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Impact of drainage and sewerage on intestinal nematode infections in poor urban areas in Salvador, Brazil

Moraes, L.R.S.; Cancio, J.A.; Cairncross, S.
Transactions of the Royal Society of Tropical Medicine and Hygiene, 2004; 98(4):197-204
This cross-sectional study was conducted in 1989 among children aged between 5 and 14 years old living in nine poor urban areas of the city of Salvador (pop. 2.44 million), capital of Bahia State, in Northeast Brazil. Three of these areas had benefited from both drainage and sewerage, 3 from improved drainage only, and 3 from neither. The children studied thus belonged to 3 exposure groups regarding their level of sanitation infrastructure. An extensive questionnaire was applied to collect information on each child and on the conditions of the household, and stool examinations of the children 5-14 years old were performed to measure nematode infection. Comparison of the sewerage group with the drainage-only group and the latter with the control (no sewerage or drainage) group showed that, when the level of community sanitation was better, the prevalence of infection among children was less, but risk factors identified for infection were more numerous and more significant. Intensity of infection with Trichuris, but not with Ascaris or hookworm, was also less. The results suggest that sewerage and drainage can have a significant effect on intestinal nematode infections, by reducing transmission occurring in the public domain.