes. Seasonal details are discussed, concluding that wet and dry seasons affect presence of parasites. Some remarks are made on the importance of these first findings for Costa Rica, especially considering the systematic way in which the collection of samples was carried out. Rev. Biol. Trop. 60 (2): 799-808. Epub 2012 June 01.

INTRODUÇÃO: A esquistossomose é endêmica no Brasil, com elevada prevalência no Estado de Sergipe, apesar da existência do Programa de Controle da Esquistossomose (PCE). MÉTODOS: Foi realizado levantamento de dados do PCE-Sergipe de 2005 a 2008. A partir da matriz bruta formulou-se planilha de dados no software Access e analisou-se frequência e distribuição geográfica das infecções por Schistosoma mansoni e outros enteroparasitos. Estes dados foram exportados para o software Spring 5.0.5 para georreferenciamento e confecção de mapas temáticos de distribuição espacial e temporal por ano de avaliação. RESULTADOS: Foram positivos para S. mansoni 13,6% (14471/106287) de exames nos anos de 2005, 11,2% (16196/145069) em 2006, 11,8% (10220/86824) em 2007 e 10,6% (8329/78859) em 2008. A análise de mapas mostrou elevada prevalência da doença em Sergipe, em particular nos municípios Ilha das Flores, Santa Rosa de Lima, Santa Luzia do Itanhi e São Cristóvão. Além disso, avaliamos a associação entre as frequências dessas doenças parasitárias com indicadores sociais e de desenvolvimento dos diferentes municípios, de acordo com os dados do Instituto Brasileiro de Geografia e Estatística (IBGE) e da Superintendência de Recursos Hídricos (SRH). Observamos que os municípios com prevalência da esquistossomose maior do que 15% têm menor concentração de rede de esgotos (índice de higiene); p = 0,05. Adicionalmente, os municípios com prevalência de infecção por ancilostomídeos maior do que 10% apresentam um menor IDH educacional; p = 0,04. CONCLUSÕES: Ressalta-se a importância de maior controle dos fatores de risco ambientais e educacionais, na tentativa de reduzir prevalências dessas doenças parasitárias.

INTRODUCTION: Schistosomiasis is endemic in Brazil, with high prevalence in the State of Sergipe, despite the existence of the Schistosomiasis Control Program (PCE). METHODS: The data from Sergipe's PCE between 2005 and 2008 were surveyed. From the raw information, a database was created on a spreadsheet using the Access software. The frequency and geographic distribution of infections due to Schistosoma mansoni and other intestinal parasites were analyzed. These data were exported to the Spring 5.0.5 software for georeferencing and preparation of thematic maps of the spatial and temporal distribution according to year of evaluation. RESULTS: In 2005, 13.6% (14,471/106,287) of the tests were positive for S. mansoni, 11.2% (16,196/145,069) in 2006, 11.8% (10,220/86,824) in 2007 and 10.6% (8,329/78,859) in 2008. Analysis on the maps showed that there was high prevalence of the disease in Sergipe, and particularly in the municipalities of Ilha das Flores, Santa Rosa de Lima, Santa Luzia do Itanhi and São Cristóvão. Furthermore, we evaluated the association between the frequencies of these parasitic diseases and social and developmental indicators in the different municipalities, according to data from the Brazilian Institute for Geography and Statistics (IBGE) and the Department of Water Resources (SRH). We found that municipalities with schistosomiasis prevalence higher than 15% had lower coverage of sewage systems (hygiene index) (p = 0.05). Additionally, municipalities with hookworm prevalence higher than 10% had lower educational HDI (p = 0.04). CONCLUSIONS: The importance of greater control over environmental risk and educational factors needs to be emphasized in attempts to reduce the prevalence of these parasitic diseases.

