Anti-Helmínticos, Helmintíase, Pediatria, Prevenção de Doenças, Saúde Pública
Resumo
Introdução: As geo-helmintoses são doenças negligenciadas, sendo o tratamento quimioprofilático coletivo (TQPC) um possível mitigador para populações de risco (cuja prevalência de infecção é de 20%). Contudo, sua eficácia é questionada há décadas, sem um consenso estabelecido. Objetivos: Discorrer sobre a eficácia, segurança e os desfechos da TQPC. Material e métodos: Foi realizada revisão bibliográfica abrangendo recomendações recentes da OMS e artigos do PubMed. Foram incluídos estudos mais recentes e de maior qualidade. Ao final, 22 artigos e diretrizes foram selecionados. Resultados: Como benefícios, a TQPC apresenta grande aceitabilidade da população, efeitos adversos praticamente inexistentes e é 7 vezes mais barato em relação ao binômio testar e tratar, sendo o custo a curto prazo muito inferior ao investimento para construção de rede de saneamento básico (RSB). De evidência moderada, possibilita melhora na produtividade econômica e desempenho escolar. Um dos maiores impasses a TQPC é a possível resistência aos antiparasitários (AP), fenômeno já observado na veterinária. Outros pontos negativos são: a reinfestação rápida, caso não haja ações complementares; o custo elevado em relação a programas de alimentação escolar, pois para atingir o mesmo ganho de peso o AP possui custo 35x maior; a desestimulação para construção de RSB, pela rápida e fugaz melhora na prevalência das infestações. Além disso, pela falta de medidas preventivas eficazes a reinfestação é regra, o que pode deixar a população acometida refém da ajuda de organizações humanitárias, sem perspectivas de melhora real da qualidade de vida. Há muita divergência sobre recuperação de peso, altura, catch up na curva de crescimento, escore cognitivo, podendo ser explicada pela alta frequência de reinfestações entre doses de AP, o que pode sobrepor o potencial efeito benéfico do AP. Conclusão: Embora metanálises recentes tenham sugerido a ineficácia do TQPC, elas usaram estudos heterogêneos e de baixa qualidade. A OMS segue a favor do TQPC, pois os danos são mínimos em relação aos potenciais benefícios. Assim, estudos de melhor qualidade são necessários, especialmente em relação à resistência a AP. Deve-se frisar que a solução definitiva é o tripé RSB, higiene e educação em saúde, sendo o TQPC apenas uma medida paliativa.
Publicado
2021-03-01
Como Citar
Santos, D. de C., de Lima, I. J. V., Senger, C. R., Xavier, C. A., & Rompkovski, M. R. (2021). EFICÁCIA DO TRATAMENTO QUIMIOPROFILÁTICO COLETIVO NO CONTROLE DE GEO-HELMINTOSES EM CRIANÇAS. Revista Multidisciplinar Em Saúde, 2(1), 22. https://doi.org/10.51161/rems/700
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SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line 132, file: SubmissionSearch.inc.php
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