Resumo OBJETIVO: caracterizar os materiais educativos impressos sobre esquistossomose produzidos no Brasil, nos níveis federal, estadual e municipal. MÉTODOS: os materiais foram caracterizados considerando-se as categorias 'formato', 'parasito e hospedeiro intermediário', 'hospedeiro definitivo' (doente) e 'doença'. RESULTADOS: dos 60 materiais avaliados, três não traziam informação sobre as atividades de risco e 41 indicavam mais de um nome popular para a doença, possibilitando maior alcance do público-alvo nas diversas áreas endêmicas; em 53 materiais, o ciclo biológico estava ausente ou incorreto; o molusco, hospedeiro intermediário, estava retratado incorretamente, com imagens estereotipadas em 39 materiais, e ausente em um; o diagnóstico foi mencionado em 36 materiais. CONCLUSÃO: os materiais educativos impressos avaliados mostraram incorreções que podem comprometer o trabalho de educação em saúde; ademais, o diagnóstico da esquistossomose foi pouco abordado.

Abstract OBJECTIVE: to characterize printed educational materials about schistosomiasis produced at federal, state and municipal levels in Brazil. METHODS: the educational materials were characterized considering the following categories: 'format', 'parasite and intermediate host', 'definitive host (ill)' and 'disease'. RESULTS: 60 materials were assessed, three had no information about risk activities and 41 indicated more than one popular name for the disease, thus allowing greater reach among the target audience in diverse endemic areas; the biological cycle was missing or incorrect in 53 materials; the intermediate host (snail) was incorrectly illustrated, with use of stereotyped images in 39 and no image in one material; diagnosis was mentioned in 36 materials. CONCLUSION: the printed educational materials assessed had incorrect content which may compromise health education efforts; little attention was paid to schistosomiasis diagnosis.

Resumen OBJETIVO: evaluar materiales educativos impresos (MEIs) sobre esquistosomiasis producidos en Brasil a nivel Federal, Estatal y Municipal. MÉTODOS: los MEIs fueron sometidos a una evaluación de contenidos teniendo en cuenta las categorías: formato, parásito y hospedero intermediario, hospedero definitivo y enfermedad. RESULTADOS: de los 60 MEIs evaluados, tres no tenían información sobre actividades de riesgo y 41 daban más de un nombre popular a la enfermedad, permitiendo un mayor alcance de público objetivo en diferentes zonas endémicas; en 53 MEIs el ciclo de vida no era mencionado o era incorrectoo; el molusco, hospedero intermediario, era retratado incorrectamente, con imágenes estereotipadas em 39 MEIs y ausente en uno; se daba poca importancia al diagnóstico, siendo mencionado en apenas 36 de ellos. CONCLUSIÓN: los MEIs mostraron inexactitudes que podrían comprometer el trabajo de educación de la salud.

Resumo OBJETIVO: caracterizar os materiais educativos impressos sobre esquistossomose produzidos no Brasil, nos níveis federal, estadual e municipal. MÉTODOS: os materiais foram caracterizados considerando-se as categorias 'formato', 'parasito e hospedeiro intermediário', 'hospedeiro definitivo' (doente) e 'doença'. RESULTADOS: dos 60 materiais avaliados, três não traziam informação sobre as atividades de risco e 41 indicavam mais de um nome popular para a doença, possibilitando maior alcance do público-alvo nas diversas áreas endêmicas; em 53 materiais, o ciclo biológico estava ausente ou incorreto; o molusco, hospedeiro intermediário, estava retratado incorretamente, com imagens estereotipadas em 39 materiais, e ausente em um; o diagnóstico foi mencionado em 36 materiais. CONCLUSÃO: os materiais educativos impressos avaliados mostraram incorreções que podem comprometer o trabalho de educação em saúde; ademais, o diagnóstico da esquistossomose foi pouco abordado.