The article discusses medical research and public health programs on hookworm disease in Costa Rica in the late nineteenth and early twentieth centuries. Between 1908 and 1914 Costa Rican hookworm specialists proposed that hookworm disease ("cansancio" in popular parlance) was a generalized problem throughout the rural sectors, and not particular to any region or racial group. This allowed them to give their authochthonous hookworm campaign a national scope and to introduce the rural popular sectors to notions of bacteriology and hygiene. The Costa Rican experience with hookworm disease pre-dated the Rockefeller Foundation's better known global hookworm eradication program, and led to the reorientation of the Rockefeller mission when it set up in Costa Rica in 1914 to a broader public health agenda built around programs of school hygiene.

El artículo analiza la investigación médica y los programas de salud pública sobre la anquilostomiasis en Costa Rica a finales del siglo XIX y principios del XX. Entre 1908 y 1914, los especialistas costarricenses dedicados al estudio de la anquilostomiasis propusieron que la enfermedad, conocida popularmente como "cansancio", era un problema generalizado en toda la población rural y no particular de algún grupo racial o regional. Esto les permitió dar a su programa autóctono de anquilostomiasis una extensión nacional e introducir en todos los sectores populares ideas sobre bacteriología e higiene. La experiencia costarricense se anticipó al mejor conocido programa global de la Fundación Rockefeller para la erradicación de la anquilostomiasis y condujo a reorientar a la misión Rockefeller establecida en Costa Rica en 1914 a trabajar una agenda de salud pública más amplia en los programas de higiene escolar.

The article discusses medical research and public health programs on hookworm disease in Costa Rica in the late nineteenth and early twentieth centuries. Between 1908 and 1914 Costa Rican hookworm specialists proposed that hookworm disease ("cansancio" in popular parlance) was a generalized problem throughout the rural sectors, and not particular to any region or racial group. This allowed them to give their authochthonous hookworm campaign a national scope and to introduce the rural popular sectors to notions of bacteriology and hygiene. The Costa Rican experience with hookworm disease pre-dated the Rockefeller Foundation's better known global hookworm eradication program, and led to the reorientation of the Rockefeller mission when it set up in Costa Rica in 1914 to a broader public health agenda built around programs of school hygiene.

El artículo analiza la investigación médica y los programas de salud pública sobre la anquilostomiasis en Costa Rica a finales del siglo XIX y principios del XX. Entre 1908 y 1914, los especialistas costarricenses dedicados al estudio de la anquilostomiasis propusieron que la enfermedad, conocida popularmente como "cansancio", era un problema generalizado en toda la población rural y no particular de algún grupo racial o regional. Esto les permitió dar a su programa autóctono de anquilostomiasis una extensión nacional e introducir en todos los sectores populares ideas sobre bacteriología e higiene. La experiencia costarricense se anticipó al mejor conocido programa global de la Fundación Rockefeller para la erradicación de la anquilostomiasis y condujo a reorientar a la misión Rockefeller establecida en Costa Rica en 1914 a trabajar una agenda de salud pública más amplia en los programas de higiene escolar.

Os primeiros programas da International Health Commission - IHC - da Fundação Rockefeller eram projetos-piloto para o tratamento da ancilostomíase nas colônias britânicas do Caribe: Guiana e Trinidad e Tobago. Esses programas pioneiros na saúde pública internacional foram com freqüência descritos como guiados por rígidos princípios biomédicos. Sem contestar o fato de que pretendiam tornar inteligível a biomedicina no âmbito de sistemas médicos de populações vassalas, este artigo observa em que medida as exigências de tais programas de saúde pública se combinavam com os conhecimentos dos quadros locais da IHC, de origem indo-caribenha, de modo a gerar experiências fascinantes em tradução etno-médica. Um texto em particular, "The Demon that Turned Into Worms" [O demônio que se transformou em vermes], tem a intenção de mostrar como essas tentativas de tradução podem ter legitimado e promovido o pluralismo médico.

