The inherited form of primary open angle glaucoma, a disorder characterized by increased intraocular pressure and retina degeneration, is linked to mutations in the olfactomedin (OLF) domain of the myocilin gene. Disease-causing myocilin variants accumulate within trabecular meshwork cells instead of being secreted to the trabecular extracellular matrix thought to regulate aqueous humor flow and control intraocular pressure. Like other diseases of protein misfolding, we hypothesize myocilin toxicity originates from defects in protein biophysical properties. In this thesis, the first preparative recombinant high-yield expression and purification system for the C-terminal OLF domain of myocilin (myoc-OLF) is described. To determine the relative stability of wild-type (WT) and mutant OLF domains, a fluorescence thermal stability assay was adapted to provide the first direct evidence that mutated OLF is folded but less thermally stable than WT. In addition, mutant myocilin can be stabilized by chemical chaperones. Together, this work provides the first quantitative demonstration of compromised stability among identified OLF variants and placing myocilin glaucoma in the context of other complex diseases of protein misfolding. Subsequent investigations into the biophysical properties of WT myoc-OLF provide insight into its structure and function. In particular, myoc-OLF is stable in the presence of glycosaminoglycans (GAGs), as well as over a wide pH range in buffers with functional groups reminiscent of such GAGs. Myoc-OLF contains significant â-sheet and â-turn secondary structure as revealed by circular dichroism analysis. At neutral pH, thermal melts indicate a highly cooperative transition with a melting temperature of ~55°C. A compact core structural domain of OLF was identified by limited proteolysis and consists of approximately residues 238-461, which retains the single disulfide bond and is as stable as the full myoc-OLF construct. This construct also is capable of generating 3D crystals for structure determination. This data, presented in Chapter 3, inform new testable hypotheses for interactions with specific trabecular extracellular matrix components. To gain further insight into the biological function of myoc-OLF, a facile fluorescence chemical stability assay was designed to identify possible ligands and drug candidates. In the assay described in Chapter 4, the target protein is initially destabilized with a chemical denaturant and is tested for re-stabilization upon the addition of small molecules. The assay requires no prior knowledge of the structure and/or function of the target protein, and it is amendable to high-throughput screening. Application of the assay using a library of 1,280 compounds revealed 14 possible ligands and drug candidates for myoc-OLF that may also generate insights into myoc-OLF function. Due to the high â-sheet content of monomeric myoc-OLF and presence of an aggregated species upon myoc-OLF purification, the ability of myoc-OLF to form amyloid fibrils was suspected and verified. The fibril forming region was confirmed to reside in the OLF domain of myocilin. Kinetic analyses of fibril formation reveal a self-propagating process common to amyloid. The presence of an aggregated species was confirmed in cells transfected with WT myocilin, but to a greater extent in cells transfected with P370L mutant myocilin. Both cell lines stained positive for amyloid. Taken together, these results provide further insights into the structure of myocilin and suggest a new hypothesis for glaucoma pathogenesis. Finally, in a related study, small molecule drug candidates were investigated to treat acid â-glucosidase (GCase), the deficient lysosomal enzyme in Gaucher disease, another protein conformational disorder. Three new GCase active-site directed 3,4,5,6-tetrahydroxylazepane inhibitors were synthesized that exhibit half inhibitory concentrations (IC50) in the low millimolar to low micromolar range. Although the compounds thermally stabilize GCase at pH 7.4, only one of the synthesized analogs exhibits chaperoning activity under typical assay conditions. This successful pharmacological chaperone is also one in which GCase is in its proposed active conformation as revealed by X-ray crystallography. Probing the plasticity of the active-site of GCase offers additional insight into possible molecular determinants for an effective small molecule therapy for GD.

Crystallization is often a major bottleneck to macromolecular structure determination. This is particularly true for membrane proteins, which have hydrophobic surfaces that cannot readily form crystal contacts. Of the roughly 109,000 protein structures in the PDB, only about 539 represent unique membrane proteins, despite immense interest in membrane proteins from both a biological and therapeutic standpoint. Membrane protein crystallization has been facilitated by the development of new detergents, lipidic cubic phase methods, soluble protein chimeras, and non-covalent protein complexes. The design process of protein fusion constructs and non-covalent antibody fragments specific for each target membrane protein, however, is costly and time-consuming. An improved, more general method of membrane protein co-crystallization is needed. This dissertation details the development of two approaches for cost-effective non-covalent crystallization chaperones: (1) Engineered hypercrystallizable Fab antibody fragment with high affinity for EYMPME (EE epitope), which form complexes with EE-tagged soluble and membrane proteins. (2) Engineered monomeric streptavidin (mSA2) for complexation with biotinylated membrane proteins. Both methods are generalizable through insertion of a short epitope into a surface-exposed loop of a membrane protein by site directed mutagenesis. Crystallization trials of representative chaperone-membrane protein complexes and possible difficulties with the approach are discussed.

