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A Proposal to Control Schistosomiasis in Caju

A Proposal to Control Schistosomiasis in Caju. January 18, 2008. Outline. Introduction Objectives Methods Results Discussion Recommendations. Caju. Approximately 570 residents in central Caju and surrounding area (2005 data) 1 health post with one health worker

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A Proposal to Control Schistosomiasis in Caju

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  1. A Proposal to Control Schistosomiasis in Caju January 18, 2008

  2. Outline • Introduction • Objectives • Methods • Results • Discussion • Recommendations

  3. Caju • Approximately 570 residents in central Caju and surrounding area (2005 data) • 1 health post with one health worker • Physician visit every 15 days

  4. Caju Travessa Ma. Gato St. Manoel Gato St. Stream Nova St. Stream Rural Area Cesario Martins St. School Joaquim M. Araujo St. Plaza PSF 7 de setembro St. Church Main Acess

  5. Snapshot of Caju 2005 • 23% illiterate • 43% lack a bathroom • Occupations: • 22% agriculture • 13% housewife • 7% retired • 32% students • 13% under school-age

  6. Earlier Study of Schisto. Methods: • Data from 2003-2005 • Prior to availability of treated water • Feces exam: 1 egg/g of feces  Prevalence: 61,4% (n=235) • 1o Stool Exam: nov/2003 • 1o Treatment: nov/2004 • 2o Stool Exam: dec/2004 • 2o Treatment: feb/2005 • 3o Stool Exam: mar/2005 • Analysis of database: Epi-Info 6.04 d Program

  7. Schisto. Cases in Caju Results • Median age: 17 (range: 1-91) • Gender: 57% Female • Median monthly earnings: 250 reais • Median monthly govt. support: 75 reais

  8. Earlier Study of Schisto. Results • Feces exam: 1 egg/g of feces  n: 387 *Missing: 17.9% **No information in database

  9. Descriptive Study Comparison of in-home laundry facility between cases and non-cases Prevalence Ratio = 0.35 (0.21 – 0.57) p < 0.05

  10. Descriptive Study Comparison of in-home water container* between cases and non-cases Prevalence Ratio = 0.42 (0.25 – 0.68) p = 0.0001 * containing untreated water

  11. Descriptive Study Comparison of faucet between cases and non-cases Prevalence Ratio = 0.48 (0.30 – 0.76) p = 0.0008

  12. Descriptive Study Comparison of stream use between cases and non-cases Prevalence Ratio = 2.09 (1.31 – 3.36) p = 0.001

  13. Descriptive Study Comparison of gender between cases and non-cases Prevalence Ratio = 1.82 (1.17 – 2.83) p = 0.0045

  14. Descriptive Study Comparison of age between cases and non-cases

  15. Earlier Study of Schisto. Results • Warm burden (eggs/g feces) of Caju Schisto. Cases (first exam)

  16. Descriptive Study Comparison of median of eggs/g feces between gender

  17. Earlier Study of Schisto. Results • Percentage of Distribution of Different Sources of Water

  18. Our Project

  19. Objectives • To identify the sources and purposes of water used by residents in central Caju • To evaluate residents’ knowledge of Schistosomiasis • To propose potential solutions to control Schistosomiasis

  20. Methods • Attempted to interview the eldest member of every household (preferably female) in central Caju on January 15 & 16, 2008 • 3 teams of two administered a 10-question survey instrument • Visited main sources of water for Caju residents

  21. Results • Interviewed 79 households (out of 91) • Median Age of respondents: 46 (range: 13-95) • Percentage that use treated water: 100% • Percentage willing to pay for treated water: 93.7% • Percentage that own a water container: 70% • 12.7% fill container with untreated water

  22. Knowledge of Schisto.

  23. Water Use

  24. Sources of Water in Caju

  25. Untreated Water

  26. Uses of Stream Water

  27. Discussion (1) • High-risk populations: women and children • Lack of facilities for large loads of laundry • No safe alternatives for water recreation

  28. Quality and appearance of water Lack of water During part of the day During the dry season Lack of knowledge about Schistosomiasis Limited impact of health education Discussion (2)

  29. Proposed Solution 1 • Community laundry facility and sprinkler using treated water • Provide a safe, attractive alternative to untreated water

  30. Proposed Solution 1 • Create a community space for domestic work and social activities

  31. Proposed Solution 1 • Free for all Caju residents • Proposed location in plaza near school and health center

  32. Proposed Solution 1 • Project specifications/requirements • Routine cleaning and maintenance • Potential to negotiate with COPASA • Follow “Oficina Municipal de Saneamento, 2006” • Improve domestic and community sanitation

  33. Proposed Solution 2 • Develop partnerships with local cities/towns to create one shared health education team • Provide more specific information • Potential to use teams for education for other diseases

  34. Longer-Term Planning • Improved water quality control • Training of technician • Water testing kits • Fence off area around dam and clear vegetation

  35. Longer-Term Planning • Better sanitation and sewage treatment • 43% lack a bathroom (2005 data) • Itabirinha success story • Concrete latrine and septic tank for every house

  36. Limitations • Study and recommendations are specific to Caju • Make sure residents will use a community laundry facility and sprinkler • Could ask a sample of residents if they would use such a facility and where they would like the facility to be located • Limitations of self-reported data • Limited amount of field work

  37. Acknowledgements • UFMG and Fiocruz • Jequitinhonha Mayor’s Office • Residents of Caju • Caju Public Health Post • Santa Casa • Harvard School of Public Health • Brazil Studies, DRCLAS, Harvard

  38. Obrigada!

  39. Thank you!

  40. ありがとう!(Arigatou)

  41. “Field Work”

  42. Many Hardships

  43. Our Fearless Leader

  44. Earlier Study of Schisto. Results • Feces exam: 1 egg/g of feces  n: 387 *Missing: 17.9% **No information in database

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