The earliest programs of the Rockefeller Foundation’s International Health Commission - IHC were pilot projects for the treatment of hookworm disease in the British colonies of British Guiana and Trinidad. These pioneering ventures into international health have often been portrayed as governed by rigid biomedical principles. In contrast to this view, the article emphasizes the degree to which the exigencies of a public health project that sought to make biomedicine intelligible within the medical systems of subject populations combined with the knowledge of local IHC staff members of Indo-Caribbean descent to generate some fascinating experiments in ethno-medical translation. One text in particular, "The Demon that Turned into Worms" is focused on to show how these efforts at medical translation may have legitimized and promoted medical pluralism.

The occurrence of intestinal parasites, their regional distribution and their relations to eosinophilia were studied in 133 human immunodeficiency virus (HIV) positive individuals from Honduras. After signing an informed consent, participants answered a socio-demographic and risk factor questionnaire, a complete physical examination, medical history, and a series of laboratory tests. All participants were HIV positive but not acquired immunodeficiency syndrome positive. Of them, 67% were co-infected with pathogen and non pathogen parasites. Overall occurrence of nematodes was: 44.3% for Trichuris trichiura, 24% for Ascaris lumbricoides, 12% for Hookworm and 7.5% for Strongyloides stercoralis. No cases of Giardia lamblia, acute amebiasis or cryptosporidiasis were diagnosed. Mean eosinophil percents for participants were consistently and significantly higher in infected than in non infected individuals: 22% for Hookworm vs 7.2% (p < 0.001), 11% for Trichuris compared to 5.2% (p < 0.001), 13.2% compared to 7.5% for S. stercoralis (p < 0.05), and 12% compared to 6% for Ascaris cases (p < 0.05). Helminths and non pathogenic protozoa, as single or mixed infections, occurred among the participants. There was a strong correlation between eosinophilia and helminthiasis infections; however, none was identified between CD4 levels and eosinophilia. Because parasitic infections aggravate malnutrition and promote a disbalanced Th2 response in a potentially immuno-compromised host, their effect on HIV disease progression needs further study, mainly in countries were HIV and parasitic infections are highly prevalent.

OBJECTIVE: To assess the short-term and long-term impact of selective mass treatment with ivermectin on the prevalence of intestinal helminthiases and parasitic skin diseases in an economically depressed community in north-east Brazil. METHODS: An intervention was carried out in a traditional fishing village in north-east Brazil where the population of 605 is heavily affected by ectoparasites and enteroparasites. The prevalence of intestinal helminths was determined by serial stool examination and the prevalence of parasitic skin diseases by clinical inspection. A total of 525 people out of a target population of 576 were treated at baseline. The majority of these were treated with ivermectin (200 µg/kg with a second dose given after 10 days). If ivermectin was contraindicated, participants were treated with albendazole or mebendazole for intestinal helminths or with topical deltamethrin for ectoparasites. Follow-up examinations were performed at 1 month and 9 months after treatment. FINDINGS: Prevalence rates of intestinal helminthiases before treatment and at 1 month and 9 months after mass treatment were: hookworm disease 28.5%, 16.4% and 7.7%; ascariasis 17.1%, 0.4% and 7.2%; trichuriasis 16.5%, 3.4% and 9.4%; strongyloidiasis 11.0%, 0.6% and 0.7%; and hymenolepiasis 0.6%; 0.4% and 0.5%, respectively. Prevalence rates of parasitic skin diseases before treatment and 1 month and 9 months after mass treatment were: active pediculosis 16.1%, 1.0% and 10.3%; scabies 3.8%, 1.0% and 1.5%; cutaneous larva migrans 0.7%, 0% and 0%; tungiasis 51.3%, 52.1% and 31.2%, respectively. Adverse events occurred in 9.4% of treatments. They were all of mild to moderate severity and were transient. CONCLUSION: Mass treatment with ivermectin was an effective and safe means of reducing the prevalence of most of the parasitic diseases prevalent in a poor community in north-east Brazil. The effects of treatment lasted for a prolonged period of time.

