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Schistosomiasis mansoni

Schistosomiasis mansoni. Eduardo FingerSanta Casa SP 2008. Objectives. Acquaint students with a basic knowledge of schistosomiasis mansoniIllustrate the experience of a few countries in trying to deal with schistosomiasisDiscuss what can be learned from these examples and how that applies to the project.

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Schistosomiasis mansoni

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    2. Schistosomiasis mansoni

    3. Objectives Acquaint students with a basic knowledge of schistosomiasis mansoni Illustrate the experience of a few countries in trying to deal with schistosomiasis Discuss what can be learned from these examples and how that applies to the project

    7. Spread of S. mansoni followed slave trade routes

    8. Schistosomiasis: route of spread inside Brazil

    9. S.mansoni life cycle

    10. Infection

    11. Skin penetration by S. mansoni

    12. Adult worm habitat

    13. Destination of S. mansoni eggs

    14. Liver pathology associated with schistosomiasis Morbidity and mortality in schistosomiasis are due to granulomas formed around parasite eggs

    15. Polar forms of chronic schistosomiasis mansoni Intestinal: Well tolerated, can last years without significant harm to host Low morbidity and mortality Hepatosplenic: Important inflammation and fibrosis in portal spaces Extensive liver fibrosis produces portal hypertension, splenomegaly, ascites, portal-systemic shunting and gastrointestinal bleeding High morbidity and mortality

    16. Clinical presentation of severe schistosomiasis

    17. Treatment and control Treatment: praziquantel and oxamniquine Reinfection rate is very high. Vaccine strategy: not expected to be available soon Control strategy: massive populational screening and treatment. Increase access to treated water.

    18. Programs to control schistosomiasis Four pillars Mass chemotherapy (WHO guidelines) Molluscicides (chemical and/or biological) Sanitation (water and sewer treatment) Education Other factor: Urbanization

    19. Control of Schistosomiasis: 4 different experiences

    20. Prevalence of schistosomiasis following PECE

    21. Conclusions from the PECE no method is able, in an isolated way, to control schistosomiasis and every control program should consider the need of multidisciplinary application of existing methods; the main methods for long term control of infection are the implementation of basic sanitation conditions, potable water supply, as well as sanitary education and community participation; specific treatment in endemic areas associated to intermediary hosts control in "epidemiological important" foci is extremely relevant regarding short term morbidity control, though not sufficient to interrupt disease transmission; although schistosomiasis control, in a country like Brazil, with great vectors dissemination and population mobilization, is a difficult process, it is possible through intensification, adjustment, and continuity of programs in long term; it is necessary to develop a critical analysis of schistosomiasis control experience in Brazil, in order to redirect the program in an effective way, aiming to achieve only residual levels of infection for the next 20 or 30 years or, even better, its full control. Cienc. Cult.vol.55no.1So PauloJan./Mar2003

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