RESUMO
This study analyzed the evolution of socioeconomic, sanitary, and personal factors as well as spatiotemporal changes in the prevalence of helminthiasis and giardiasis in urban Amazonian children between 2003 and 2011. Child age, lack of sanitation, and lack of access to bottled water were identified as significant associated factors for helminthiasis and giardiasis. There was an overall improvement in socioeconomic and sanitary conditions in the city resulting in decreased helminth prevalences from 12.42 to 9.63% between 2003 and 2010, but the prevalence increased to 15.03% in 2011 due to migratory movement and unstable sanitary conditions. As for Giardiasis, socioeconomic and environmental changes were not enough to reduce prevalence (16% in 2003 and 23% in 2011). Spatial analysis identified a significant cluster for helminthiasis in an area of poor housing conditions. Control programs in the Amazon need to target high-risk areas focusing changes in sanitation, water usage, and health education.
Assuntos
Giardíase/epidemiologia , Helmintíase/epidemiologia , Fatores Socioeconômicos , Criança , Pré-Escolar , Cidades , Feminino , Giardíase/economia , Helmintíase/economia , Humanos , Masculino , Prevalência , Fatores de Risco , SaneamentoRESUMO
BACKGROUND: The Amazon region has the highest seroprevalence of hepatitis A virus (HAV) in Brazil. METHODS: In the present study, the seroprevalence of total HAV antibodies in two groups, composed of 147 and 254 children between 1 and 5 years old in Assis Brasil, Acre, was measured in 2003 and 2010, respectively, and compared with socio-economic changes in the city. RESULTS: In 2003, the HAV seroprevalence rate was 26.5%, while in 2010, it was 22.4%. There was an overall improvement in socio-economic and sanitary conditions, with the exception of open sewage. In 2003, factors associated with positive serology were child age (aOR [adjusted odds ratio] 1.84; 95% CI: 1.28-2.64), having a latrine or not having a toilet at home (aOR 4.73; 95% CI: 1.06-21.17) and the treatment of drinking water with chlorine (aOR 0.26; 95% CI: 0.07-0.92). In 2010, the main factors associated with positive serology were using rivers, streams and rainwater as sources of water for domestic purposes (aOR 24.36; 95% CI: 3.69-160.85); having a wooden or ground floor at home (OR 2.51; 95% CI: 1.11-5.69) and child age (aOR 2.33; 95% CI: 1.66-3.28). CONCLUSIONS: In the Brazilian Amazon, sanitation and water treatment still require improvement and socio-economic development is warranted in order to decrease hepatitis A transmission.