OBJETIVO: Evaluar el impacto del tratamiento masivo selectivo con ivermectina, a corto y a largo plazo, en la prevalencia de las helmintiasis intestinales y las parasitosis cutáneas en una comunidad económicamente deprimida del noreste del Brasil. MÉTODOS: Se llevó a cabo una intervención en un pueblo tradicional de pescadores del noreste del Brasil cuya población, de 605 habitantes, está gravemente afectada por diversos ectoparásitos y enteroparásitos. La prevalencia de los helmintos intestinales se determinó mediante examen coproparasitoscópico seriado, y la prevalencia de las parasitosis cutáneas, mediante inspección clínica. En total se trató al principio del estudio a 525 personas, de una población destinataria de 576. La mayoría de ellas fueron tratadas con ivermectina (200 µg/kg de peso, con una segunda dosis al cabo de 10 días). Cuando la ivermectina estaba contraindicada, el participante era tratado con albendazol o mebendazol si tenía helmintos intestinales, o con deltametrina tópica si tenía ectoparásitos. Los exámenes de seguimiento se realizaron al cabo de un mes y 9 meses del tratamiento. RESULTADOS: Las tasas de prevalencia de las helmintiasis intestinales antes del tratamiento y al cabo de un mes y 9 meses del tratamiento masivo fueron las siguientes: anquilostomiasis, 28,5%, 16,4% y 7,7%; ascariasis, 17,1%, 0,4% y 7,2%; tricuriasis, 16,5%, 3,4% y 9,4%; estrongiloidiasis, 11,0%, 0,6% y 0,7%; y himenolepiasis, 0,6%, 0,4% y 0,5%, respectivamente. Las tasas de prevalencia de las parasitosis cutáneas antes del tratamiento y al cabo de un mes y 9 meses del tratamiento masivo fueron las siguientes: pediculosis activa, 16,1% 1,0% y 10,3%; sarna, 3,8%, 1,0% y 1,5%; larva migrans cutánea, 0,7%, 0% y 0%; y tungiasis, 51,3%, 52,1% y 31,2%, respectivamente. Se registraron acontecimientos adversos en el 9,4% de los tratamientos, todos ellos entre leves y moderados y de carácter transitorio. CONCLUSIÓN: El tratamiento masivo con ivermectina fue un método eficaz y seguro de reducción de la prevalencia de la mayoría de las enfermedades parasitarias prevalentes en una comunidad pobre del noreste del Brasil. El tratamiento tuvo efectos prolongados.

OBJECTIF: Evaluer l'impact à court et à long terme d'un traitement de masse sélectif par l'ivermectine sur la prévalence des helminthiases intestinales et des dermatoses parasitaires dans une communauté économiquement défavorisée du nord-est du Brésil. MÉTHODES: Une intervention a été réalisée dans un village de pêcheurs traditionnel du nord-est du Brésil dont la population (605 habitants) est sévèrement touchée par des ectoparasites et des parasites intestinaux. La prévalence des helminthes intestinaux a été déterminée par examen en série de selles et celle des dermatoses parasitaires par inspection clinique. Au total, 525 personnes sur les 576 de la population cible ont été traitées en début d'intervention. La plupart ont reçu de l'ivermectine (200 µg/kg, avec une deuxième dose au bout de 10 jours). Lorsque l'ivermectine était contre-indiquée, les participants étaient traités par l'albendazole ou le mébendazole contre les helminthes intestinaux ou par la deltaméthrine en application locale contre les ectoparasites. Des examens de contrôle ont été réalisés 1 mois et 9 mois après le traitement. RÉSULTATS: La prévalence des diverses helminthiases intestinales avant le traitement et au bout d'un mois et de 9 mois après le traitement était, respectivement, de : ankylostomiase 28,5 %, 16,4 % et 7,7 % ; ascaridiase 17,1 %, 0,4 % et 7,2 % ; trichocéphalose 16,5 %, 3,4 % et 9,4 % ; strongyloïdose 11,0 %, 0,6 % et 0,7 % ; et hyménolépiase 0,6 %, 0,4 % et 0,5 %. La prévalence des diverses dermatoses parasitaires avant le traitement et au bout d'un mois et de 9 mois était, respectivement, de : pédiculose active 16,1 %, 1,0 % et 10,3 % ; gale 3,8 %, 1,0 % et 1,5 % ; larva migrans cutanée 0,7 %, 0 % et 0 % ; et tungose 51,3 %, 52,1 % et 31,2 %. Des effets indésirables ont été observés avec 9,4 % des traitements. Il s'agissait dans tous les cas d'effets passagers, de gravité faible à modérée. CONCLUSION: Le traitement de masse par l'ivermectine était un moyen efficace et sans danger pour réduire la prévalence de la plupart des affections parasitaires présentes dans une communauté pauvre du nord-est du Brésil, et ses effets étaient durables.