Abstract OBJECTIVE: to characterize printed educational materials about schistosomiasis produced at federal, state and municipal levels in Brazil. METHODS: the educational materials were characterized considering the following categories: 'format', 'parasite and intermediate host', 'definitive host (ill)' and 'disease'. RESULTS: 60 materials were assessed, three had no information about risk activities and 41 indicated more than one popular name for the disease, thus allowing greater reach among the target audience in diverse endemic areas; the biological cycle was missing or incorrect in 53 materials; the intermediate host (snail) was incorrectly illustrated, with use of stereotyped images in 39 and no image in one material; diagnosis was mentioned in 36 materials. CONCLUSION: the printed educational materials assessed had incorrect content which may compromise health education efforts; little attention was paid to schistosomiasis diagnosis.

Resumen OBJETIVO: evaluar materiales educativos impresos (MEIs) sobre esquistosomiasis producidos en Brasil a nivel Federal, Estatal y Municipal. MÉTODOS: los MEIs fueron sometidos a una evaluación de contenidos teniendo en cuenta las categorías: formato, parásito y hospedero intermediario, hospedero definitivo y enfermedad. RESULTADOS: de los 60 MEIs evaluados, tres no tenían información sobre actividades de riesgo y 41 daban más de un nombre popular a la enfermedad, permitiendo un mayor alcance de público objetivo en diferentes zonas endémicas; en 53 MEIs el ciclo de vida no era mencionado o era incorrectoo; el molusco, hospedero intermediario, era retratado incorrectamente, con imágenes estereotipadas em 39 MEIs y ausente en uno; se daba poca importancia al diagnóstico, siendo mencionado en apenas 36 de ellos. CONCLUSIÓN: los MEIs mostraron inexactitudes que podrían comprometer el trabajo de educación de la salud.

This population study, which evaluated two parasitological methods for the diagnosis of schistosomiasis mansoni, was performed in a low-transmission area in Pedra Preta, Montes Claros, Minas Gerais, Brazil. A total of 201 inhabitants of the rural area participated in this research. Four stool samples were obtained from all participants and analysed using the Kato-Katz method (18 slides) and a commercial test, the TF-Test®, which was performed quantitatively. The data were analysed to determine prevalence, the sensitivity of the diagnostic methods, the worm burden and the definition of the "gold standard", which was obtained by totalling the results of all samples examined using the Kato-Katz technique and the TF-Test®. The results showed that the prevalence obtained from the examination of one Kato-Katz slide (the methodology adopted by the Brazilian control programme) was 8% compared to 35.8% from the "gold standard", which was a 4.5-fold difference. This result indicates that the prevalence of schistosomiasis in so-called low-transmission areas is significantly underestimated.

OBJETIVO: Descrever uma estratégia educativa participativa de construção de conhecimentos relacionados à malária entre professores em um município altamente endêmico. MÉTODOS: Foi feito um estudo observacional. Um curso de 40 horas foi realizado sob enfoque multidisciplinar e problematizador para 46 professores, prioritariamente da área rural, no município de Barcelos, AM, em 2008. O processo educativo participativo incluiu oficinas e aulas práticas. Para investigar os conhecimentos, aplicou-se um questionário previamente validado, antes e após o curso, avaliado por abordagens quantitativa e qualitativa usando a análise temática para respostas abertas. RESULTADOS: Previamente ao curso, os professores tinham pouca informação sobre os mecanismos de transmissão, meios de prevenção e a associação da malária aos seus vetores, bem como conceitos restritos sobre saúde. Após o curso, não somente aumentou o conhecimento dos professores sobre a malária como também emergiram reflexões sobre o papel do professor na sociedade. CONCLUSÕES: O efeito da ação educativa na construção de um saber contextualizado sobre malária e saúde indica o potencial da estratégia desenvolvida. Processos de educação permanente são necessários à sustentabilidade dos novos saberes e práticas, orientados pela promoção da saúde.

OBJECTIVE: To describe a participatory educational program for building up knowledge on malaria among primary school teachers in a highly endemic city. METHODS: An observational study was conducted. A 40-hour course with a multidisciplinary and problematizing approach was held in 2008, including 46 teachers mainly from rural areas of the city of Barcelos, Northern Brazil. The participatory educational process was comprised of workshops and practical classes. A previously validated questionnaire was applied before and after the course to assess teachers' knowledge and subsequently analyzed using qualitative and quantitative approaches and open-response thematic analysis. RESULTS: Prior to the course, teachers had little information about the transmission mechanisms, means of prevention, and the association between malaria and its vectors, and their health concepts were limited. After the course, teachers' knowledge of malaria increased and they reflected on their role in society. CONCLUSIONS: The effect of the educational program on the construction of contextualized knowledge of malaria and health indicates the potential of the strategy developed. Continuing education processes are required for the maintenance of new knowledge and practices directed towards health promotion.

