The objective of the present paper was to compare accessibility and utilisation of schistosomiasis diagnostic and treatment services in a small village and the surrounding rural area in northern part of the state of Minas Gerais Brazil. The study included 1,228 individuals: 935 central village residents and 293 rural residents of São Pedro do Jequitinhonha. Schistosoma mansoni infection rates were significantly higher in the central village than in the rural area during a survey in 2007 (44.3% and 23.5%, respectively) and during the 2002 schistosomiasis case-finding campaign (33.1% and 26.5%, respectively) (p < 0.001). However, during the 2002-2006 period, only 23.7% of the villagers and 27% of the rural residents obtained tests on their own from health centres, hospitals and private clinics in various nearby towns. In 2007, 63% of the villagers and 70.5% of the rural residents reported never having received treatment for schistosomiasis. This paper reveals considerable variation in the accessibility and utilisation of schistosomiasis-related health services between the central village and the rural area. A combination of low utilisation rates between 2002-2006 and persistently high S. mansoni infection rates suggest that the schistosomiasis control program must be more rapidly incorporated into the primary health services.

This paper examines recent developments in migration studies. It reviews literature related to the potential role of internal population movement in the occurrence of schistosomiasis in Brazil and modifies Prothero's typology of population movement for use in Brazil. This modified classification system may contribute to a better understanding of schistosome transmission as well as improved research and control programs. The results of this study indicate that population movement in Brazil primarily involves economically-motivated rural-urban and interregional movement. However, several movement patterns have become increasingly important in recent years as a result of changing socioeconomic and urbanisation dynamics. These patterns include urban-urban, intracity and urban-rural movement as well as the movement of environmental refugees and tourists. Little is known about the epidemiological significance of these patterns. This paper also highlights the role of social networks in the decision to migrate and to settle. Prothero's classic population movement typology categorises movement as either one-way migrations or circulations and examines them along spatial and temporal scales. However, the typology must be modified as epidemiological information about new patterns becomes available. This paper identifies areas that require further research and offers recommendations that can improve the measurement and spatial analysis of the relationship between population movement and schistosomiasis.

Schistosomiasis prevalence and egg counts remained low one year after chemotherapy in most households in a hyperendemic rural area in northern Minas Gerais but several distinct spatial patterns could be observed in relation to IgE levels and to a lesser extent to exposure risk (TBM) and type of water supply. An inverse relationship between pre-treatment household prevalence and egg counts on the one hand and post-treatment IgE levels on the other were noted in two of the five communities. Low exposure risk was associated with the low pre-treatment infection rates in the central village but did not contribute to the decline of infection rates after chemotherapy in the study area, as indicated by the significant increase in water contact during the posttreatment period (p < 0.0001). Distance between households and the streams and socioeconomic factors were also unimportant in predicting the spatial distribution of infection. These results are consistent with the production and antiparasitic effect of high levels of IgE in Schistosoma mansoni infection.

The objective of this study was to analyse the effect of using two health education approaches on knowledge of transmission and prevention of schistosomiasis of school children living in a rural endemic area in the state of Minas Gerais, Brazil. The 87 children participating in the study were divided into three groups based on gender, age and presence or absence of Schistosoma mansoni infection. In the first group the social representation model and illness experience was used. In the second group, we used the cognitive model based on the transmission of information. The third group, the control group, did not receive any information related to schistosomiasis. Ten meetings were held with all three groups that received a pre-test prior to the beginning of the educational intervention and a post-test after the completion of the program. The results showed that knowledge levels in Group 1 increased significantly during the program in regard to transmission (p = 0.038) and prevention (p = 0.001) of schistosomiasis. Groups 2 and 3 did not show significant increase in knowledge between the two tests. These results indicate that health education models need to consider social representation and illness experience besides scientific knowledge in order to increase knowledge of schistosomiasis transmission and prevention.