OBJECTIVE: To design and implement a rapid and valid epidemiological assessment of helminths among schoolchildren in Chad using ecological zones defined by remote sensing satellite sensor data and to investigate the environmental limits of helminth distribution. METHODS: Remote sensing proxy environmental data were used to define seven ecological zones in Chad. These were combined with population data in a geographical information system (GIS) in order to define a sampling protocol. On this basis, 20 schools were surveyed. Multilevel analysis, by means of generalized estimating equations to account for clustering at the school level, was used to investigate the relationship between infection patterns and key environmental variables. FINDINGS: In a sample of 1023 schoolchildren, 22.5% were infected with Schistosoma haematobium and 32.7% with hookworm. None were infected with Ascaris lumbricoides or Trichuris trichiura. The prevalence of S. haematobium and hookworm showed marked geographical heterogeneity and the observed patterns showed a close association with the defined ecological zones and significant relationships with environmental variables. These results contribute towards defining the thermal limits of geohelminth species. Predictions of infection prevalence were made for each school surveyed with the aid of models previously developed for Cameroon. These models correctly predicted that A. lumbricoides and T. trichiura would not occur in Chad but the predictions for S. haematobium were less reliable at the school level. CONCLUSION: GIS and remote sensing can play an important part in the rapid planning of helminth control programmes where little information on disease burden is available. Remote sensing prediction models can indicate patterns of geohelminth infection but can only identify potential areas of high risk for S. haematobium.

OBJETIVO: Diseñar y aplicar un sistema de evaluación epidemiológica rápida y válida de las helmintiasis entre los escolares en el Chad utilizando zonas ecológicas definidas por los datos de un satélite de teleobservación, e investigar los límites ambientales de la distribución de los helmintos. MÉTODOS: Se utilizaron datos ambientales indirectos de teleobservación para definir siete zonas ecológicas en el Chad. Dichos datos se combinaron con datos demográficos en un sistema de información geográfica (SIG) para definir un protocolo de muestreo. Sobre esta base, se analizaron 20 escuelas. Se realizó un análisis jerarquizado, usando ecuaciones de estimación generalizadas a fin de tener en cuenta el agrupamiento a nivel de las escuelas, para investigar la relación entre los modelos de infección y variables ambientales clave. RESULTADOS: En una muestra de 1023 escolares, el 22,5% estaban infectados por Schistosoma haematobium, y el 32,7% por anquilostoma. Ninguno estaba infectado por Ascaris lumbricoides o Trichuris trichiura. La prevalencia de S. haematobium y de anquilostoma mostró una marcada heterogeneidad geográfica, y la distribución observada resultó estar estrechamente relacionada con las zonas ecológicas definidas, y ligada de forma importante a variables ambientales. Estos resultados permiten definir más fácilmente los límites de temperatura de las especies de geohelmintos. Se hicieron predicciones de la prevalencia de las infecciones para cada escuela analizada con la ayuda de modelos desarrollados anteriormente para el Camerún. Estos modelos predijeron correctamente que A. lumbricoides y T. trichiura no se detectarían en el Chad, pero las predicciones para S. haematobium fueron menos fiables a nivel de las escuelas. CONCLUSIÓN: Los SIG y la teleobservación pueden ser instrumentos valiosos para planificar rápidamente programas de lucha antihelmíntica cuando se dispone de poca información sobre la carga de morbilidad. Los modelos predictivos basados en la teleobservación pueden indicar la distribución de las infecciones por geohelmintos, pero sólo logran identificar las zonas potenciales de alto riesgo de infección por S. haematobium.