Résumé en français Objectifs : Ce mémoire propose d’explorer l’assiduité aux interventions psychosociales chez les personnes atteintes de troubles psychotiques en répondant à trois questions : 1- Quels sont les facteurs influençant l’assiduité aux interventions psychosociales pour une clientèle atteinte de troubles psychotiques? 2- Sont-ils comparables aux facteurs influençant l’observance à la médication? 3- Quel est le taux d’abandon des interventions psychosociales et quels sont les facteurs qui font varier ce taux? Méthodes : Cette étude a permis de faire la synthèse des facteurs influençant l’observance à la médication à partir des revues systématiques publiées sur le sujet, et d’établir les facteurs influençant l’assiduité aux interventions psychosociales à partir des raisons d’abandon citées dans les essais cliniques randomisés publiés. Une méta-analyse a permis de combiner les essais cliniques rapportant les abandons et ainsi d’en établir un taux. Résultats : Nous avons répertorié 92 essais cliniques randomisés sur les interventions psychosociales avec les personnes atteintes de troubles psychotiques. De ce nombre, 43 ont permis de répertorier les raisons d’abandon. Les raisons d’abandon s’avèrent principalement liées à la maladie et liées à l’accessibilité, la continuité et la qualité des soins et services. Un taux d’abandon de 13% a été obtenu à partir de l’agrégation de 74 études dans la méta-analyse. Des facteurs faisant varier ce taux ont été identifiés. Conclusion : Plusieurs facteurs (personnels, lié aux traitements, sociaux) influençant l’assiduité aux interventions psychosociales chez les personnes atteintes de troubles psychotiques ont été identifiés. De plus, le faible taux d’abandon obtenu démontre bien la faisabilité clinique de ce type d’intervention. S’ajoutant à l’efficacité déjà bien démontrée de certaines modalités d’intervention psychosociales, le taux d’assiduité à ces mêmes modalités constitue un argument supplémentaire pour en assurer la disponibilité aux personnes atteintes d’un trouble psychotique. / Abstract Aims : This report suggest investigating the compliance in the psychosocial treatment among persons with schizophrenia spectrum disorder by answering three questions : 1- What are factors influencing compliance in the psychosocial treatment among persons with schizophrenia spectrum disorder? 2- Are they comparable to factors influencing compliance with pharmacological treatment? 3- What is the dropout rate of the psychosocial treatment and which are the factors which make vary this rate? Methods : A systematic review allowed to make the synthesis of factors influencing the compliance in the medication from the systematic reviews published on the subject and to establish factors influencing the compliance in the psychosocial treatment from the reasons of drop-out specified in the published randomized clinical trials. A meta-analysis allowed to combine clinical trials reporting drop-out and so to establish a rate. Results : We listed 92 clinical trials randomized on the psychosocial treatment among persons suffering from schizophrenia spectrum disorder , of this number 43 allowed to list the reasons of drop-out. The reasons of drop-out turn out mainly related to the disease and related to the accessibility, the continuity and the quality of the care and the services. A 13 % dropout rate was obtained from the aggregation of 74 studies in the meta-analysis. Factors making vary this rate were identified. Conclusions: Several factors which influence the compliance in the psychosocial treatment among persons suffering from schizophrenia spectrum disorders are identified. Furthermore, the low drop-out rate calculated demonstrates well the clinical feasibility of this type of treatment. Being added to the efficiency already well demonstrated by certain psychosocial modalities of treatnebt, the compliance rate in these same modalities establishes an additional argument to assure the availability among persons suffering from schizophrenia spectrum disorders.

