School-based and community-based actions for scaling-up diagnosis and treatment of XXXX toward its elimination in an endemic area of Brazil.

@entity1 @entity383 @entity380 @entity2040 @entity7400 @entity2039
UNASSIGNED: This study evaluated a school-based and a community-based scheme for diagnosis, treatment and follow-up of @entity2040 mansoni among school-aged @entity1 in views of resolution CD49.R19 of the Pan American Health Organization toward the elimination of @entity2040 as a public health problem in the Americas and subsequent commitments endorsed by the Brazilian government. The school-aged population from a representative municipality of the endemic area of Northeastern Brazil was randomly allocated to either school-based or community-based scheme. The two schemes were compared with regard to coverage of diagnosis by the Kato-Katz method (KK) at baseline, treatment of the positives for @entity380 with @entity2039 , treatment of the positives for soil-transmitted helminthes (STH) with @entity7400 , as well as follow-up of treatment efficacy and reinfection assessed respectively at four and 12 months after treatment. Nutritional status of the positives for @entity383 was assessed at baseline and re-assessed at 12 months after treatment. Coverage of diagnosis and treatment was satisfactory (>75%) in both schemes. Diagnosis coverage at baseline and at 12 months was significantly higher in the community scheme, whereas treatment coverage did not differ significantly between the two schemes either at baseline or at 12 months. The number of @entity1 covered per day was significantly higher in the schools than in the community at baseline but not at follow-up, when daily coverage was higher in the community. With regard to @entity383 , overall treatment efficacy rate at four months was 90.8%, and reinfection rate at 12 months was 21.6%. For STH, overall treatment efficacy was 45.4% and reinfection, 32.8%. The nutritional status of the positives for @entity383 at baseline did not change significantly at 12 months post-treatment. Actions targeted at this particularly vulnerable high-risk group should combine school-based and community-based interventions as well as preventive measures to reduce transmission.
