Resumo

We describe two cases of fascioliasis from rural areas of Rio de Janeiro that are endemic for schistosomiasis, both of which were found during a coprological survey. The patient from Paracambi complained of dizziness. The patient from Sumidouro complained of dizziness, tiredness and cough. She was treated with praziquantel and her stool parasitological examination became negative.

Five annual parasitological surveys and one serological survey, respectively based on the Kato-Katz and free sedimentation methods and the Western blot technique, were conducted in Sumidouro, Rio de Janeiro, Brazil, an endemic county for schistosomiasis. Possible influences of the use of these methodologies on social, cultural, and ethical aspects of the study population were also evaluated. Having the opportunity to choose the different techniques was a conclusive issue influencing participation by the population. Prevalence rates of positive results for stool tests were: 11.6% (1995); 8.8% (1996); 12.2% (1998); 5.9% (1999); and 3.2% (2000). In the period during which the serological survey was performed, the use of laboratory testing in association with analysis of clinical data and available data on transmission and treatment generated a diagnostic procedure termed "coproseroepidemiology". This methodology contributed to significant improvements in the accuracy of measurement of local schistosomiasis prevalence, indicating that epidemiological surveillance could help prevent the recurrence of high prevalence rates. The fact that Biomphalaria glabrata was replaced by Melanoides tuberculata in the main transmission focus contributed to a significant decrease in infection rates.

Este texto apresenta o caminho pelo qual temos evoluído em direção a uma solução para os problemas de Guapirimirim (Rio de Janeiro, Brasil) na área de saúde e ambiente. Nosso objetivo vem sendo atingido a partir de um estudo interdisciplinar e de uma parceria que vem assimilando, gradativamente, conceitos e práticas propostos por teóricos contemporâneos para lidar com complexidade, incerteza e avaliação. Os conceitos de ciência "pós-normal", "comunidade ampliada de pares" e "transdisciplinaridade" servem de base para o entendimento do empreendimento científico em curso naquele município, e para a formulação de uma proposta para sua continuidade.

No abstract