According to the National Drug Policy one of the health services objectives is to ensure the availability and accessibility of essential drugs to all citizens. An economic objective of the same policy is to promote the cost-effective and rational use of drugs (Department of Health, 1996). Currently, there is no system to scientifically determine the usage of medicines in the public sector and whether the current usage is satisfactory enough (John, 2004:2). The World Health Organization states that "good drug supply management is an essential component of effective and affordable health care services globally (World Health Organization, 1998:1). In the South African context, even though the Essential Drug List helps health care professionals to treat diseases in the public sector, it does not prescribe the minimum guidelines for medicine supply systems (Department of Health, 2006a). The general objective of this study was to develop a therapeutic medicine budget model in a district hospital in the public sector of the North-West Province to control medicine usage. This can be done after analysing the medicine usage patterns and then developing a framework for therapeutic budgeting by evaluating appropriate systems, i.e. the International Code for Disease (ICD-10) classification system, with the therapeutic budget model framework. Retrospective drug utilisation of six months (January 2007 until June 2007) was documented. A random sample population of 25% was selected (n = 1 494). After the data collection period of 9 weeks, the actual study population was only 18.67% (only 1 166 of the 1 494 patients files had a medicine history). All the medicine items prescribed were classified in the therapeutic budget model. Patient confidentially was assured by using a unique pin number on the survey form, so that no names of patients or other biographical details were collected from the patient files onto the survey form, which is in line with the requirements of the Ethics Committee approval conditions for the North-West University. The total number of medicine items dispensed during the study period was 11 768. The average cost per medicine item was R19.36 ± 86.79 for inpatients. The total number of consultations was 3 220. The average number of medicine items per consultation was 3.66 ± 1.98. The total cost of medicine items during the study period was R244 677.11. The average medicine cost per consultation for inpatients was R70.80 ± 177.72. The top three budget groups according to frequency represented 68.11% of all medicine used according to budget groups. The top three pharmacological groups according to total cost represented 61.68% of the total cost of pharmacological groups. The top three therapeutic codes according to frequency represented 18.75% of all therapeutic codes. The top three ICD-10 codes based on total cost represented 59.35% of all medical conditions diagnosed. The total hospital budget for 2007 was predicted at R3 276 750.00. Of this budget, 75% was for pharmaceuticals (R2 457 562.50). The total pharmaceutical medicine cost (excluding surgicals) from the study was R224 677.11 (this was for 18.67% of the total patient visits for six months) which can be calculated at R2 406 824.96 for all patients visits in a full year. The correlation between the actual budget and the projected budget showed a R50 737.54 surplus in the budget of the hospital. A therapeutic budget model can also help in achieving the following: • Proper preparation and planning of budgetary policies in a phased manner based on scientific evidence; • Evaluation of budgetary compliance, cost-efficiency of therapy and standard treatment guidelines (STG) / Essential Drug List (EDL) / formulary compliance; • Better procurement strategies based on demand, expenditure and inventory control; and • Better delivery and maintenance of quality health care by evaluating operational and clinical policies. The therapeutic budget model is a more appropriate manner to use in the projections of budgets and medicine usage. The scope of a therapeutic budget model to be implemented in the hospitals in the public sector of the North-West Province seems to be promising. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

According to the National Drug Policy one of the health services objectives is to ensure the availability and accessibility of essential drugs to all citizens. An economic objective of the same policy is to promote the cost-effective and rational use of drugs (Department of Health, 1996). Currently, there is no system to scientifically determine the usage of medicines in the public sector and whether the current usage is satisfactory enough (John, 2004:2). The World Health Organization states that "good drug supply management is an essential component of effective and affordable health care services globally (World Health Organization, 1998:1). In the South African context, even though the Essential Drug List helps health care professionals to treat diseases in the public sector, it does not prescribe the minimum guidelines for medicine supply systems (Department of Health, 2006a). The general objective of this study was to