Reductions in the Prevalence and Incidence of Geohelminth Infections following a City-wide Sanitation Program in a Brazilian Urban Centre
Reductions in the Prevalence and Incidence of Geohelminth Infections following a City-wide Sanitation Program in a Brazilian Urban Centre
复制标题
DOI：
10.1371/journal.pntd.0000588
复制
发表时间：
2010-02-01
影响因子：
3.8
通讯作者：
Barreto, Mauricio L.
中科院分区：
文献类型：
--
作者：
Mascarini-Serra, Luciene Maura;Telles, Carlos A.;Barreto, Mauricio L.
目标：在巴西东北部的大型城市中心萨尔瓦多，1997年开始了一项全市范围的卫生干预措施，旨在将家庭的污水处理覆盖率从26%提高到80%。我们的目的是研究干预对学龄期人群中地线虫患病率和发病率的影响。方法：本研究包括两个可比较的队列：第一个队列在干预前的1997年，第二个队列在干预后的2003年。这两个样本都是从24个哨所地区选择的，以代表全市不同的环境条件。在基线和9个月后，对两个队列中的每个人进行了寄生虫学检查。使用半结构化问卷和环境调查收集了人口、社会经济和环境数据。为了检验干预变量对患病率和发病率的影响，采用Poisson多元线性模型序列的分层建模方法，对729名和890名7-14岁儿童(平均年龄=10.4岁，SD=0.05岁)在第一和第二队列中进行了分析。与第一组相比，第二组的患病率和发病率调整后分别降低了27%和34%，25%和32%，33%和26%，以及82%和42%，蛔虫，鞭虫和钩虫。分层模型显示，干预可以解释这些减少的主要部分。结论：我们的结果表明，全市范围内的卫生计划可能会显著降低地球蠕虫的患病率和发病率。
Objective: In the city of Salvador, a large urban centre in Northeast Brazil, a city-wide sanitation intervention started in 1997, aimed at improving the sewerage coverage of households from 26% to 80%. Our aim was to study the impact of the intervention on the prevalence and incidence of geohelminths in the school-aged population.Methods: The study comprised two comparable cohorts: the first assembled in 1997, before the intervention, and the second assembled in 2003, after the intervention. Both were sampled from 24 sentinel areas chosen to represent the different environmental conditions throughout the city. Copro-parasitological examinations were carried out on every individual from both cohorts, at baseline and nine months later. Demographic, socio-economic, and environmental data were collected using semi-structured questionnaires and environmental surveys. A hierarchical modelling approach fitting a sequence of Poisson multivariate linear models was undertaken to test the effect of the intervention variables on the prevalence and incidence rate ratios.Findings: 729 and 890 children aged 7-14 years (mean = 10.4 y, SD = 0.05 y) were analysed over the first and the second cohorts, respectively. The adjusted reductions of the prevalence and incidence rates at the second in relation to the first cohort were 27% and 34%, 25% and 32%, 33% and 26%, and 82% and 42% for geohelminths overall, Ascaris lumbricoides, Trichuris trichiura, and hookworm, respectively. Hierarchical modelling showed that a major part of each of these reductions was explained by the intervention.Conclusion: Our results show that a city-wide sanitation program may reduce significantly the prevalence and incidence of geohelminths.