URBAN SCHISTOSOMIASIS - MORBIDITY, SOCIODEMOGRAPHIC CHARACTERISTICS AND WATER CONTACT PATTERNS PREDICTIVE OF INFECTION

Background. Schistosomiasis (Schistosoma mansoni) is classically descr ibed as a rural disease that occurs in areas with poor sanitary condit ions. This cross-sectional study was undertaken in a suburban area of a large industrialized city in Brazil (Belo Horizonte), aiming at exam ining epidemiological characteristics of schistosomiasis in an urban s etting. Methods. A simple random sample of 658/1896 dwellings was sele cted and 3049/3290 (92.7%) residents were submitted to stool examinati on. Of 518 eligible infected cases and 518 uninfected controls, 87.1% and 89.8% participated in the study, respectively. Results. The preval ence of S.mansoni infection was 20%, predominantly low egg counts in s tools; no cases of splenomegaly were found. Signs and symptoms associa ted with infection were bloody stools (odds ratio [OA] = 8.0) and hard ened palpable liver at the middle clavicular and at the middle sternal line (OR = 5.5 and 8.0, respectively), Sociodemographic variables and water contacts predictive of infection were age (10-19 and greater th an or equal to 20 yrs; OR = 7.1 and 3.3, respectively), gender (male; OR = 3.1), contacts for swimming and/or playing (twice a month or less and more than twice a month; OR = 2.2 and 3.0, respectively) and resi dence in Belo Horizonte (born in the City; OR = 2.5), Ninety per cent of dwellings had a piped water supply; no association between water su pply and infection was found. Conclusion. Our results emphasize the ne ed for schistosomiasis control measures focusing on water contacts for leisure purposes in this industrialized urban area.