develop a therapeutic medicine budget model in a district hospital in the public sector of the North-West Province to control medicine usage. This can be done after analysing the medicine usage patterns and then developing a framework for therapeutic budgeting by evaluating appropriate systems, i.e. the International Code for Disease (ICD-10) classification system, with the therapeutic budget model framework. Retrospective drug utilisation of six months (January 2007 until June 2007) was documented. A random sample population of 25% was selected (n = 1 494). After the data collection period of 9 weeks, the actual study population was only 18.67% (only 1 166 of the 1 494 patients files had a medicine history). All the medicine items prescribed were classified in the therapeutic budget model. Patient confidentially was assured by using a unique pin number on the survey form, so that no names of patients or other biographical details were collected from the patient files onto the survey form, which is in line with the requirements of the Ethics Committee approval conditions for the North-West University. The total number of medicine items dispensed during the study period was 11 768. The average cost per medicine item was R19.36 ± 86.79 for inpatients. The total number of consultations was 3 220. The average number of medicine items per consultation was 3.66 ± 1.98. The total cost of medicine items during the study period was R244 677.11. The average medicine cost per consultation for inpatients was R70.80 ± 177.72. The top three budget groups according to frequency represented 68.11% of all medicine used according to budget groups. The top three pharmacological groups according to total cost represented 61.68% of the total cost of pharmacological groups. The top three therapeutic codes according to frequency represented 18.75% of all therapeutic codes. The top three ICD-10 codes based on total cost represented 59.35% of all medical conditions diagnosed. The total hospital budget for 2007 was predicted at R3 276 750.00. Of this budget, 75% was for pharmaceuticals (R2 457 562.50). The total pharmaceutical medicine cost (excluding surgicals) from the study was R224 677.11 (this was for 18.67% of the total patient visits for six months) which can be calculated at R2 406 824.96 for all patients visits in a full year. The correlation between the actual budget and the projected budget showed a R50 737.54 surplus in the budget of the hospital. A therapeutic budget model can also help in achieving the following: • Proper preparation and planning of budgetary policies in a phased manner based on scientific evidence; • Evaluation of budgetary compliance, cost-efficiency of therapy and standard treatment guidelines (STG) / Essential Drug List (EDL) / formulary compliance; • Better procurement strategies based on demand, expenditure and inventory control; and • Better delivery and maintenance of quality health care by evaluating operational and clinical policies. The therapeutic budget model is a more appropriate manner to use in the projections of budgets and medicine usage. The scope of a therapeutic budget model to be implemented in the hospitals in the public sector of the North-West Province seems to be promising. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Abstract The repair of thoracoabdominal aortic aneurysms carries a substantial risk of ischaemic perioperative spinal cord injury. Although several protective methods have been developed, the risk of paraplegia has not been eliminated. Moreover, aortic aneurysms, including arch aneurysms, are complex clinical challenges requiring cerebral protection with hypothermic circulatory arrest (HCA). Hypothermia lowers the rate of cerebral metabolism and allows a temporary halt of the systemic circulation. However, there is still a risk for cerebral damage and a need for additional neuroprotective methods. During the last 15 years, our research group has used a porcine model to investigate a variety of neuroprotective tools. In this thesis, an animal model was utilized to study the efficacy of remote ischaemic preconditioning (RIPC) to ameliorate ischaemic damage to the central nervous system, and to shed light on the potential mechanism. Moreover, diazoxide, the pharmacological mimetic of RIPC, was tested in the HCA animal model. In the first Study (I), RIPC showed beneficial effect on the spinal cord against ischaemic insult as recorded with motor-evoked potentials. Strikingly, the beneficial effect of RIPC was observed even before the ischaemia. In the second Study (II), some beneficial effect of RIPC was seen in the immunohistochemical analysis of the spinal cord ischemia but the result remains inconclusive. Similarly, the diazoxide-treated animals had better hemodynamic status postoperatively and mildy better antioxidant activity of the brain in the third Study (III). The fourth study (IV) was a review of the current knowledge of RIPC from the cardiovascular point of view. Our studies indicate that RIPC might be a potential adjunct for preventing neuronal ischaemic injury in the setting of thoracoabdominal aortic surgery. Our result indicates that further