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. 2021 Oct 28;6(4):193.
doi: 10.3390/tropicalmed6040193.

Persistence of Schistosomiasis-Related Morbidity in Northeast Brazil: An Integrated Spatio-Temporal Analysis

Bárbara Morgana da Silva  1 , Anderson Fuentes Ferreira  1 , José Alexandre Menezes da Silva  2 , Rebeca Gomes de Amorim  2   3 , Ana Lúcia Coutinho Domingues  4   5 , Marta Cristhiany Cunha Pinheiro  6 , Fernando Schemelzer de Moraes Bezerra  6 , Jorg Heukelbach  1 , Alberto Novaes Ramos Jr  1   7
Affiliations

Persistence of Schistosomiasis-Related Morbidity in Northeast Brazil: An Integrated Spatio-Temporal Analysis

Bárbara Morgana da Silva et al. Trop Med Infect Dis. .

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.

Keywords: epidemiology; morbidity; public health surveillance; schistosomiasis mansoni.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Areas of study: states and northeast regions of Brazil.
Figure 2
Figure 2
Percentage of positivity (A), crude case detection rate (SINAN) (B), crude case detection rate (SINAN and SISPCE) (C) and rate of hospital admissions (D) per 100,000 Inhabitants—according to year and state of the Northeast region. Brazil, 2001–2017.
Figure 3
Figure 3
Spatial distribution of schistosomiasis cases according to percentage of positivity (A), crude detection rate (B), spatial moving average rate (SMA) of detection (C), and standardized morbidity ratio (SMR) of detection (D), in municipalities of the states of the northeast Region, divided by trienniums, Brazil, 2001–2017.
Figure 4
Figure 4
Spatial distribution of hospitalization for schistosomiasis according to analyses by adjusted hospitalization rate (A), spatial moving average rate (SMA) (B), and standardized morbidity ratio (SMR) (C), in municipalities of the states of the northeast region, according to triennials, Brazil, 2001–2017.
See this image and copyright information in PMC

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