Community based approach to communities with high prevalence of Ancylostoma duodenale, Strongyloides stercoralis and anemia in northern Argentina

ECHAZÚ A; CIMINO R; PAREDES G; ARIAS LM; HEREDIA V; CAROPRESI S; LÓPEZ S; GUILLARD E; SOCÍAS ME; KROLEWIECKI A

Washington DC,

Encuentro; 62 Annual Meeting of the American Society of Tropical Medicine & Hygiene; 2013

American Society of Tropical Medicine and Hygiene

Soil-transmitted helminth (STH) infections are the most prevalent neglected tropical diseases, causing anemia, malnutrition and negative consequences in growth and cognitive development of children. Among STH, Strongyloides stercoralis (Stst) deserves special consideration due to difficulties in diagnosis and the use of ivermectin for treatment. The aim of this study was to describe the prevalence and morbidity of STHs through a cross-sectional study and the usefulness and feasibility of a community based MDA program integrated to the public primary health care system in two Wichii aboriginal communities (Kilometro6 and Lapacho) in Tartagal, northern Argentina. A statistically representative group using the household as the unit of randomization was selected for surveillance. Single stool samples were analyzed with four methods: sedimentation, McMaster, Agar plate and Harada-Mori. Hemoglobin and antibodies titers against Stst using ELISA-NIE were measured. Single dose albendazole and ivermectin were used for treatment from March to December 2012. The study population included 2289 individuals, 157 had their stool analized. STH prevalence was 47% for hookworms, 13% for Stst and 2% for Ascaris lumbricoides. The cumulative prevalence of STH was 55%. Hookworms were all Ancylostoma duodenale. Stst seroprevalence was 50%. Anemia prevalence was 55%. Calculated coverage achieved 79%. Tartagal is an area of high prevalence of STH infections where preventive antihelminthic chemotherapy is indicated twice a year. Anemia is a severe public health problem due its high prevalence. The inclusion of ivermectin is justified by the prevalence of Stst, which was detected more frequently by serology. Pharmacovigilance revealed adequate safety of the drug regimen. Community treatment in a house-to-house approach is useful, particularly for risk groups such as preschool-aged children and women of reproductive age. The strategy of integrating the antihelminthic treatment to the primary health care system was successfull in achieving the acceptance of the comunity and high coverage.