preclinical studies with diazoxide are required before studies can be conducted in humans. / Tiivistelmä Torakoabdominaalisen aortan aneurysman kirurginen korjaaminen sisältää riskin iskeemiselle selkäytimen vauriolle. Vaikka useita suojaavia tekniikoita on kehitetty, paraplegian riskiä ei ole saatu poistettua kokonaan. Kirurgisen korjaamisen haasteellisuus moninkertaistuu, jos aneurysma on laajentunut myös aortan kaareen. Tällöin vaaditaan hypotermista verenkierron pysäytystä (HCA). Hypotermia alentaa aivojen metabolista aktiivisuutta merkittävästi ja siten verenkierron väliaikainen pysäytys on mahdollista. Tästä huolimatta hypotermiseen verenkierron pysäytykseen liittyy riski aivokudoksen vauriolle. Meidän tutkimusryhmämme on tutkinut useita keskushermostoa suojaavia tekniikoita ja lääkeaineita viimeisen 15 vuoden aikana. Käytämme sikaa koe-eläin mallina, jota on tämänkin väitöskirjan osajulkaisuissa käytetty. Tämän väitöskirjatyön tarkoituksena on ollut tutkia sekä esialtistavan raajaiskemian (RIPC) että farmakologisen mimeetin, diazoxiden, keskushermostoa suojaavia vaikutuksia sekä niiden mahdollista vaikutusmekanismia. Ensimmäisessä osajulkaisussa esialtistava raajaiskemia paransi selkäytimen iskemian sietokykyä, mikä näkyi alaraajojen motorisissa herätepotentiaaleissa. Merkittävintä tutkimuksessa oli, että esialtistavan raajaiskemian edulliset vaikutuksen selkäytimeen oli nähtävissä jo ennen iskemiaa. Toisessa osajulkaisussa esialtistava raajaiskemialla oli nähtävissä edullisia, mutta ei varauksettomia, vaikutuksia selkäytimen iskemian immunohistokemiallisessa analyysissä. Kolmannessa osatyössä diazoxidin vaikutukset iskemiaa vastaan nähtiin parempana hemodynaamisena tilana ja antioksidatiivisen aktiivisuuden lisääntymisenä aivoissa, mutta tulos on myös tulkinnanvarainen. Neljäs osajulkaisu kokosi tämän hetken tietämyksen esialtistavasta raajaiskemiasta. Tutkimuksissamme osoitimme, että esialtistava raajaiskemiassa on potentiaalia tulla yhdeksi välineeksi keskushermoston iskemiaa vastaan torakoabdominaalisen aortan kirurgiassa. Lisäksi diazoxidin mahdolliset neuroprotektiiviset vaikutukset vaativat lisää koe-eläintutkimuksia ennen ihmiskokeisiin siirtymistä.

Face à la multiplication exponentielle du nombre de personnes souffrant d’une maladie chronique d’origine comportementale (e.g., tabagisme, alcoolisme, mauvaise alimentation, sédentarité), des interventions non médicamenteuses (INM) agissant sur ces comportements modifiables sont devenues incontournables en prévention et en complément des traitements. Parmi ces INM, les interventions numériques santé (INS) ouvrent un champ prometteur de changement durable de comportement de santé (e.g., objet connecté santé, application pour le téléphone, jeu vidéo). La thèse s’intéresse, au-delà de leur ergonomie et de leur fonctionnalité, à leur évaluation santé, de leur validation à leur surveillance. La première étude recense les modèles proposés dans le monde pour évaluer ces INS et les catégorise selon leurs paradigmes épistémologiques sous-jacents. Les résultats montrent une augmentation exponentielle de ces modèles et une absence de consensus ou de convergence vers un modèle comme cela a été le cas dans le médicament à la fin du XXème siècle. La deuxième étude s’appuie sur une revue systématique ayant identifié 90 essais interventionnels publiés testant les bénéfices et les risques de solutions numériques visant à lutter contre le tabagisme. Les résultats montrent une efficacité de certaines INS sur le tabagisme mais issue d’un corpus méthodologique très hétérogène limitant la portée des conclusions. Cette hétérogénéité est liée aux caractéristiques intrinsèques des INS (e.g., technologies utilisées et combinaison entre elles, multiplicité des théories du changement de comportement utilisées), aux méthodes d’évaluation utilisées (e.g., type de groupe contrôle, durée de suivi) et aux critères de jugement choisis (e.g., réduction du tabagisme ou arrêt). La discussion porte sur les limites actuelles dans la mise en évidence de l’efficacité et des risques des INS à cause d’approches paradigmatiques parallèles, le paradigme biomédical, le paradigme d’ingénierie et le paradigme comportemental. Le manque de consensus limite la comparabilité et la reproductibilité des résultats des études testant ces solutions numériques de santé. Elles restent pour la plupart à ce jour des solutions gadgets malgré un potentiel prometteur et promis par les industriels. La thèse encourage à la convergence vers un modèle consensuel de détermination du bénéfice/risque santé fondé sur la science de chaque INS et fait des propositions en ce sens. / To deal with the exponential increase of chronic diseases caused by health behavior (e.g., smoking, alcoholism, unhealthy eating, physical inactivity), non-pharmacological interventions (NPI) have become essential as a prevention tool and as a complement to treatments. Among these NPIs, behavioral intervention technologies (BIT) open up a promising field to a sustainable change in health behaviour (e.g., connected health devices, smartphone health apps, serious games). Beyond their ergonomics and their features, this thesis focuses