OBJETIVO: Describir una estrategia educativa participativa para construción de conocimientos relacionados con la malaria entre profesores en un municipio altamente endémico. MÉTODOS: Fue realizado un estudio observacional. Un curso de 40 horas fue realizado bajo el enfoque multidisciplinario y problematizador para 46 profesores, prioritariamente del área rural, en el municipio de Barcelos, Norte de Brasil, en 2008. El proceso educativo participativo incluyó talleres y aulas prácticas. Para investigar los conocimientos, un cuestionario previamente validado fue aplicado antes y después del curso y analizado por abordajes cuantitativa y cualitativa usando el análisis temático para respuestas abiertas. RESULTADOS: Previamente al curso, los profesores tenían poca información sobre los mecanismos de transmisión, medios de prevención y la asociación de la malaria con sus vectores, así como conceptos restringidos sobre salud. Posterior al curso, no solamente aumentó el conocimiento del profesor sobre la malaria, sino que también emergieron reflexiones sobre el papel del profesor en la sociedad. CONCLUSIONES: El efecto de la acción educativa en la construcción de un saber contextualizado sobre malaria y salud indica el potencial de la estrategia desarrollada. Procesos de educación permanente son necesarios para la sustentabilidad de los nuevos saberes y prácticas orientados por la promoción de la salud.

OBJETIVO: Descrever uma estratégia educativa participativa de construção de conhecimentos relacionados à malária entre professores em um município altamente endêmico. MÉTODOS: Foi feito um estudo observacional. Um curso de 40 horas foi realizado sob enfoque multidisciplinar e problematizador para 46 professores, prioritariamente da área rural, no município de Barcelos, AM, em 2008. O processo educativo participativo incluiu oficinas e aulas práticas. Para investigar os conhecimentos, aplicou-se um questionário previamente validado, antes e após o curso, avaliado por abordagens quantitativa e qualitativa usando a análise temática para respostas abertas. RESULTADOS: Previamente ao curso, os professores tinham pouca informação sobre os mecanismos de transmissão, meios de prevenção e a associação da malária aos seus vetores, bem como conceitos restritos sobre saúde. Após o curso, não somente aumentou o conhecimento dos professores sobre a malária como também emergiram reflexões sobre o papel do professor na sociedade. CONCLUSÕES: O efeito da ação educativa na construção de um saber contextualizado sobre malária e saúde indica o potencial da estratégia desenvolvida. Processos de educação permanente são necessários à sustentabilidade dos novos saberes e práticas, orientados pela promoção da saúde.

OBJECTIVE: To describe a participatory educational program for building up knowledge on malaria among primary school teachers in a highly endemic city. METHODS: An observational study was conducted. A 40-hour course with a multidisciplinary and problematizing approach was held in 2008, including 46 teachers mainly from rural areas of the city of Barcelos, Northern Brazil. The participatory educational process was comprised of workshops and practical classes. A previously validated questionnaire was applied before and after the course to assess teachers' knowledge and subsequently analyzed using qualitative and quantitative approaches and open-response thematic analysis. RESULTS: Prior to the course, teachers had little information about the transmission mechanisms, means of prevention, and the association between malaria and its vectors, and their health concepts were limited. After the course, teachers' knowledge of malaria increased and they reflected on their role in society. CONCLUSIONS: The effect of the educational program on the construction of contextualized knowledge of malaria and health indicates the potential of the strategy developed. Continuing education processes are required for the maintenance of new knowledge and practices directed towards health promotion.