This paper examines the distribution and infection of Biomphalaria glabrata with Schistosoma mansoni in all aquatic snail habitats in a rural area in the state of Minas Gerais, Brazil, in relation to physico/biotic and behavioral factors. Snail and environmental surveys were carried out semi-annually between July 2001 and November 2002 at 106 sites. Collected snails were examined in the laboratory for infection. B. glabrata densities were highest in overflow ponds, irrigation ponds, springs, canals and wells, and lowest in fishponds and water tanks. Snail densities were higher during the hot, rainy season except for streams and canals and were statistically associated with the presence of fish, pollution, and vegetation density. Tilapia fish and an unidentified Diptera larva were found to be predators of B. glabrata but ducks were not. Twenty-four of the 25 infected snails were collected in 2001(1.4% infection rate) and only one in 2002, after mass chemotherapy. The occurrence of B. glabrata in all 11 snail habitats both at and away from water contact sites studied indicates widespread risk of human infection in the study area. In spite of the strong association between B. glabrata and tilapia in fishponds we do not recommend its use in schistosomiasis control for ecological reasons and its relative inefficiency in streams and dams.

The dichloromethane extract prepared from the underground parts of Eleutherine bulbosa (Miller) Urban (Iridaceae) showed strong activity in the direct bioautography assay with the phytopathogenic fungus Cladosporium sphaerospermum. This assay was used to guide the fractionation of this extract and allowed the isolation of four compounds: the new naphthoquinone eleutherinone[8-methoxy-1-methyl-1,3-dihydro-naphtho(2,3-c)furan-4,9 -dione] and the known compounds, previously isolated from this species, eleutherin [9-methoxy-1(R),3(S)-dimethyl-3,4-dihydro-1H-benzo(g)isochromene-5,10-dione], isoeleutherin [9-methoxy-1(R),3(R)-dimethyl-3,4-dihydro-1H-benzo(g)isochromene-5,10-dione], and eleutherol [4-hydroxy-5-methoxy-3(R)-methyl-3H-naphtho(2,3-c)furan-1 -one]. All quinonoid compounds showed strong antifungal activity in the bioautography assay at 100 µg/spot, while eleutherol was inactive.

A total of 256 sites in 11 habitats were surveyed for Biomphalaria in Melquiades rural area (State of Minas Gerais) in August and November 1999 and in March 2000. Of the 1,780 Biomphalaria collected, 1,721 (96.7%) were B. glabrata and 59 (3.3%) B. straminea. Snails were found in all habitats except in wells, with the largest mean numbers in tanks, seepage ponds and canals, and the smallest numbers in springs, rice fields and fishponds. People's knowledge of the occurrence of Biomphalaria at the collection sites and the presence of Biomphalaria ova were strongly correlated with the occurrence of snails, and distance between houses and collection sites, as well as water velocity were inversely correlated with Biomphalaria occurrence (p < 0.001). The strongest predictor o f Biomphalaria occurrence was the presence of tilapia fish in fishponds. Fourteen Biomphalaria (0.8% of all snails) found at 6 sites were infected with Schistosoma mansoni. Suggestions are made for the utilization of local people's knowledge in snail surveys and further studies are recommended on the possible use of tilapia for biological control of Biomphalaria in fishponds, as well as modeling of S. mansoni transmission and reinfection.

Polygonum punctatum (Polygonaceae) is an herb known in some regions of Brazil as "erva-de-bicho" and is used to treat intestinal disorders. The dichloromethane extract of the aerial parts of this plant showed strong activity in a bioautographic assay with the fungus Cladosporium sphaerospermum. The bioassay-guided chemical fractionation of this extract afforded the sesquiterpene dialdehyde polygodial as the active constituent. The presence of this compound with antibiotic, anti-inflammatory and anti-hyperalgesic properties in "erva-de-bicho" may account for the effects attributed by folk medicine to this plant species.

Este estudo foi realizado em área endêmica do Estado de Minas Gerais, Brasil, com o objetivo de determinar os fatores sócio-culturais que influenciam o conhecimento, as atitudes e práticas dos indivíduos da comunidade em relação a esquistossomose mansoni. Os resultados mostraram que tanto crianças quanto professores conhecem a doença e possuem concepções corretas e incorretas sobre a transmissão. A doença não é vista como um problema importante de saúde pública e não afeta as atividades pelo fato de não causar sintomas graves na maior parte da população. Apesar da maioria dos entrevistados relacionar a transmissão da doença à água e falta de saneamento básico, não utiliza nenhuma medida preventiva para evitar a infecção, tendo em vista que sua subsistência depende em grande parte da agricultura, pesca e outras atividades relacionadas à água. Neste trabalho, os autores discutem o desenvolvimento de um programa de educação em saúde baseado na percepção e conhecimento dos indivíduos sobre a doença e seus determinantes como sendo de utilidade para a modificação não só do seu comportamento mas também do contexto.