OBJECTIF: Planifier et mettre en œuvre une évaluation épidémiologique rapide et correcte de la présence d'helminthes chez des écoliers du Tchad en se basant sur des zones écologiques définies grâce à des données de télédétection par satellite, et chercher à établir les limites environnementales de la distribution des helminthes. MÉTHODES: Des données environnementales indirectes obtenues par télédétection ont été utilisées pour définir sept zones écologiques au Tchad. Ces données ont été combinées avec des données de population dans un système d'information géographique (SIG) en vue de définir un protocole d'échantillonnage, lequel a conduit à réaliser une enquête dans 20 écoles. Une analyse à plusieurs niveaux a été effectuée au moyen d'équations de généralisation pour tenir compte du regroupement des cas au niveau des écoles afin d'étudier la relation entre le tableau épidémiologique de l'infection et certaines variables environnementales. RÉSULTATS: Sur un échantillon de 1023 écoliers, 22,5 % étaient infectés par Schistosoma haematobium et 32,7 % par des ankylostomes. Aucun d'entre eux n'était infecté par Ascaris lumbricoides ni par Trichuris trichiura. La prévalence de S. haematobium et des ankylostomes présentait une forte hétérogénéité géographique et la répartition observée montrait une association étroite avec les zones écologiques définies et une relation significative avec les variables environnementales. Ces résultats contribuent à définir les limites thermiques de la distribution des différentes espèces de géohelminthes. Des prévisions de la prévalence de l'infection ont été réalisées pour chaque école enquêtée à l'aide des modèles déjà établis pour le Cameroun. Ces modèles ont correctement prévu l'absence de A. lumbricoides et de T. trichiura au Tchad mais les prévisions concernant S. haematobium étaient moins fiables au niveau des écoles. CONCLUSION: Les SIG et la télédétection peuvent jouer un rôle important dans la planification rapide des programmes de lutte contre les helminthes lorsqu'on ne dispose que de peu d'informations sur la charge de morbidité. Les modèles de prévision tirés des données de la télédétection peuvent indiquer la répartition générale des infections à géohelminthes mais ne peuvent qu'identifier les zones à haut risque potentielles pour S. haematobium.

É apresentada uma revisão das recentes aquisições na anemia ancilostomótica, assinalando a importância de alimentação qualitativamente deficiente junto á infestação helmíntica na gênese desta doença. Acentuou-se que a anemia ancilostomótica é uma doença de carência. Profilaxia clássica da Ancilostomose resume-se em evitar a infestação do homem pelos ancilostomídeos. Critica-se a aplicabilidade destas medidas e eficiência das mesmas no que diz respeito á incidência da anemia. O presente trabalho mostra aquisições preliminares sôbre fundamentos de uma profilaxia de carência (tipo profilaxia do bócio endêmico) da anemia ancilostomótica, baseada na administração de alimentos contaminados por um sal de ferro. As misturas sulfato ferroso-farinha de mandióca e citrato férrico amoniacal-caldo de feijão, mostraram-se eficientes em prevenir a queda das cifras hemáticas durante largos períodos de tempo em indivíduos maciçamente infestados (6-8 meses). Não foi verificada a dose diária mínima eficiente dêstes sais, obtendo-se resultados satisfatorios mesmo com 0.1 g diária de sulfato ferroso (correspondendo a 0.037 g de ferro metálico). Numerosos alimentos e sais de ferro foram experimentados com resultados infrutíferos por diferentes razões. A influência dos helmintos, pela hemorragias intestinais que acarretam poude ser mais uma vez estudada, nos casos de sais de ferro administrados em doses ineficientes ou em períodos de prova sem medicação marcial. É proposta nova classificação de intensidade de infestação, levando em consideração o conhecido fato de ser a atividade dos helmintos, exclusivamente expoliadora. Em conclusão, nos parece exequível a profilaxia da anemia ancilostomótica mediante ingestão de alimentos contaminados por quantidades eficientes de sais de ferro. Êste método profilático extremamente econômico será na prática, provàvelmente, muito superior aos métodos de profilaxia anti-helmíntica, que além de onerosos são pouco práticos, pois interferem em hábitos enraizados nas populações rurais.

