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Impact of a City-Wide Sanitation Programme in Northeast Brazil on Intestinal Parasites Infection in Young Children.

Barreto, M.L.; Genser, B.; Strina, A.; Teixeira, M.G.; Assis, A.M.; Rego, R.F.; Teles, C.A.; Prado, M.S.; Matos, S.; Alcântara-Neves, N.M.; Cairncross, S.;
Environ Health Perspect, 2011; 118(11):1637-42
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Malaria Centre

pub_id
20705544
pubmedid
20705544
ISI
283711800039
reference_type
author
Barreto, M.L.; Genser, B.; Strina, A.; Teixeira, M.G.; Assis, A.M.; Rego, R.F.; Teles, C.A.; Prado, M.S.; Matos, S.; Alcântara-Neves, N.M.; Cairncross, S.;
title
Impact of a City-Wide Sanitation Programme in Northeast Brazil on Intestinal Parasites Infection in Young Children.
secondary_title
Environ Health Perspect
ISBNISSN
1552-9924
volume
118
number
11
pages
1637-42
year
2011
abstract
BACKGROUND: Sanitation affects health, especially that of young children. Residents of Salvador, in Northeast Brazil, have had a high prevalence of intestinal parasites. A citywide sanitation intervention started in 1996 aimed to raise the level of sewer coverage from 26% to 80% of households.
OBJECTIVES: We evaluated the impact of this intervention on the prevalence of Ascaris lumbricoides, Trichuris trichuria, and Giardia duodenalis infections in preschool children.
METHODS: The evaluation was composed of two cross-sectional studies (1998 and 2003-2004), each of a sample of 681 and 976 children 1-4 years of age, respectively. Children were sampled from 24 sentinel areas chosen to represent the range of environmental conditions in the study site. Data were collected using an individual/household questionnaire, and an environmental survey was conducted in each area before and after the intervention to assess basic household and neighborhood sanitation conditions. Stool samples were examined for the presence of intestinal parasites. The effect of the intervention was estimated by hierarchical modeling, fitting a sequence of multivariate regression models.
FINDINGS: The prevalence ofA. lumbricoides infection was reduced from 24.4% to 12.0%, T. trichuria from 18.0% to 5.0%, and G. duodenalis from 14.1% to 5.3%. Most of this reduction appeared to be explained by the increased coverage in each neighborhood by the sewage system constructed during the intervention. The key explanatory variable was thus an ecological measure of exposure and not household-based, suggesting that the parasite transmission prevented by the program was mainly in the public (vs. the domestic) domain.
CONCLUSION: This study, using advanced statistical modeling to control for individual and ecological potential confounders, demonstrates the impact on intestinal parasites of sanitation improvements implemented at the scale of a large population.
keywords
secondary_author
place_published
publisher
number_of_volumes
tertiary_author
tertiary_title
edition
date
type_of_work
subsidiary_author
alternate_title
call_number
accession_number
custom_1
WOS OK
custom_2
Unknown
custom_3
custom_4
10.1289/ehp.1002058
custom_5
PMC
custom_6
10
label
2016-10-18
notes
Journal Article
url
author_address
Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil. mauricio@ufba.br
library
10.1289/ehp.1002058 20705544 PMC2974706
date_accepted
date_online
created
2010-11-25 16:27:12
modified
2016-07-08 00:00:00
library

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<ArticleId IdType="pubmed">20705544</ArticleId>
<ArticleId IdType="pmc">PMC2974706</ArticleId>