OBJETIVO: Describir una estrategia educativa participativa para construción de conocimientos relacionados con la malaria entre profesores en un municipio altamente endémico. MÉTODOS: Fue realizado un estudio observacional. Un curso de 40 horas fue realizado bajo el enfoque multidisciplinario y problematizador para 46 profesores, prioritariamente del área rural, en el municipio de Barcelos, Norte de Brasil, en 2008. El proceso educativo participativo incluyó talleres y aulas prácticas. Para investigar los conocimientos, un cuestionario previamente validado fue aplicado antes y después del curso y analizado por abordajes cuantitativa y cualitativa usando el análisis temático para respuestas abiertas. RESULTADOS: Previamente al curso, los profesores tenían poca información sobre los mecanismos de transmisión, medios de prevención y la asociación de la malaria con sus vectores, así como conceptos restringidos sobre salud. Posterior al curso, no solamente aumentó el conocimiento del profesor sobre la malaria, sino que también emergieron reflexiones sobre el papel del profesor en la sociedad. CONCLUSIONES: El efecto de la acción educativa en la construcción de un saber contextualizado sobre malaria y salud indica el potencial de la estrategia desarrollada. Procesos de educación permanente son necesarios para la sustentabilidad de los nuevos saberes y prácticas orientados por la promoción de la salud.

In this transversal study, factors related to infection with and transmission of Schistosoma mansoni were explored. Based on stool examinations of two Kato-Katz smears of a single sample, the prevalences of schistosomiasis and geohelminths were established. In a multivariable analysis, sets of demographic, socio-economic and water contact pattern variables were tested for strength of relation with infection. Males presented a 3.39-times higher risk for infection than females. The age groups between 10-19 years and 20-30 years showed risks of infection 7.1- and 7.5-times higher, respectively, than the control age group between 0-10 years. Individuals practicing leisure activities had a 1.96-times higher risk than those without these activities. The malacological survey identified snails of the species Biomphalaria glabrata, Biomphalaria straminea and Biomphalaria tenagophila. Two exemplars of B. glabrata (0.53%) proved positive for S. mansoni. The socio-economic improvements observed in the locality suggest a protective and preventive effect towards infection with schistosomiasis, which requires further investigation with a longitudinal and more detailed study design. Considering our findings, a proposal for an integrated control program should be based on two pillars: one horizontal, which involves social empowerment and health education, and another more vertical, which delivers treatment and infrastructure improvements.

This paper reports an outbreak of acute schistosomiasis among 38 tourists who rented a country house in the district of Igarapé, the metropolitan region of Belo Horizonte, Brazil, during a holiday period in 2006. A total number of 32 individuals were positive for Schistosoma mansoni. Results of stool examinations revealed individual S. mansoni egg counts per gram of faeces (epg) ranging from 4-768 epg with a geometric mean egg count of 45. The most frequent clinical symptoms were abdominal pain (78.1%), headache (75%), fever (65.6%), dry cough (65.2%) and both diarrhoea and asthenia (59.4%). A malacological survey of the area, where 22 specimens of Biomphalaria glabrata were collected, revealed three (13.6%) specimens eliminating Schistosoma cercariae. This investigation re-confirms a recently described pattern of schistosomiasis infection, resulting in the acute form of the disease and connected to rural tourism, which contributes to the spread of the disease among the middle-class and into non-endemic areas. The lack of specific knowledge about acute schistosomiasis among health services causes an increased number of unnecessary diagnostic procedures and delays in accurate diagnosis and treatment, resulting in considerable discomfort for the patients.

INTRODUCTION: vegetable contamination is a persistent health problem. The different methods of processing and diagnosis make it difficult to determine the most effective and sensitive technique. OBJECTIVE: a comparative analysis of parasitological technique sensitivity in vegetable samples. METHODS: a total of 30 samples were harvested lettuce (Lactuca sativa), rocket (Eruca sativa) and watercress (Nasturtium officinale) and later analyzed using Hoffman, Pons, and Janer (HPJ) and Faust (f) techniques. Data were analyzed, using the Bland-Altman test to evaluate the correlation and the Mann-Whitney test to compare the medians. RESULTS: of the analyzed samples, 46.6 % were positive for intestinal parasites; Balantidium coli, accounting for 20 % of contamination, Entamoeba coli (21.6 %) and Entamoeba histolityca (5 %), Trichuris trichiura(3,3 %) and Strongyloides stercoralis (2.5 %) The Bland-Altman test showed significant correlation between the analyzed methods. When evaluating the averages separately, there was significant difference (pd» 0.05) among the results. CONCLUSIONS: this study proved that the HPJ technique was more effective for the detection of eggs, helminth larvae and protozoan cysts in the plants under study.