on their evaluation in health, from their validation to their surveillance. The first study identifies the existing frameworks proposed around the world to evaluate these BITs and categorizes them, based on their underlying epistemological paradigm. The results show an exponential increase of these frameworks and a lack of consensus or convergence towards a common framework, as it had been the case for the drugs, by the end of the twentieth century. The second study is based on a systematic review used to identify 90 published interventional studies evaluating the benefits and the risks of digital solutions to fight against smoking. The results show that some BITs are effective against smoking but their effectiveness is based on a heterogeneous methodological corpus limiting the significance of the results produced. This heterogeneity is related to the inherent characteristics of the BITs (e.g., employed technologies and combination of technologies, multiplicity of the theories to change health behavior), to the chosen assessment methods (e.g., kind of control group, follow-up time) and to the chosen outcome measures (e.g., smoking reduction, smoking cessation). The discussion is focused on the current limitations to demonstrate the effectiveness and the risks of the BITs., due to parallel paradigmatic approaches, the biomedical paradigm, the engineering paradigm and the behavioral paradigm. The lack of consensus limits the comparability and the reproducibility of the results of the studies evaluating these BITs. Most of them are still gadgets, despite a promising potential, as predicted by the manufacturers. This thesis promotes the convergence to a consensual framework to determine the evidence-based benefits and risks of each BITs and introduces proposals to this effect.

Intestinal parasites are a problem of great public health importance. Both in rural areas as in urban areas, they are widespread due to poor sanitation and irrigation water is one of the major intestinal diseases transmission vehicles. We evaluated the prevalence of intestinal parasites in children aged 7 to 11, from a public school in Maceio, through parasitological examination of Lutz, popularly known as HPJ in two steps (with and without drug treatment) investigating whether there influence of sanitation and socioeconomic and environmental conditions. After preventive education and adequate pharmacological treatment, repeated parasitology and the physical analysis, chemical (titration of complexation and Argentometric - Alfakit/Ecokit) and microbial by the Technical Multiple tubes of water. It was the prevalence of Giardia lamblia and Ascaris lumbricoides in 59.25% of the positive samples. After preventive education and adequate pharmacological treatment the prevalence of intestinal parasites was statistically significant (p <0.05), being effective in reducing the degree of parasitism in the period. The water distributed for consumption at the Municipal School Rui Palmeira is not within the potability standards required by Brazilian law. The concentration of residual chlorine and the presence of fecal coliform leaves unsuitable for consumption. The study showed that not enough only minimum conditions of sanitation and public policy of urban and housing planning must also be encouraged educational practices of tutoring to raise awareness of the need to acquire the knowledge to prevent parasites. / As parasitoses intestinais representam um problema de grande importância em Saúde Pública. Tanto nas áreas rurais quanto nas urbanas, elas são amplamente difundidas devido às más condições sanitárias, sendo a água um dos principais veículos de transmissão de enfermidades intestinais. Avaliou-se a prevalência de enteroparasitos em crianças em idade entre 7 e 11 anos, de uma escola pública de Maceió, por meio de exame parasitológico de Lutz, conhecido popularmente como HPJ, em duas etapas (sem e com tratamento farmacológico) investigando se existe influência do saneamento básico e das condições socioeconômica e ambiental. Após educação preventiva e tratamento farmacológico adequado, repetiu-se o exame parasitológico bem como as análises físico, química (Titulação de complexação e argentimétrica – Alfakit/Ecokit) e microbiológica, pela Técnica dos Tubos Múltiplos da água. Verificou- se a prevalência de Giárdia lamblia e Ascaris lumbricoides em 59,25% das amostras positivas. Após educação preventiva e tratamento farmacológico adequado a prevalência de enteroparasitos foi estatisticamente significativa (p<0,05), sendo eficaz para reduzir o grau de parasitismo no período. A água distribuída para consumo na Escola Municipal Rui Palmeira não se apresenta dentro dos padrões de potabilidade exigidos pela legislação brasileira. A concentração de cloro residual e a presença de coliformes termotolerantes a deixa inadequada para o consumo. O estudo evidenciou que não bastam apenas mínimas condições de saneamento básico e políticas públicas de planejamento urbano e habitacional, há também que se incentivar práticas educacionais de orientação pedagógica para a conscientização da necessidade de adquirirem os conhecimentos para prevenção de parasitoses.