title: Socioeconomic studies of schistosomiasis in Brazil: a review.
abstract: This review finds considerable evidence that socioeconomic status has significantly influenced the transmission, spread and treatment of schistosomiasis in Brazil. High infection rates persist among both the rural and urban poor. Rural living, poor housing and water supplies and low educational level were major factors in schistosomiasis occurrence among agricultural populations. In urban areas, prevailing living conditions in shantytowns and labor migrations from and periodic return movements to rural areas were predictive of schistosomiasis. The risk of the establishment of new transmission foci exists in both rural and urban areas, conferred by and affecting poorer people. Associations between schistosomiasis and socioeconomic parameters, persisting inequities in health services accessibility, prevailing health impacts of schistosomiasis, and the ongoing decentralization of health services point to opportunities and strategies for focused interventions aimed at promoting health-enhancing behavior and living conditions and improving access to health care. The authors call for multidisciplinary studies to better examine the complexities of the socioeconomic environment in relation to schistosomiasis and for economic programs to reduce prevailing socioeconomic inequalities.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California Medical Center, San Francisco, CA 94143-0560, USA.
authors.forename: Helmut
authors.initials: H
authors.lastname: Kloos
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Correa-Oliveira
authors.forename: Humberto Ferreira
authors.initials: HF
authors.lastname: Oliveira Quites
authors.forename: Márcia Christina
authors.initials: MC
authors.lastname: Caetano Souza
authors.forename: Andréa
authors.initials: A
authors.lastname: Gazzinelli
mesh_terms: D001938:Brazil / Q000453:epidemiology; D006801:Humans; D012307:Risk Factors; D012424:Rural Population; D012552:Schistosomiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D012959:Socioeconomic Factors; D014505:Urban Population