Socioenvironmental conditions and intestinal parasitic infections in Brazilian urban slums: a cross-sectional study.

Intestinal parasitic infections (IPIs) are neglected diseases with limited data regarding prevalence in Brazil and many other countries. In increasingly urban societies, investigating the profile and socioenvironmental determinants of IPIs in the general population of slum dwellers is necessary for establishing appropriate public policies catered to these environments. This study assessed the socioenvironmental conditions and prevalence of IPIs in slums of Rio de Janeiro, RJ State, Brazil. Methods: A cross-sectional study covering an agglomeration of urban slums was conducted between 2015 and 2016 using participants observation, a socioeconomic survey, and the spontaneous sedimentation method with three slides per sample to analyze fresh stool specimens (n= 595) searching for intestinal parasites. Results: Endolimax nana (n= 95, 16.0%) and Entamoeba coli (n= 65, 10.9%) were the most frequently identified agents, followed by Giardia intestinalis (n= 24, 4.0%) and Ascaris lumbricoides (n= 11, 1.8%). Coinfections caused by E. nana and E. histolytica/ dispar and by Entamoeba coli/A. lumbricoides were significant. The use of piped water as drinking water, the presence of A. lumbricoides, and contamination with coliform bacteria and Escherichia coli were more common in major area (MA) 1. Children (0-19 years) had a greater chance of living in poverty (OR 3.36; 95% CI: 2.50-4.52; p < 0.001) which was pervasive. The predominance of protozoa parasites suggests that a one-size-fits-all approach focusing on preventive chemotherapy for soil-transmitted helminths is not appropriate for all communities in developing countries. It is important that both residents and health professionals consider the socioenvironmental conditions of urban slums when assessing intestinal parasitic infections for disease control and health promotion initiatives.