Efeito do praziquantel no desempenho cognitivo de crianças infectadas pelo S.mansoni em área rural do vale do Jequitinhonha, Minas gerais

Abstract

This study aimed at evaluating praziquantel treatment effect on the cognitiveperformance of children previously infected with S. mansoni in the JequitinhonhaValley, Minas Gerais. Two hundred and one (201) children from 6 to 10 years oldparticipated in this study, all living in Caju and Sao Pedro do Jequitinhonha, ruraldistricts Jequitinhonha municipality. Data was gathered in 2 phases. On the firstphase, the parasitologic exam was performed by the Kato-Katz method. Measurementof height and weight were done to evaluate nutritional status and the cognitiveassessment was made by Raven test and Digit subtests as well as through WISCIIICode and Aritmethic test. All childrens parents answered to a socioeconomicquestionnaire. After the first phase, children were treated with Praziquantel andAlbendazol. On the second phase the nutritional measurements and cognitive testswere repeated. Schistosomiasis prevalence was 70.6%, hookworm was 18.5% andascaris was 2.6%. The percentage of children with acute malnutrition on the firstphase was 3.5% and 11.4 % presented chronic malnutrition, 4.5% overweight and2.5% obesity. Concerning the cognitive performance, most children were under theaverage rate in both tests but, there was an increase in the cognitive scores on thesecond phase of the study, apart from being infected or not on the first phase. Themultivariate analysis showed that children who achieved the higher scores all lived inCaju (OR=2,10 IC 95%=1,07-4,11) in houses with head of the family up to 4 years ofschooling, (OR=2,93 IC 95%=1,26-6,81). Children living in Caju also showed a betterperformance on the subtest Code (OR=2,21 IC95%=1,02-4,81). Children between 9and 10 years of age (OR=2,48 IC 95% 1,07-5,76) also improved on this test. Thebigger difference in the body mass index was associated to the improvement in theCode Test (OR=1,12 IC95% 1,01-1,23). Mothers with a higher education levelincreased the chance of the children presenting a better performance on the Raventest (OR=4,28 IC 95% 1,32-13,87). Children with better socio-economic conditionswere bound to improve in cognitive performance on the Raven test (OR=5,17 IC 95%2,12-12,59). The results of this study showed that treatment did not have any effectson cognitive performance of children previously infected with S. mansoni, howeverother factors were found to improve childrens cognitive performance. This studyidentified the importance of developing public policies associated in association withthe community to increase population income and decrease poverty. Educationalhealth programs are recommended to help the families managing childrens healthcare and also to stimulate their adequate developmental process.