INTRODUCIÓN: la contaminación de los vegetales es un persistente problema de salud. Las diferentes técnicas de diagnóstico y de procesamiento dificultan determinar qué técnica es más eficiente y sensible. OBJETIVO: efectuar una comparación entre la sensibilidad de las técnicas parasitológicas en muestras de vegetales. MÉTODOS: se recogieron 30 muestras de vegetales - lechuga (Lactuca sativa), rúcula (Eruca sativa) y berro (Nasturtium officinale) - y se investigaron por las técnicas de Hoffman, Pons y Janer (HPJ) y Faust (F). Los datos fueron analizados utilizando la prueba de Bland-Altman para evaluar la correlación y la prueba de Mann-Whitney para comparar las medianas. RESULTADOS: de las muestras analizadas, 46,6 % resultó positivo, se observó Balantidium coli (20,0 % de la contaminación), Entamoeba coli (21,6 %), Entamoeba histolityca (5,0 %), Trichuris trichiura (3,3 %) y Strongyloides stercoralis (2,5 %). La prueba de Bland-Altman mostró correlación significativa entre los métodos examinados. Hubo una diferencia significativa (p< 0,05) entre los resultados, al evaluar individualmente el promedio. CONCLUSIÓN: este estudio demostró que la técnica HPJ fue más eficaz en la detección de huevos, larvas de helmintos y quistes de protozoos en las plantas estudiadas.

Os programas de controle da esquistossomose no Brasil têm contribuído para a redução da prevalência e das formas graves da doença, mas não têm impedido que novos focos apareçam, especialmente nas áreas periféricas dos grandes centros urbanos do país. O presente artigo tem como objetivo avaliar a prevalência da esquistossomose e a presença de hospedeiros intermediários do Schistosoma mansoni no distrito de Ravena, Município de Sabará, Minas Gerais, Brasil, após 27 anos da implantação do sistema de água tratada e do tratamento específico da população infectada. Ravena apresentou uma resposta positiva às intervenções de controle da esquistossomose, apresentando uma prevalência de 2,5%. Porém, é uma área de risco em potencial, pois apresenta fatores ambientais e ecológicos favoráveis à manutenção da doença. Para que os níveis de prevalência continuem baixos, será necessário investir em saneamento, educação em saúde além de tratamento dos infectados.

Schistosomiasis control programs in Brazil have helped reduce prevalence and the severe forms of the disease, but have failed to prevent new foci from appearing, especially on the periphery of large cities. The current article aims to assess the prevalence of schistosomiasis and the presence of intermediates hosts for Schistosoma mansoni in the district of Ravena, Municipality of Sabará, Minas Gerais State, Brazil, 27 years after implementing water treatment and specific treatment for infected individuals. Ravena responded positively to schistosomiasis control measures, with a prevalence of 2.5%. However, the district remains a potential risk area, since it displays favorable environmental and ecological factors for maintenance of the disease. For the prevalence rates to continue low, it will be necessary to invest in sanitation and health education, in addition to treatment of infected individuals.

Os programas de controle da esquistossomose no Brasil têm contribuído para a redução da prevalência e das formas graves da doença, mas não têm impedido que novos focos apareçam, especialmente nas áreas periféricas dos grandes centros urbanos do país. O presente artigo tem como objetivo avaliar a prevalência da esquistossomose e a presença de hospedeiros intermediários do Schistosoma mansoni no distrito de Ravena, Município de Sabará, Minas Gerais, Brasil, após 27 anos da implantação do sistema de água tratada e do tratamento específico da população infectada. Ravena apresentou uma resposta positiva às intervenções de controle da esquistossomose, apresentando uma prevalência de 2,5%. Porém, é uma área de risco em potencial, pois apresenta fatores ambientais e ecológicos favoráveis à manutenção da doença. Para que os níveis de prevalência continuem baixos, será necessário investir em saneamento, educação em saúde além de tratamento dos infectados.

