Análise espacial da esquistossomose no estado do Rio Grande do Norte, entre 2010 e 2019

Abstract

Objective: analyze the spatial distribution of the prevalence of schistosomiasis and its association between socioeconomic and environmental factors in municipalities in the state of Rio Grande do Norte, between 2010 and 2019. Method: this is an ecological and temporal study, based on secondary data obtained from the “Schistosomiasis Control Program (PCE)”, available on the portal of the Department of Informatics of the Unified Health System (DATASUS); demographic data available on the website of the Brazilian Institute of Geography and Statistics — IBGE; and socioeconomic and environmental data from the Atlas Brasil portal, referring to the Gini index, Municipal Human Development Index (IDHM), extreme poverty, water supply and sanitation. The data obtained was organized, processed and analyzed, including calculating prevalence, using Google spreadsheets; for the analysis of spatial data, the GeoDa software (version 1.22) was used; and the magnitude of the disease was identified based on spatial distribution using QGIS software (version 3.2.3). Results: 7,359 (2.6%) tests were identified with the presence of Schistosoma mansoni eggs, with the highest prevalence of the disease occurring in 2012 (2.9%) and the lowest (0.8%) in 2018. The 18 municipalities revealed as endemic are distributed in the Health Regions of São José de Mipibu (1st Health Region), João Câmara and Metropolitan Zone (7th Health Region) of the State. In the last five years of the period studied, the percentage of positivity averaged 2.3%, showing a slight variation from the average over the ten years (0.3%). Of the total positive cases for schistosomiasis, 95% were treated, showing a low percentage of pending treatment due to refusal (15.3%). From the analysis of the local Moran index (LISA), the analysis of the correlation between the prevalence of schistosomiasis and the six socioeconomic and environmental variables, it was evidenced that those that presented a statistically significant spatial correlation were: the Gini Index, the Education Human Development and the Human Development Index – in the three dimensions of human development. Conclusion: the study highlighted the need for government intervention, through measures to control and prevent the disease, teaching projects for communities, implementation of changes and improvements in sanitation, water and sewage systems, in addition to the authorities' interest in developing strategies combating poverty and socioeconomic inequality.