Historical epidemiology and global health history / Epidemiologia histórica e história global da saúde

Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).

Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).

Hookworm disease: Puerto Rico's secret killer

Drs. Bailey Ashford and Pedro Gutiérrez, with the economic aid of the United States and Puerto Rican governments, were able to implement a program to reduce the incidence of hookworm infestations in Puerto Rico during the turn of the century. The program was conducted in three phases. The first phase consisted of evaluating the prevalence of infestations among the population. The second phase was concerned with treating patients and reducing further infestations. The last phase of the program was the implementation of prevention programs whose goals were to educate the population on the mechanisms of contaminations and to help implement improvements in the waste disposal systems so as to reduce the exposure to contaminated soil. The programs greatly improved the level of health of many Puerto Ricans. The incidence of hookworm infestations was reduced from 90 per cent to 15 per cent among members of the population. The program obtained world-wide recognition and serves as a model for similar programs

Periodic deworming with pyrantel in an industrial township.

Between June 1986 and September 1987 a population of 100 families was dewormed every 3 months (quarter) by using a single dose of pyrantel. Stool samples were examined by Kato's thick smear method; height (m), weight (kg), hemoglobin concentration (g/dl) and clinical morbidity were recorded before each deworming treatment. Clinical morbidity was recorded in another 100 control families who did not receive anthelmlntics. There were 477 and 490 individuals in the study and the control families respectively. In the study group the prevalence of roundworm was reduced from 10.3% to to 0% and that of hookworm infection was reduced from 2.9% to 0% after 2 quarters. At the end of the 4th quarter the mean hemoglobin rose by 0.1 g/dl (P less than 0.01) and the mean BMI increased by 0.37 (P less than 0.01). There was a significant reduction in the clinical morbidity in the study group compared with the control group (P less than 0.05). There were no side effects reported to pyrantel treatment. Thus quarterly treatment with pyrantel was found to be effective in keeping roundworm and hookworm prevalence at 0% in an industrial township.