Parasitismo intestinal em comunidades tradicionais vivendo ao redor de uma área de proteção ambiental no estado do Maranhão, nordeste do Brasil

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OBJECTIVES: To estimate prevalence and describe socio-ecological factors associated with intestinal parasitism in rural and peri-urban communities surrounding an environmental protection area in Maranhão State, Brazil. MATERIALS AND METHODS: A cross-sectional survey was conducted on 469 subjects in two communities around the Chapada das Mesas National Park. Qualitative and quantitative parasitological examinations were performed, and socio-ecological data were assessed. A geographic information system was used for spatial analysis. RESULTS: The prevalence of hookworm infection was 20.6% in Canto Grande and 2.4% in Alto Bonito. The ascariasis prevalence in Canto Grande and Alto Bonito was 0.4% and 2.9%, respectively. Infections with gut protozoa were more frequent in Alto Bonito. Hookworm infection was associated with the male sex, open defecation, clay floors in homes, and lower monthly family income. Ascariasis was associated with open defecation. Ingestion of water directly from a river was associated with Giardia duodenalis infection. A total of 86.0% of the hookworm-positive subjects had light infection intensity, 4.0% moderate, and 10.0% heavy. Geoprocessing demonstrated that soil-transmitted helminths hotspots were in Canto Grande, while protozoa were concentrated in Alto Bonito. CONCLUSION: The present study suggests that intestinal parasitism should be considered a heterogeneous group of infections with distinct determinants in the studied communities. Intestinal parasitism persists, revealing the inadequacy of sanitation in traditional communities around the Chapada das Mesas National Park.

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