Accessibility to and utilisation of schistosomiasis-related health services in a rural area of state of Minas Gerais, Brazil

ABSTRACT

The objective of the present paper was to compare accessibility and utilisation of schistosomiasis diagnostic and treatment services in a small village and the surrounding rural area in northern part of the state of Minas Gerais Brazil. The study included 1,228 individuals 935 central village residents and 293 rural residents of São Pedro do Jequitinhonha. Schistosoma mansoni infection rates were significantly higher in the central village than in the rural area during a survey in 2007 (44.3 percent and 23.5 percent, respectively) and during the 2002 schistosomiasis case-finding campaign (33.1 percent and 26.5 percent, respectively) (p < 0.001). However, during the 2002-2006 period, only 23.7 percent of the villagers and 27 percent of the rural residents obtained tests on their own from health centres, hospitals and private clinics in various nearby towns. In 2007, 63 percent of the villagers and 70.5 percent of the rural residents reported never having received treatment for schistosomiasis. This paper reveals considerable variation in the accessibility and utilisation of schistosomiasis-related health services between the central village and the rural area. A combination of low utilisation rates between 2002-2006 and persistently high S. mansoni infection rates suggest that the schistosomiasis control program must be more rapidly incorporated into the primary health services.