title: Low transmission areas of schistosomiasis in Venezuela: consequences on the diagnosis, treatment, and control.
abstract: Schistosomiasis low transmission areas as Venezuela, can be defined as those where the vector exists, the prevalence of active cases is under 25%, individuals with mild intensity of infection predominate and are mostly asymptomatic. These areas are the consequence of effective control programs, however, "silent" epidemiological places are difficult to trace, avoiding the opportune diagnosis and treatment of infected persons. Clinic and abdominal ultrasound have not shown to discriminate infected from uninfected persons in areas where besides Schistosoma mansoni, intestinal parasites are the rule. Under these conditions, serology remains as a very valuable diagnostic tool, since it gives a closer approximation to the true prevalence. In this sense, circumoval precipitin test, ELISA-SEA with sodium metaperiodate, and alkaline phosphatase immunoassay joined to coprology allow the identification of the "schistosomiasis cases". In relation to public health, schistosomiasis has been underestimated by the sanitary authorities and the investment on its control is being transferred to other diseases of major social and political relevance neglecting sanitary efforts and allowing growth of snail population. Some strategies of diagnosis and control should be done before schistosomiasis reemergence occurs in low transmission areas.
authors.affiliation: Cátedra de Parasitología, Escuela Luís Razetti, Universidad Central de Venezuela. belkisyole@yahoo.com.mx
authors.forename: Belkisyolé Alarcón de
authors.initials: BA
authors.lastname: Noya
authors.forename: Raiza Ruiz
authors.initials: RR
authors.lastname: Guevara
authors.forename: Cecilia
authors.initials: C
authors.lastname: Colmenares
authors.forename: Sandra
authors.initials: S
authors.lastname: Losada
authors.forename: Oscar
authors.initials: O
authors.lastname: Noya
mesh_terms: D000818:Animals; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D012555:Schistosomiasis mansoni / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D014687:Venezuela