Schistosomiasis control programs in Brazil have helped reduce prevalence and the severe forms of the disease, but have failed to prevent new foci from appearing, especially on the periphery of large cities. The current article aims to assess the prevalence of schistosomiasis and the presence of intermediates hosts for Schistosoma mansoni in the district of Ravena, Municipality of Sabará, Minas Gerais State, Brazil, 27 years after implementing water treatment and specific treatment for infected individuals. Ravena responded positively to schistosomiasis control measures, with a prevalence of 2.5%. However, the district remains a potential risk area, since it displays favorable environmental and ecological factors for maintenance of the disease. For the prevalence rates to continue low, it will be necessary to invest in sanitation and health education, in addition to treatment of infected individuals.

Neste trabalho, são discutidos os modos de transmissão da esquistossomose na localidade de São José da Serra, com 500 habitantes, no Município de Jaboticatubas, Minas Gerais, Brasil. A região ao redor recebe, durante todo o ano, milhares de pessoas para a prática de ecoturismo. A ocorrência de esquistossomose aguda em um casal que viajou para essa área, no carnaval de 2007, motivou este estudo. Exames de fezes foram feitos em 268 moradores, 53,6% da população total. Trinta e cinco (13%) estavam eliminando ovos nas fezes. Comparando os resultados coproscópicos com os de um inquérito feito em 2005, observa-se um aumento da proporção de positivos de 9,6% para 12,5%, entre 56 pessoas que participaram em ambos os estudos. Foram coletados 65 exemplares de Biomphalaria glabrata, sendo 1 (1,5%) positivo. No inquérito malacológico realizado em 2005, em 182 biomphalarias, nenhum exemplar foi encontrado positivo. Esses dados indicam a ocorrência de transmissão ativa de esquistossomose na área, revelando a necessidade de planejamento coordenado no desenvolvimento do setor turístico, incluindo a implantação de programas educativos integrados para a comunidade e, principalmente, para os turistas.

This paper discusses schistosomiasis transmission in São José da Serra, a village with a population of 500 in the county of Jaboticatubas, Minas Gerais State, Brazil. The area receives thousands of visitors a year for ecotourism. The study was motivated by a case of acute schistosomiasis involving a couple that spent the 2007 Carnival (Mardi Gras) holiday in the area. Stool tests from 268 local residents (53.6% of the population) showed that 35 (13%) were positive for the infection. A comparison with a previous survey (2005) in the same location showed an increase in the schistosomiasis-positive rate from 9.6% to 12.5%, among the 56 individuals who participated in both surveys. A malacological survey of 65 Biomphalaria glabrata snails showed one specimen (1.5%) eliminating cercariae. In a similar survey in 2005, no positive snail specimens were found. The study indicates that active schistosomiasis transmission is occurring in the area, and that integrated educational programs are needed for both the local community and tourists.

Neste trabalho, são discutidos os modos de transmissão da esquistossomose na localidade de São José da Serra, com 500 habitantes, no Município de Jaboticatubas, Minas Gerais, Brasil. A região ao redor recebe, durante todo o ano, milhares de pessoas para a prática de ecoturismo. A ocorrência de esquistossomose aguda em um casal que viajou para essa área, no carnaval de 2007, motivou este estudo. Exames de fezes foram feitos em 268 moradores, 53,6% da população total. Trinta e cinco (13%) estavam eliminando ovos nas fezes. Comparando os resultados coproscópicos com os de um inquérito feito em 2005, observa-se um aumento da proporção de positivos de 9,6% para 12,5%, entre 56 pessoas que participaram em ambos os estudos. Foram coletados 65 exemplares de Biomphalaria glabrata, sendo 1 (1,5%) positivo. No inquérito malacológico realizado em 2005, em 182 biomphalarias, nenhum exemplar foi encontrado positivo. Esses dados indicam a ocorrência de transmissão ativa de esquistossomose na área, revelando a necessidade de planejamento coordenado no desenvolvimento do setor turístico, incluindo a implantação de programas educativos integrados para a comunidade e, principalmente, para os turistas.

