Esquistossomose mansônica em áreas focais no estado do Ceará de 1997 a 2007 : epidemiologia, vigilância e controle de ações

Abstract

Schistosomiasis mansoni of African origin is known to expand in Brazil through the slave trade in the period of colonization by the arrival of blacks coming from endemic areas of those continents. Pirajá da Silva (1908) was responsible for the first record of human infection with S. mansoni in Brazil. The distribution of the disease could only be known in Brazil as the first national survey, conducted by Pellon & Teixeira in 1950. In this investigation we examined the states of the Northeast and Minas Gerais State, whereas the prevalence of schistosomiasis estimated 10% of the population of the endemic area studied in the country. In Ceará,states the survey was carried out by Alencar in 1948 and 1949. Among counties that had higher levels of positivity can point Pacoti (31.4%) and Redenção (62.2%). The main objective of this study is to characterize the epidemiological evolution of schistosomiasis in focal areas of the State of Ceará, with emphasis on surveillance and control, from 1977 to 2007. This is a retrospective descriptive study, by time series analysis using secondary data aggregated by municipalities of the endemic and potential endemic area of Schistosomiasis in Ceará, and also the site of the outbreaks and description of control. The study was conducted using secondary data from 1977 to 2007, divided into three periods from 1977 to 1986, from 1987 to 1996 and from 1997 to 2007. In the first two periods were analyzed for PCE worked municipalities in Ceará, and last time the survey was conducted in the regions of Ceará state, and Cariri Caririaçu, which are considered the main focal areas for schistosomiasis. They were worked with greater frequency by the PCE during the proposed period.The results were presented through a historical, political and epidemiological view of schistosomiasis mansoni in Ceará state. About the historical aspects, was made a bibliographical survey of the disease existence in the period from 1920 to 2007. It is noteworthy that from 1997 to 2007 showed the permanence of targeting the disease, with overall mean prevalence of 1%, although it was found cities with prevalence above 10%. In relation to the political analysis has been conducted since 1950, when we performed the first survey coprological nationwide, which led to the creation of the campaign against schistosomiasis and Special Program for Schistosomiasis Control (PECE) who lost the character of specialty and became Control Program Schistosomiasis (PCE). About the epidemiology aspects in the 31 years analysed there was an average prevalence below 5%. It is important to note that from 1997 to 2007, there was no significant difference by sex among patients with schistosomiasis and 85.3% showed low intensity of infection. Schistosomiasis mansoni in Ceará state continues to present itself as a serious public health problem. The decentralization of monitoring and control of diseases now to municipal administrations, has become more serious since the non- prioritization of this disease in these instances, although the magnitude of the problem.