Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.

SUMMARY In a recent study by our group on the prevalence of intestinal parasitic infections and on the knowledge, attitudes and practices of local residents of Campos dos Goytacazes, Rio de Janeiro, Brazil, we observed that about 50% of the inhabitants were parasitized and had some knowledge of intestinal parasitic infections but did not apply this knowledge in daily practice. We were thus motivated to implement strategies in health education to promote preventive measures in the locality. The goal of the present work was to evaluate the influence of health education on the prevalence of intestinal parasitic infections in the region in an effort to strengthen public policies for controlling these diseases in Brazil. The methodology adopted was based on action-research and a theoretical framework of health promotion. Our results demonstrate that the study population exhibited an enhanced awareness of the importance of disease from intestinal parasitic infections. Attitudes and practices related to prevention were significantly improved after the shared health education. In conclusion, this study allowed the shared construction of knowledge that reflected the true needs of the residents.

Resumo A promoção da saúde possui um conjunto de estratégias para trazer saúde e reduzir desigualdades. No entanto, tem sido um desafio avaliar a efetividade de programas de promoção de saúde. Este artigo apresenta o desenvolvimento e a aplicação de Matriz de Avaliação, construída por meio de indicadores quali-quantitativos e multidimensionais, que estão apoiados nas políticas públicas voltadas para territórios com vulnerabilidade social. Estudo transversal, com realização de programa de promoção da saúde e a finalidade de desenvolver uma Matriz de Avaliação, com possibilidade de aplicação em duas áreas de distinta vulnerabilidade socioambiental. A Matriz de Avaliação demonstrou ser de fácil aplicação e permitiu detectar os pontos fortes e fracos dos programas de promoção da saúde aplicados em diferentes territórios. Verificou-se que a adesão dos gestores, das equipes, da população e dos diversos setores da sociedade foram decisivos para o sucesso do programa. Adicionalmente, os agentes de saúde se destacaram como atores essenciais devido ao seu vínculo com a população. As contribuições incluem instrumento e metodologia para avaliar os programas de promoção da saúde, que podem ser aplicados em realidades distintas e modificados de acordo com o território.