title: [Environmental and social determinants in schistosomiasis mansoni in Ravena, Minas Gerais, Brazil].
abstract: This study identified the role of biological and social determinants in the transmission of schistosomiasis mansoni in Ravena, Minas Gerais, Brazil, in 1980. This data was used to characterize the clinical and epidemiological profiles of the endemic desease in the population, allowing for the determination of the efficacy of the potable water supply and the specific treatment of those infected with S. mansoni. The district contains three locations, Ravenopolis, Ravena and Lavapes, where the prevalence of the endemic disease was, 20.1%, 42.6% and 63.9%, respectively. The prevalence in the district was statistically higher in men. The age brackets that displayed differences by gender were 10-14 and 15-19 years. Severity of infection was statistically different among individuals within the 10-14 year bracket in ali three locations, and in the 15-19 year bracket among individuals from Ravenopolis and Ravena. The hepatointestinal form was associated with age, and individuals under 15 years of age presented risk of infection 8.85 times higher than adults. Multivariable analysis of the factors involved in transmission of the disease showed that Lavapes was independently associated with infection. In that area, poor sanitary conditions and the proximity of houses to streams infested with S. marsoni cercariae facilitated infection of neighborhood women while performing domestic activities, as well as men digging sand from the streams for construction. These results show the focal nature of transmission of the endemic requiring specific intervention for effective control of disease.
authors.affiliation: Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, 30190-002, Brasil.
authors.forename: P
authors.initials: P
authors.lastname: Coura-Filho
authors.forename: M W
authors.initials: MW
authors.lastname: Farah
authors.forename: D F
authors.initials: DF
authors.lastname: Rezende
authors.forename: S S
authors.initials: SS
authors.lastname: Lamartine
authors.forename: O S
authors.initials: OS
authors.lastname: Carvalho
authors.forename: N
authors.initials: N
authors.lastname: Katz