title: A combined strategy to improve the control of Schistosoma mansoni in areas of low prevalence in Brazil.
abstract: Results of stool examinations for infections with Schistosoma mansoni among schoolchildren, living in a village of Minas Gerais State, Brazil, were used as an indicator to identify schistosomiasis-positive individuals within the entire population. This new approach is based on dividing the community into schoolchildren, members of households of schistosomiasis-positive and -negative schoolchildren, and members of households without schoolchildren. Each subgroup was evaluated comparing different sampling efforts with the predetermined "gold standard" to find the best relationship between detection rate and sampling effort. Consequently these results were combined, and a proposal for a new strategy, valid for an entire community, was elaborated. This alternative approach during the screening process permits to treat a similar proportion of positives as detected with 6 Kato-Katz slides of 3 stool samples, with 3-fold reduced sampling effort, enhancing the efficiency of schistosomiasis control programs in low-endemic areas.
authors.affiliation: Laboratory of Schistosomiasis, Department of Scientific Support-Unit for Biostatistics, René Rachou Research Center/Oswaldo Cruz Foundation, Avenida Augusto de Lima 1715, Belo Horizonte, Minas Gerais, Brazil. marenk@cpqrr.fiocruz.br
authors.forename: Martin Johannes
authors.initials: MJ
authors.lastname: Enk
authors.forename: Anna Carolina Lustosa
authors.initials: AC
authors.lastname: Lima
authors.forename: Cristiano Lara
authors.initials: CL
authors.lastname: Massara
authors.forename: Paulo Marcos Zech
authors.initials: PM
authors.lastname: Coelho
authors.forename: Virginia Torres
authors.initials: VT
authors.lastname: Schall
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D010270:Parasite Egg Count; D011159:Population Surveillance; D011237:Predictive Value of Tests; D015995:Prevalence; D011314:Preventive Health Services; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D012680:Sensitivity and Specificity