This paper discusses schistosomiasis transmission in São José da Serra, a village with a population of 500 in the county of Jaboticatubas, Minas Gerais State, Brazil. The area receives thousands of visitors a year for ecotourism. The study was motivated by a case of acute schistosomiasis involving a couple that spent the 2007 Carnival (Mardi Gras) holiday in the area. Stool tests from 268 local residents (53.6% of the population) showed that 35 (13%) were positive for the infection. A comparison with a previous survey (2005) in the same location showed an increase in the schistosomiasis-positive rate from 9.6% to 12.5%, among the 56 individuals who participated in both surveys. A malacological survey of 65 Biomphalaria glabrata snails showed one specimen (1.5%) eliminating cercariae. In a similar survey in 2005, no positive snail specimens were found. The study indicates that active schistosomiasis transmission is occurring in the area, and that integrated educational programs are needed for both the local community and tourists.

Using media discourse analysis for material published by the press on schistomisasis in the city of Jaboticatubas, the possible determining factors of narrative and discursive constructions in the diffusion of information are discussed. It was observed that media discourse treats schistosomiasis in 1962 as something from the natural order. By 1997 and 1998, the media discourse strategies reveal ideological treatment in favor of certain social segments. Situations are identified in which social agents in specific contexts construct the meanings of this endemic disease. It was concluded that the economic organization of space was a determining factor in the production and circulation of the media discourses.

Jaboticatubas is a municipality in the metropolitan region of Belo Horizonte which has been a target of a wide media release as "the capital of schistosomiasis" since the 1960's. In order to give support to a work based on an integrated control, we sought to identify the disease determinants at the site. A transversal study was carried out aimed at identifying prevalence rates of the disease and factors associated with the infection in the district of São José de Almeida, and two close localities, Cipó Velho and São José da Serra, all of them located in the municipality of Jaboticatubas. A parasitological survey was performed, applying the Kato-Katz method with two slides per sample in 1186 schoolchildren which represents 77% of all registered pupils in four public schools in 2001. Among these schoolchildren a number of 101 (8.6%) prooved positive for Schistosoma mansoni eggs in their stool samples. A total of 64 families, whose schoolchildren had shown to be positive for schistosomiasis, also undertook examinations. As negative control, a random sample was collected from the 206 families, whose children had proven negative for schistosomiasis. The prevalence among 270 families (1304 people) was 12%. To assess those who continued to have contact with possibly contaminated water, 1061 (81.4%) people of the 270 families were interviewed. A multivariate analysis identified the following factors associated with the infection: time of residence in the area (short period), garbage disposal (use of deserted areas), gender (male), age (from 10 to 29 years), and water contact (daily and weekly). Further analysis of these factors revealed a close correlation between water contact and the disease, with a positive significant frequency concerning almost all those items. Depending on gender and age significant variations of water contact patterns associated with leisure and professional activities were found. A malacological survey on water collections in the area identified snails of the species Biomphalaria straminea and B. glabrata. The latter showed 17 (0.6%) specimens positive for S. mansoni. Qualitative studies have complemented such evidences, which allowed us to design a reference picture and specific indicators of the disease for the local population. Those data provided the essential information to continue the development of an already ongoing educative process, as well as projects on environmental improvements.

The experience described here is part of an extensive program that aims to stimulate schools to develop health integrated projects from theme generators, i.e., themes that have a meaning for the community. It was developed in Jaboticatubas, a town in the metropolitan region of Belo Horizonte, capital of the state of Minas Gerais, Brazil, and the focus was schistosomiasis. The selection was based on the expressive and historical prevalence of this disease in the county, which has been known as the "capital of schistosomiasis", in a national press release since the 1960's. Schistosomiasis is also a theme pointed out by teachers as requiring more information and methodologies to work with their students, most of them living in areas of high risk of transmission. In addition, during the last years, this disease has been transmitted silently through an increasing rural tourism in that region, requiring integrated and effective control actions. The developed strategy included four schools, whose teachers, students, and families took part in the process. It emphasizes in a critical pedagogy approach, which focuses on health issues as themes that may mobilize the school community and awake the population to a work which integrates environment, health, and citizenship. The results demonstrate that teachers and students not only acquired new knowledge and methodological skills, but also gained confidence in their ability to improve their health conditions. Thus, the project promotes a critical education that can result a more permanent effect on the control of schistosomiasis as well as other benefits for the schools and for the population.