Avaliação das ações do programa de prevenção e controle de arboviroses urbanas no município de São Luís/MA - Brasil

Abstract

The National Dengue Control Program (PNCD) was created to reduce the impact of this disease in Brazil. However, with the confirmation of autochthonous chikungunya cases in 2014 and Zika in 2015 the epidemiological situation has become more challenging in the country. The objective of this study was to evaluate the actions of the Program for prevention and control of urban arboviruses (dengue, chikungunya and Zika) in São Luís / MA, from 2013 to 2017, considering the components: epidemiological surveillance, vector control and education. in health and social mobilization. The research is evaluative based on institutional documents, Notification Disease Information System (SINAN) and Mortality Information System (SIM). For data collection and analysis we used a Checklist of Items consisting of structural, managerial and operational elements. Regarding epidemiological indicators 17,749 probable cases of urban arboviruses were recorded, being 58.49% for dengue, 24.08% chikungunya and 17.42% Zika, with 39 deaths confirmed by epidemiological laboratory and clinical criteria. Over the period, there were no targets for timely closure of compulsory notifiable diseases or coverage of 80% of properties with visits for vector control. However, 5,917,314 homes visits were made with 1,582,726 properties and 1,335,205 deposits treated, as well as 2,818,618 deposits eliminated. For the Aedes aegypti rapid index survey, averages equal to and above 1% were recorded. The highest rates were observed in June and August 2015 (2.2%) and March 2017 (1.8%). The presence of focus was predominant in the type A2 deposit, ranging from 87.7% to 93%, which corresponds to ground-level water storage deposits. Regarding health education actions, seven information and social mobilization campaigns were carried out with 36 urban clean-up efforts. Although consolidated in its practices and strategies, the Program proved to have structural inadequacies that made it impossible to respond more efficiently and effectively to the problem, mainly influenced by the compromise in the availability of human and financial resources, as well as by the need to implement actions. As a form of technical contribution, instructional didactic material was elaborated for managers and health professionals, focusing on the evaluation process and a scientific article considering the epidemiological aspects of arboviruses in the analyzed time interval.