A study to determine the sociocultural factors influencing knowledge, attitudes, and practices of individuals from a small community toward Schistosoma mansoni infection was carried out in an endemic area in the State of Minas Gerais, Brazil. The study used qualitative approaches to collect data from school-aged children and teachers. Specific findings were that the individuals interviewed were aware of the disease, but also held inaccurate popular beliefs about transmission. Misconceptions coexisted with accurate knowledge both in children and teachers. The disease was not seen as a major health problem and did not affect their activities since it did not cause severe symptoms in most of the individuals. Although the majority of the participants related transmission to water and lack of sanitation, they did not take any preventive measures since their subsistence is highly dependent on irrigation, farming, fishing, and other essential work that is directly related to water activities. The authors discuss the development of a health education program based on the knowledge and perception of individuals about the disease and its determinants as being important for the context and behavioral change.

Este estudo foi realizado em área endêmica do Estado de Minas Gerais, Brasil, com o objetivo de determinar os fatores sócio-culturais que influenciam o conhecimento, as atitudes e práticas dos indivíduos da comunidade em relação a esquistossomose mansoni. Os resultados mostraram que tanto crianças quanto professores conhecem a doença e possuem concepções corretas e incorretas sobre a transmissão. A doença não é vista como um problema importante de saúde pública e não afeta as atividades pelo fato de não causar sintomas graves na maior parte da população. Apesar da maioria dos entrevistados relacionar a transmissão da doença à água e falta de saneamento básico, não utiliza nenhuma medida preventiva para evitar a infecção, tendo em vista que sua subsistência depende em grande parte da agricultura, pesca e outras atividades relacionadas à água. Neste trabalho, os autores discutem o desenvolvimento de um programa de educação em saúde baseado na percepção e conhecimento dos indivíduos sobre a doença e seus determinantes como sendo de utilidade para a modificação não só do seu comportamento mas também do contexto.

A study to determine the sociocultural factors influencing knowledge, attitudes, and practices of individuals from a small community toward Schistosoma mansoni infection was carried out in an endemic area in the State of Minas Gerais, Brazil. The study used qualitative approaches to collect data from school-aged children and teachers. Specific findings were that the individuals interviewed were aware of the disease, but also held inaccurate popular beliefs about transmission. Misconceptions coexisted with accurate knowledge both in children and teachers. The disease was not seen as a major health problem and did not affect their activities since it did not cause severe symptoms in most of the individuals. Although the majority of the participants related transmission to water and lack of sanitation, they did not take any preventive measures since their subsistence is highly dependent on irrigation, farming, fishing, and other essential work that is directly related to water activities. The authors discuss the development of a health education program based on the knowledge and perception of individuals about the disease and its determinants as being important for the context and behavioral change.

Este trabalho teve como objetivo estudar a relação da utilização doméstica de água com fatores sócio-econômicos, ambientais e espaciais em comunidade rural do nordeste de Minas Gerais. Utilizamos observação direta, entrevistas, questionário, análise de regressão e mapas estatísticos. Os resultados mostraram que a utilização da água é caracterizada por 1) valores geralmente baixos mas altamente flutuantes por pessoa/dia; 2) uso comum das fontes de água entre famílias; 3) uso de várias fontes de água; 4) não utilização de locais altamente contaminados dos córregos e 5) predominância de fatores sócio-econômicos. Os domicílios que possuem fonte própria de água utilizaram, em média, 25,3 litros por pessoa/dia e aqueles sem fonte própria, 9,0 l, com o último grupo utilizando mais as águas dos córregos. O uso de água apresentou, ainda, variação espacial. Os fatores sócio-econômicos, condições de moradia, presença de fossa, tipo de água e índice de bens de consumo foram relacionados significativamente ao uso de água. Os dados sugerem uma relação entre fonte de água, condições sanitárias e a ocorrência de doenças transmitidas pela água. Este estudo confirma a adequação dos métodos microgeográficos, de observação direta e de entrevista para os estudos quantitativos sobre utilização de água.

