Investigação sobre os casos e óbitos por esquistossomose na cidade do Recife, Pernambuco, Brasil, 2005-2013*

Abstract

Objective: to describe schistosomiasis cases and deaths among residents of the city of Recife, Pernambuco, Brazil, from 2005 to 2013. Methods: this was a descriptive epidemiological study using data from the Mortality Information System (SIM) (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) and the Notifiable Diseases Information System (SINAN) (2007)(2008)(2009)(2010)(2011)(2012)(2013); active tracing of the relatives of the dead was undertaken and probabilistic linkage of the databases (2007)(2008)(2009)(2010)(2011)(2012)(2013) was performed using the Reclink program. Results: 297 schistosomiasis deaths were recorded on the SIM system; through active tracing, 130 relatives were contacted and 20.8% autochthony was identified; 388 cases resident in Recife were registered on the SINAN system; through probabilistic linkage, 23 matching records were identified on SIM and SINAN. Conclusion: investigation of deaths showed that some individuals had never traveled outside Recife and progressed to the chronic stage of the disease; 23.8% of the cases registered on SINAN had Recife as the municipality in which infection occurred.

Situação epidemiológica e controle da esquistossomose em Pernambuco: estudo descritivo, 2010-2016*

“…29 Socio-economically precarious communities where low schooling levels together with environmental problems prevail, are characterized by these additional factors which result in these problems continuing, within a context in which reinfection is facilitated. [1][2][3][4][5][6][7]9,10,12,14,16,18,[23][24][25][26][27][28][29] The reduction in the percentage of positivity for other helminthiases may be associated with treatment with low toxicity medication (albendazole, mebendazole), which has taken place for decades in Brazil and has been reinforced by SANAR. 7,25 Data from the national survey on the prevalence of Manson's schistosomiasis and geo-helminthiases showed that periodic use of these low cost and easy to administer forms of medication is responsible for the reduction in approximately 80% of cases of other helminthiases.…”

“…2,4,13 These areas were only included as a priority when changes were found in the profile of schistosomiasis occurrence. [2][3][4]7,12 In 2000, an outbreak of acute schistosomiasis occurred in Porto de Galinhas. 14 Interventions took place and the disease was believed to have been controlled at that coastal resort.…”

“…1 Within this new context, municipal health departments have been encouraged to gain knowledge of the local reality of schistosomiasis and to overcome the diagnosis-treatment dyad which was characteristic of classic control actions, in order for these actions to become part of Primary Health Care. [2][3][4] Schistosomiasis is still a public health problem, as in 2017 it affected approximately 1.5 million people in Brazil, 80% of whom lived in the country's Northeast region. 1 Moreover, the severe clinical forms in which schistosomiasis manifests itself contribute to its magnitude and transcendency.…”

“…2 As a classically chronic and rural disease, associated with poverty and occurring above all in the Zona da Mata (an area where the soil is fertile, rivers are perennial and not subject to periodic droughts), schistosomiasis took on new facets to its epidemiological profile when it began to occur in the acute form, in outbreaks located along the state's coast. 3,4 In 2015, mean positivity was 3% in the areas examined in Pernambuco, accounting for approximately 180 deaths a year between 2005 and 2014. This mortality rate is five times greater than the national rate.…”

“…7 These particularities contribute to the Brazilian epidemiological transition pattern, with old and new problems existing alongside each other, making it a hard-to-control nosological entity. 2,3 The contribution of government bodies, considering the large number of factors associated with the disease and its different forms of expression, is an essential condition for supporting schistosomiasis control actions. The Schistosomiasis Control Program (PCE), formerly called the Special Schistosomiasis Control Program (PECE), implemented in 1976, was launched by the Ministry of Health with the aim of providing guidance to municipal health departments on control of the disease, concentrating its actions on diagnosis and treatment of infected cases in endemic areas.…”