A review of the recent advances in the mechanism of hookworm anemia is presented, pointing out the importance of a qualitatively defective nutrition in the genesis of this disease. The carencial aspect of hookworm anemia is emphasized. The accepted prophylaxia of hookworm disease limits itself to avoiding human infestation by the ancylostomidae. This method is criticized as a pratical means of eradicating the anemia in rural population. This paper deals with preliminary studies to build up a carencial type of prophylaxis in hookworm anemia (as in prophylaxis of endemic goitre) based on the administration of iron salts, in the food usually consumed in Brazil. The mixtures ferrous sulphate and mandioca flour or amoniacal ferric citrate and baked beans, have been able to prevent anemia in patients heavely infested. during long periods of time (6-8 months). the minimus efficient daily doses of iron needed to maintain normal blood levels have not been precisely ascertained, but even 0.1 g of ferrous sulphate (37 mg of metalic iron) daily in mandioca flour was satisfatory for that purpose. Different foods and iron salts have been tried with no results, for different reasons. When iron salts were administered in insufficient doses, the progressive evolution of the anemia was observed in detail. In conclusion the use of iron salts in suficient quantities mixed to usual food is advised as a prophylatic method is hookworm anemia. A campaign of this type can be accomplished at extremely low cost, and probably has definite advantages over the classical prophylaxis, whose methods interferes with rooted habits of people of rural areas and therefore give very poor practical results.

Estudamos 25 casos escolhidos de Ancylostomose, procurando determinar quaes os factores que provocam a regeneração hematica, procurando o mechanismo desta regeneração e o desenvolver do processo anemiante. Preferimos seleccionar um numero pequeno de casos e acompanhal-o durante um largo tempo, observando alguns delles durante 1 a 1 anno e meio. A parte hematologica constou, além de 568 exames rotineiros (numeração das hematias, dosagem de Hb., determinação do hematocrito, e na maioria das vezes, determinação da taxa de reticulocytose verificação do aspecto morphologico do sangue em esfregaços), de pesquisas sobre a resistencia globular, sobre a taxa de proteinas no sôro, e em alguns casos, contagem de plaquetas, determinação da viscosidade, etc. Empregamos para estas pesquizas os methodos usuaes, a não ser na determinação da resistencia globular, para a qual descrevemos detalhadamente um processo pouco usado. Durante todo o transcorrer das observações, a actividade biologica dos helminthos parasitos foi controlada por numerosos exames de fezes, que constavam da pesquiza de ovos eliminados, de reacções chimicas que demonstrassem a presença de sangue. Exames de urina foram feitos periodicamente e outros exames foram praticados quando sobrevinha uma complicação ou qualquer facto inesperado. Observamos nos casos graves da doença, uma anemia de caracteristicas fixas. E' uma anemia hypochromica, microcytica, fracamente regenerativa. Verificamos que a degeneração dos indices hematicos, isto é, que o grau de hypochromia e micocytose, não se apresentam nestes casos extremos de modo variavel, mas sim, de maneira particularmente constante; e verificamos mais que estes indices assim degenerados (Ind. Vol. 53 uc., Ind. Hb. 13 yy, Ind. Sat. 23%) tambem são encontrados segundo observações de outros autores, em varias anemias hypochromicas humanas ou de outros mammiferos. No exame de esfregaços, são extremamente raros ou mesmo ausentes, os normoblastos, as hematias com restos nucleares e as hematias polychromaticas. A reticulose oscilla em torno de 3%. Este aspecto é constante nos casos graves, sendo entretanto variavel na unidade de volume o numero destas hematias acima caracterisadas. A média dessa ultima cifra em numerosos casos é de 2,50 M., o que determina uma taxa de Hb. egual a 23%. Ao analysarmos certas observações, que descrevem aspectos hematologicos differentes daquelles aqui descriptos, concluimos pela existencia nesses casos anomalos, de superposições de outras doenças, cuja etio-pathogenia nada tem a ver com os factores que determinam o apparecimento da anemia ancylostomotica. A regeneração hematica processa-se na Ancylostomose unicamente após a administração de ferro em dóses variaveis, conforme o sal empregado. Mostraram-se inactivas nos casos aqui observados, as administrações de figado crú, triptophano, hystidina, lecithina, Vit. B, saes de arsenico, manganez, cobalto, cobre e a alimentação com dietas ricas em ferro. Em virtude dos resultados que obtivemos com a administração isolada de ferro, concluimos pela inefficiencia da administração de substancias pyrrholicas, da fracção hepatica sensivel nas anemias hypochromicas, e da associação ao ferro de acido chlorhydrico. Todas essas substancias, e tambem a elimanação simples dos helminthos parasitos, não só mostraram-se isoladamente sem acção sobre o sangue, como não auxiliaram a regeneração provocada pelo ferro...