This paper examines the relationship between domestic water use and socioeconomic, environmental, and spatial parameters at the household level in a small rural village in northern Minas Gerais State. Five methods are used direct observation, household interviews, self-reporting by households, regression analysis, and statistical mapping. Results show that water use is characterized by 1) generally low but widely fluctuating values per person per day, 2) sharing of water sources between households, 3) the use of multiple sources by individual households, 4) avoidance of heavily contaminated stream sites, and 5) predominance of socioeconomic factors in water use. Households owning their own water supply used, on average, 25.3 liters per person/day and those without a supply 9.0 l, with higher use of the local streams among the latter. Water use varied spatially. The socioeconomic factors house quality, latrine ownership, type of water source, and a utility index were significantly correlated with water use. Implications of these simple household water sources and the more deficient sanitary facilities for potential water-borne disease transmission are briefly discussed and suggestions made for further improvements. This study confirms the appropriateness of the application of direct observation, interview, and microgeographical methods for quantitative water use studies.

Este trabalho teve como objetivo estudar a relação da utilização doméstica de água com fatores sócio-econômicos, ambientais e espaciais em comunidade rural do nordeste de Minas Gerais. Utilizamos observação direta, entrevistas, questionário, análise de regressão e mapas estatísticos. Os resultados mostraram que a utilização da água é caracterizada por 1) valores geralmente baixos mas altamente flutuantes por pessoa/dia; 2) uso comum das fontes de água entre famílias; 3) uso de várias fontes de água; 4) não utilização de locais altamente contaminados dos córregos e 5) predominância de fatores sócio-econômicos. Os domicílios que possuem fonte própria de água utilizaram, em média, 25,3 litros por pessoa/dia e aqueles sem fonte própria, 9,0 l, com o último grupo utilizando mais as águas dos córregos. O uso de água apresentou, ainda, variação espacial. Os fatores sócio-econômicos, condições de moradia, presença de fossa, tipo de água e índice de bens de consumo foram relacionados significativamente ao uso de água. Os dados sugerem uma relação entre fonte de água, condições sanitárias e a ocorrência de doenças transmitidas pela água. Este estudo confirma a adequação dos métodos microgeográficos, de observação direta e de entrevista para os estudos quantitativos sobre utilização de água.

This paper examines the relationship between domestic water use and socioeconomic, environmental, and spatial parameters at the household level in a small rural village in northern Minas Gerais State. Five methods are used direct observation, household interviews, self-reporting by households, regression analysis, and statistical mapping. Results show that water use is characterized by 1) generally low but widely fluctuating values per person per day, 2) sharing of water sources between households, 3) the use of multiple sources by individual households, 4) avoidance of heavily contaminated stream sites, and 5) predominance of socioeconomic factors in water use. Households owning their own water supply used, on average, 25.3 liters per person/day and those without a supply 9.0 l, with higher use of the local streams among the latter. Water use varied spatially. The socioeconomic factors house quality, latrine ownership, type of water source, and a utility index were significantly correlated with water use. Implications of these simple household water sources and the more deficient sanitary facilities for potential water-borne disease transmission are briefly discussed and suggestions made for further improvements. This study confirms the appropriateness of the application of direct observation, interview, and microgeographical methods for quantitative water use studies.

This paper examines the results of spatial (microgeographical) water contact/schistosomiasis studies in two African (Egyptian and Kenyan) and one Brazilian communities. All three studies used traditional cartographic and statistical methods but one of them emploeyd also GIS (geographical information systems) tools. The advantage of GIS and their potential role in schistosomiasis control are briefly described. The three cases revealed considerable variation in the spatial distribution of water contact, transmission parameters and infection levels at the household and individual levels. All studies showed considerable variation in the prevalence and intensity of infection between households. They also show a variable influence of distance on water contact behavior associated with type of activity, age, sex, socioeconomic level, perception of water quality, season and availability of water in the home. Water contact behavior and schistosomiasis were evaluated in the Brazilian village of Nova União within the context of water sharing between household and age/sex groups. Recommendations are made for further spatial studies on the transmission and control of schistosomiasis.