Avaliação das ações de vigilância epidemiológica e controle da esquistossomose mansôni em municípios que pertencem à regional metropolitana do Espírito Santo

Abstract

Schistosomiasis is a parasitic disease, caused by Schistosoma mansoni, that is highly prevalent in rural areas. Espírito Santo is an endemic state due to the frequent occurrence of cases. This study aims to evaluate the actions of epidemiological surveillance and control measures regarding schistosomiasis mansoni from the operational point of view in an endemic area of Espírito Santo. It is a quantitative descriptive study that assessed: a historical series of exams that were performed between 1995 and 2018, the resources that municipalities used to perform the activities required by the Schistosomiasis Control Program (SCP) and the frequency in which surveillance and control activities were performed by the municipalities. The analysis consisted in the calculation of the means and the absolute and relative frequencies. Fisher's exact test was performed to assess the association between the average number of exams per individuals and the performance of control and surveillance actions. The number of screening tests decreased over the period from 1995 to 2018. Conceição do Castelo and Laranja da Terra had the average highest rate of exams performed, with 3.6 tests per inhabitant and 250 exams per 1,000 inhabitants in the period between 1997 and 2014. The geographic classification/delimitation was not performed by 64.7% of the municipalities. The epidemiological survey was not performed by 70.6% of the municipalities. Regarding the transmission cycle, 76.5% of the municipalities did not performed snails screening to investigate the infection by S. mansoni. Most of the municipalities (70.6%) performed a test-and-treat approach for the household contacts of schistosomiasis patients. Sanitation to reduce the prevalence of schistosomiasis was not performed by 70.6% of the municipalities. Community educational activities were implemented in 64.7% of the municipalities. Fisher's exact test showed that there is no association between the number of exams performed by the municipalities and the frequency of epidemiological procedures such as: geographic classification/delimitation (p = 0.644), testing/treatment of household contacts (p = 0.384), basic sanitation (p = 0.178) and targeted educational activities (p = 0.644). However, Fisher's exact test showed that there is association between the number of exams performed by the municipalities and the frequency of epidemiological procedures such as epidemiological surveys (p = 0.015) and snail screening (p = 0.008).