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SCHISTOSOMA MANSONI REINFECTION: ANALYSIS OF RISK FACTORS BY CLASSIFICATION AND REGRESSION TREE (CART) MODELING
Socioeconomic aspects of health
Schistosomiasis
Children
Decision trees
Brazil
Schools
Infectious disease control
Autor(es)
Afiliação
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil/Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Salvador, BA, Brazil/Fundação Oswaldo Cruz.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil/Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Salvador, BA, Brazil/Fundação Oswaldo Cruz.
Universidade Federal de Minas Gerais. Instituto de Ciências Exatas. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil
University of California Medical Center. Department of Epidemiology and Biostatistics. San Francisco, CA, United States of America
George Washington University. School of Medicine and Health Science. Microbiology, Immunology and Tropical Medicine. Washington DC, United States of America
Universidade Federal de Minas Gerais. Instituto de Ciências Exatas. Belo Horizonte, MG, Brazil
Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Salvador, BA, Brazil/Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil/Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Salvador, BA, Brazil/Fundação Oswaldo Cruz.
Universidade Federal de Minas Gerais. Instituto de Ciências Exatas. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brazil
University of California Medical Center. Department of Epidemiology and Biostatistics. San Francisco, CA, United States of America
George Washington University. School of Medicine and Health Science. Microbiology, Immunology and Tropical Medicine. Washington DC, United States of America
Universidade Federal de Minas Gerais. Instituto de Ciências Exatas. Belo Horizonte, MG, Brazil
Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. Salvador, BA, Brazil/Fundação Oswaldo Cruz. Instituto Rene Rachou. Belo Horizonte, MG, Brazil
Resumo em Inglês
Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas Gerais state Brazil. Parasitological, socioeconomic, demographic, and water contact information were surveyed in 506 S. mansoni-infected individuals, aged 6 to 15 years, resident in these endemic areas. Eligible individuals were treated with PZQ until they were determined to be negative by the absence of S. mansoni eggs in the feces on two consecutive days of Kato-Katz fecal thick smear. These individuals were surveyed again 12 months from the date of successful treatment with PZQ. A classification and regression tree modeling (CART) was then used to explore the relationship between socioeconomic, demographic, and epidemiological variables and their reinfection status. The most important risk factor identified for S. mansoni reinfection was their “heavy” infection at baseline. Additional analyses, excluding heavy infection status, showed that lower socioeconomic status and a lower level of education of the household head were also most important risk factors for S. mansoni reinfection. Our results provide an important contribution toward the control and possible elimination of schistosomiasis by identifying three major risk factors that can be used for targeted treatment and monitoring of reinfection. We suggest that control measures that target heavily infected children in the most economically disadvantaged households would be most beneficial to maintain the success of mass chemotherapy campaigns.
Palavras-chave em inglês
Schistosoma mansoniSocioeconomic aspects of health
Schistosomiasis
Children
Decision trees
Brazil
Schools
Infectious disease control
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