Análise temporal e espacial da esquistossomose mansoni no estado do Maranhão no período de 2007 a 2016

Abstract

Schistosomiasis is a disease caused by parasitic worms of the genus Schistosoma. This endemic is considered one of the Neglected Tropical Diseases (NTDs) and affects nearly 240 million people in 78 countries. In Brazil, schistosomiasis mansoni has been registered in 19 states. The occurrence of the disease has been recorded predominantly in rural areas, but with the intense migratory flow to urban environments, the environmental and social conditions of rural areas have been reproduced in peripheral areas of the cities, thus favoring their establishment also in urban areas. In the state of Maranhão, the micro-region of Baixada Maranhense is recognized as a traditional endemic zone of schistosomiasis, due to its diverse characteristics that favor its occurrence. The objective of this study was to analyze the temporal and spatial distribution of schistosomiasis mansoni cases in the state of Maranhão from 2007 to 2016. Data were obtained from secondary sources: Control Program of Schistosomiasis of Maranhão (PCE-MA), SINAN and IBGE. The Health Regions of the state were considered as units of analysis. Maranhão had a prevalence rate of 3.8 for the period. There was a steady trend of prevalence in the state. When correlated with other parasitic diseases (soil-transmitted helminths), the prevalence trend of schistosomiasis has increased. The Regionals that presented the highest percentages of positivity of the state were Pinheiro (7,92), Zé Doca (3,30) and Viana (3,10). There was a significant trend of decreasing prevalence in the Regionals of São Luís and Zé Doca. For the other Regionals the historical series was stationary. The spatial analysis of the cases of schistosomiasis has shown that Maranhão has two main centers of dissemination of the disease, both located in the northern part of the state, being the Baixada Maranhense and the east coast. The environmental indicators inadequate water supply and sewage collection and garbage showed significant correlation with the prevalence of the disease in the state. Schistosomiasis more commonly affects males, of brown color, in the age group of 20 to 39 years, living in the rural area and who have incomplete Elementary School level. Although the treatment coverage of PCE in Maranhão exceeds 90%, the average cure rate was below 80%. It was verified that the PCE of Maranhão underwent a reduction of its activities, with a reduction of 64.22% of the population worked and 65.42% of tests performed. This study concluded that the prevalence of schistosomiasis in Maranhão was stable throughout the analyzed period. The state still conserves the micro-region of the Baixada Maranhense as an important area of dissemination of the disease, reaching population groups in social vulnerability.