Avaliação das ações de controle da esquistossomose implementadas entre 1977 e 1996 na área endêmica de Pernambuco, Brasil

Abstract

This study assesses the evolution of schistosomiasis in the endemic area of Pernambuco, using data from five campaigns of chemotherapy control carried out by national health programmes from 1977 to 1996. Analysis of the data showed that: a) the proportion of municipalities with prevalence above 25% was significantly higher in the coastal-forest zone than in the zone of transitional vegetation Agreste in the four evaluations made in the endemic area; b) the prevalence of infection decreased in both zones even when the interval between campaigns were more than five years. The last survey (1996) indicated a predominance of municipalities with prevalences below 25%. However, the majority of these municipalities had localities with prevalence above 50%. A proposal is presented for the identification of the problematic localities, where complementary measures to chemotherapy, such as systematic snail control, improved sanitation, health education and community mobilization, are still necessary.

Spatial analysis for the identification of risk areas for schistosomiasis mansoni in the State of Sergipe, Brazil, 2005-2014

“…The data show much lower prevalence rates compared to those found in the 70's, when the activity of the PCE was started in the Northeast, but with a practically stable percentage for the endemic regions between the monitoring stage (11) (24) to values less than 5% as recommended by the World Health Organization (WHO) (28) . This reduction of the disease in the state is evident when comparing the results of this study with others conducted in Sergipe (29) and is similar to results in other states (25) (30) (31) .…”

“…Despite the study's limitations with the use of secondary data from census surveys conducted by SISPCE (23) (24) , the available information may portray the endemicity of the disease in the State of Sergipe and allow the formulation of more effective control strategies (11) . It is worth mentioning that the study period (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) corresponded to the post-decentralization stage of PCE, when the disease control measures were the responsibility of the municipalities, and each went on to perform the activities according to their criteria and conditions (25) (26) .…”

“…Consequently, in 2014 only 56.86% of the endemic municipalities were registered in the system, presenting an unsatisfactory coverage of the municipalities. Although the routine program activities will be implemented, municipalities have difficulties in exercising them due to the reduced operational framework that is needed to control other endemic diseases, in addition to municipalities performing such activities with their own criteria according to the availability of equipment, which has also been cited in other studies (11) (24) (26) .…”

“…In these endemic schistosomiasis areas, in addition to monitoring, the control of these conditions involves reducing the occurrence of severe forms and deaths, reducing the prevalence of the infection (to levels lower than 5%), and indicating measures to reduce the expansion of the endemic areas (10) (11) .…”

Attaining the minimum target of resolution WHA 54.19 for schistosomiasis control in the Rainforest Zone of the state of Pernambuco, Northeastern Brazil

“…Between 1977 and 1996 the MoH accomplished four campaigns of diagnosis and treatment in the ZMP, covering an average of 39 municipalities per campaign (Favre et al 2001). By the end of that period overall prevalence of infection by Schistosoma mansoni had dropped only 9.1 percentage points (pp), from 35.4 to 26.3%.…”