An unprecedented study by the Oswaldo Cruz Institute (IOC/Fiocruz), which investigated co-infection with malaria and intestinal parasites among the Yanomami, revealed a high rate of intestinal infections among these indigenous people. According to the survey, 81% were caused by microorganisms that cause diseases such as amebiasis and worms. Carried out at the Marani base, in Amazonas, the survey showed that around 15% had both intestinal parasitosis and malaria.
According to the study coordinator, Joseli Oliveira Ferreira, a researcher at the Laboratory of Immunoparasitology at the IOC, the rate of intestinal parasites was very high. “More than 80% of the individuals had two or more species of intestinal parasites. In 20% of cases, we found four to six different species of microorganisms. The lack of sanitation in the indigenous villages and continuous contact with the contaminated environment lead to infection by a wide variety of parasites,” said the researcher.
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The investigation included five Yanomami communities close to the border with Venezuela. Sample collection took place in 2015. 295 indigenous people participated, and all inhabitants of the villages received the necessary medical care during the study period.
The most frequent intestinal parasite was the Entamoeba coli, detected in 100% of the exams. The microorganism is considered a parasite with little pathogenic potential, but in some cases it can determine clinical conditions of abdominal discomfort. The vast majority had simultaneous infection by one or more pathogenic microorganisms.
Causes amebiasis Entamoeba histolytica was detected in 71% of the samples. Hookworm worms, which cause yellow fever, and Ascaris lumbricoides, popularly called roundworm, were observed in about 20% of the analyses.
The researchers observed, less frequently, the occurrence of the protozoan giardia intestinaliswhich causes giardiasis, from worms Trichuris trichiurawhich causes trichuriasis, and enterobius vermicularis, which causes enterobiasis (also known as oxyuriasis). All research participants received adequate treatment for infections, which, according to researchers, is essential to ensure health and combat malnutrition, which threatens children in particular.
“These microorganisms cause diarrhea and impair the absorption of nutrients. This aggravates malnutrition, increasing the children’s risk of death, as well as leading to long-term problems,” explained Joseli.
The World Health Organization (WHO) recommends periodic treatment with appropriate medications in areas with a high rate of intestinal parasites. For the scientists, the measure is important, but it is also necessary to think about actions for the sustainable control of parasites in the villages.
“Even if community treatment is carried out regularly, the environment is contaminated, and there is a vicious cycle of infection. It is necessary to think about alternative forms of environmental sanitation, which consider indigenous perceptions about diseases, housing, personal hygiene and environmental health”, said the researcher.
Malaria
A high rate of malaria was also observed in the survey. Using the PCR methodology, which allows detecting the presence of the parasites’ DNA in the blood, the infection was diagnosed in about 15% of the study participants.
More than 80% of the infections were submicroscopic, that is, they were not detected through thick smear microscopy, traditionally used in the diagnosis of malaria.
The researcher explained that the difference occurs because the PCR methodology can detect small amounts of parasites in the blood. “In endemic areas, individuals acquire immunity because they are very exposed to malaria and end up having low parasitemia (presence of parasites in the blood) without symptoms. Most of the positive cases in the thick smear test occurred in children, pregnant women and adolescents, who are more vulnerable to the disease.”
The newly published results are the result of a research project started in 2012. The work included a broad investigation into the vectors of malaria in three different areas of the indigenous land, with results already published. The occurrence of viral hepatitis in the Yanomami population was also studied.
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