Utilização de critérios Coproscópicos e Sorológicos na detecção de casos de esquistossomose mansônica em área de baixa endemicidade no Estado do Ceará

Abstract

Schistosomiasis is a disease caused by parasites of the genus Schistosoma, killing hundreds of thousands of people each year worldwide.. The Schistosoma has several species of clinical interest. In our country the cause of Schistosomiasis is the S. mansoni and the main reservoir host and the parasite is starting with the man that the eggs are removed in feces. The snails are the intermediate host. The main species of snails host of Schistosoma mansoni in Brazil are: Biomphalaria glabrata, Biomphalaria tenagophila and Biomphalaria straminea. The third kind in the predominant in Ceará. The disease has presence in over 74 countries (virtually all underdeveloped). Around state 500 to 600 million people are at risk of being affected and more than 200 million are infected every year, and this is mainly due to lack of sanitation and health education. To the best prevention of this disease is to be made the diagnosis and treatment of the population to avoid targeting comes in contact with water containing snails (ponds, lakes, rivers etc). It is a disease that can develop into serious complications, possibly leading to death according to extensive fibrosis caused by the presence in liver parenchyma of the Schistosoma mansoni eggs, forming granulomas. So the main objective of this study was to develop a strategy to increase effectiveness in identifying patients positive for Schistosomiasis in areas of low endemic in the state of Ceara, using a protocol combining a technique in which antibodies (IgG - ELISA) with examinations of sequential stool. This work was followed by steps, in which the first of the 287 patients who underwent the method of Kato-Katz, 11 (3.8%) showed positive results for S. mansoni. On the other helminths are: Trichuris trichiura 25 (8.7%), A. lumbricoides 19 (6.6%) and Hookworms 15 (5.2%). For the tests, ELISA, 97 (33.8%) were positive. All patients who had eggs in the feces were positive in the serologic test. In this group are included the 11 that were positive in feces analysis (Figure 1). From patients with Elisa positive and negative Kato-Katz, only 56 handed the three samples of stool for a second analysis Of these, 14 (25%) were positive for Schistosoma mansoni. Of the 42 patients who remained negative, 22 responded in the questionnaire that had never schistosomiasis but never received treatment for the disease. Our present study was to not only determine the prevalence of the disease in the municipality, and to identify the largest possible number of infected individuals, the serological method was applied in order to accommodate the population living in those areas of risk of transmission or at risk of infection, mainly by domestic and leisure activities. In view of our results, we believe, in agreement with other authors, that using the ELISA technique combined with repeated analysis of at least 5 simples of feces, it becomes easier to diagnose patients positive for schistosomiasis, thus improving the hypothesis that probably in the near future, being able to combine parasitological and sorological in the programme for the control of schistosomiasis, an important factor for detection of new carriers of the disease.