Abstract
Objective: To analyze the temporal trend and spatial patterns of schistosomiasis-related morbidity in Northeast Brazil, 2001–2017. Methods: Ecological study, of time series and spatial analysis, based on case notifications and hospital admission data, as provided by the Ministry of Health. Results: Of a total of 15,574,392 parasitological stool examinations, 941,961 (6.0%) were positive, mainly on the coastline of Pernambuco, Alagoas and Sergipe states. There was a reduction from 7.4% (2002) to 3.9% (2017) of positive samples and in the temporal trend of the detection rate (APC—11.6*; Confidence Interval 95%—13.9 to −9.1). There was a total of 5879 hospital admissions, with 40.4% in Pernambuco state. The hospitalization rate reduced from 0.82 (2001) to 0.02 (2017) per 100,000 inhabitants. Conclusion: Despite the reduction in case detection and hospitalizations, the persistence of focal areas of the disease in coastal areas is recognized. This reduction may indicate a possible positive impact of control on epidemiological patterns, but also operational issues related to access to healthcare and the development of surveillance and control actions in the Unified Health System.
Highlights
Intestinal schistosomiasis caused by the trematode Schistosoma mansoni is a neglected tropical disease (NTD) of chronic evolution, strongly associated with the absence of basic sanitation [1]
In Brazil, control actions began with the Special Programme for the Control of Schistosomiasis (Programa Especial de Controle da Esquistossomose: PECE) in the 1970s, which enabled the development of systematic actions based on the national plan that recommended the use of preventive chemotherapy and the application of molluscicides in water [6]
Throughout the historical series, positivity rates ranged from 7.2% in 2001 to 3.9% in 2017, a reduction of approximately 46%
Summary
Intestinal schistosomiasis caused by the trematode Schistosoma mansoni is a neglected tropical disease (NTD) of chronic evolution, strongly associated with the absence of basic sanitation [1]. It is a persistent public health problem, considering the associated high morbidity and mortality burden in different countries in South America, in Brazil [2]. The new World Health Organization (WHO) guidelines for the control of NTDs set a global goal of eliminating the disease as a public health problem by 2030 [4]. The aim was to control the transmission of the disease and, above all, to reduce the estimated prevalence of cases, as well as the occurrence of deaths in endemic areas [6]
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