[Risk factors for multiple intestinal parasites in an indigenous community of the State of Pernambuco, Brazil]. / Fatores de risco para poliparasitismo intestinal em uma comunidade indígena de Pernambuco, Brasil.

An investigation into the ethno-epidemiological profile of the Pankararu indigenous group in the State of Pernambuco, Brazil, identified multiple intestinal parasites in nearly all members of the community. To detect possible environmental risk factors, we used the data base from a previous survey to test relations between daily living conditions (housing, sanitation, water supply and treatment, and garbage disposal) and the number of different parasite species found in the same household. The sample consisted of 84 families from the original sample of 112. Selection was based on the number of stool tests performed in the family. The mean number of parasite species was 5.0 per family, for a mean family size of 6.1 members. This number was greater for wattle-and-daub houses (mean 6.0 parasite species vs. 4.9 for brick houses; p < 0.03) and when water used in the household was not treated (mean 5.1 parasite species, vs. 4.5 for treated water; p < 0.05). Other household characteristics and hygienic habits did not significantly influence this number. We concluded that multiple intestinal parasitism in the Pernambuco Pankararu community is frequent, to the point of being the rule, and that it relates essentially to water source and treatment.

[Discourses and practices concerning the social participation process in health education activities: community mobilization in the PCDEN/PE. Programa de Controle das Doenças Endêmicas do Nordeste/Pernambuco]. / Discursos e práticas referentes ao processo de participação comunitária nas ações de educação em saúde: as ações de mobilização communitária do PCDEN/PE.

This study analyzes and compares several social participation concepts in health education processes to practical experiences with schistosomiasis prevention measures under the Northeast Endemic Disease Control Program (Brazilian Ministry of Health/World Bank, 1987). Using qualitative methods, institutional documents and discourses were interpreted (Sucam, FNS, and Ministry of Health). A field study was also performed (using interviews with community-based health agents and the general population) in the Zona da Mata region of Pernambuco (a historically endemic area for schistosomiasis), focused in the county of Amaraji. Comparing discourses and educational practices, we found factors that explain respective points of convergence and divergence, as well as elements linked to the social and historical process of the target population which systematically limit the efficacy of such educational measures.

[Evolution of schistosomiasis endemicity in the Zona da Mata Sul, Pernambuco State, Brazil. Epidemiology and current situation: under control or out of control?]. / Evolução da esquistossomose na Zona da Mata Sul de Pernambuco. Epidemiologia e situação atual: controle ou descontrole?

In order to assess the present situation of schistosomiasis in the Zona da Mata Sul, Pernambuco State, Brazil, a study was conducted in the following phases: origin, historical and temporal evolution, and basic determinants of this health/disease process; critical assessment of comprehensive intervention programs implemented by the State in the region since 1970; and a case study in 17 counties, representing 1,424 communities and 485,200 inhabitants, and Brazil's second most endemic region based on prevalence rates for schistosomiasis. Temporal series over a 14-year period were used to analyze results of intervention programs. Conclusions were: a) current positivity rates are higher than those observed in the early 1980s; b) the programs' strategy focused almost exclusively on mass treatment, thus allowing for reinfestation and occurrence of new cases; c) proposals such as the PCDEN (Program for Control of Endemic Diseases in the Northeast) aimed at decentralization to the municipal level in the 1990s were not effectively implemented, helping to leave this persistent endemic out of control.

Nefrite lupica: correlacao entre hipertensao insuficiencia arterial, renal e histologia renal. / Lupus nephritis: relationship between hypertension, arterial and renal failure and renal histology

Com o objetivo de se avaliar a relacao entre hipertensao arterial, insuficiencia renal e alteracoes histologicas dos rins, 51 pacientes com lupus eritematoso sistemico (LES) foram estudados. Tambem foram analisados nestes casos outros fatores que pudessem contribuir para ocorrencia de hipertensao. Hipertensao arterial ocorreu em 38% dos pacientes, sendo mais frequente naqueles com insuficiencia renal (P < 0,001). Estudo da histologia renal mostrou glomerulonefrite proliferativa difusa mais frequente entre os pacientes com hipertensao arterial (P < 0,05), enquanto que alteracoes histologicas minimas foram encontradas apenas em normotensos. Nao houve diferenca quanto a historia familiar de hipertensao, o uso de corticosteroides e a presenca de doencas associadas ao LES nos doentes com e sem hipertensao arterial