We studied 25 selected cases of anchylostomiasis, endeavouring to determine the factors which induce the hematic regeneration and investigating the mechanism of this regeneration as well as the development of the anemiant process. We preferred to select a small number of cases and accompany them for a long period, some of them having been underobservation during 1 to 1 year and a half. Apart from 568 routine examinations (count of red cells, dosage of Hb., determination of the hematokrit and, in the majority of cases, determination of the rate of reticulocytes, verifications of the morphologic aspect of blood on slides), the haematologic part consisted in investigations on globular resistence, rate of proteins in serum and, in some cases, count of platelets, determination of viscosity, etc. In these investigations we employed the usual methods, with the exception as for the determination of globular resistance, for which we described in detail a process though little used. During the whole course of the observations, the biologic activity of the helminthic parasites was controlled by numerous examinations of the faeces, consisting in the investigation of eliminated eggs and of chemical reactions detecting the presence of blood. Uranalyses were made periodically, and other examinations were practised whenever a complication or any unexpected fact came upon. In severe cases of the disease we observed an anemia of constant features. It is a hypochromic, microcytic and slightly regenerative anemia. We verified that the degeneration of the hematic indices, i. e. the degree of hypochromia and microcytosis in these extreme cases, does not appear in a variable but in a particularly constant manner; furthermore, we verified that these indices thus degenerated (Vol. Ind. 53 uc., Hb. Ind. 13'yy, Sat. Ind. 23%), according to observation by other authors, are also met with in various hypochromic anemiae of man or other mammals. Normoblasts, red cells with nuclear remainders and polychromatic red cells are extremely rare or even absent in the slides examined. This aspect is constant in severe cases; however, the number of these red cells characterized above is variable in the volume unit. The average of this reading is in numerous cases 2.50 M. which determines the rate of Hb, equal to 23%. After analysing certain observations which describe hematologic aspects different from those here described, we concluded that in such anomalous cases there are superpositions of other diseases, the etio-pathogenesis of which has nothing to do with the factors that determine the appearance of the anchylostomotic anemia. Hematic regeneration takes place in anchylostomiasis only after the administration of iron in variable doses, in conformity the salt employed. In the case here observed, the following prescriptions appeared inactive: raw liver, tryptophan, histidine, lecithin, Vit. B, arsenic, manganese, cobalt, copper and diets rich in iron. Owing to the results obtained by us through the separate administration of iron, we concluded that pyrrholic substances, liver fraction used in hypochromic anemiae and the association of iron with hydrochloric acid are inefficient. All these substances as well as the mere explusion of helminthic parasites, when used separately, not only appeared to have no action on the blood, but even did not help the regeneration induced by iron...