Evaluation of the schistosomiasis control program (PCE) in an endemic area, northeastern Brazil: a population-based and 10-year time series study

Schistosomiasis is an endemic disease in Brazil and the State with the highest positive rate in the country is Sergipe. Herein, we assessed data from the Brazilian Schistosomiasis Control Program (PCE) in the State of Sergipe between the period 2008 and 2017. We evaluated data about schistosomiasis and snails of the genus Biomphalaria. We used the log-linear regression model (joinpoint) to assess temporal trends and the Kernel estimator for spatial statistics analysis. According to the PCE, Sergipe has 51 endemic municipalities for schistosomiasis. Nevertheless, information about the disease and that collected by the PCE has not been recorded regularly in all endemic municipalities. Additionally, only nine municipalities (17.6%) carried out the malacological survey. The average of positive rate from schistosomiasis in Sergipe was 8.4%. However, our data suggest that it may be underestimated. The spatial analysis maps (Kernel maps) showed areas of high transmission of the disease in municipalities close to the São Francisco River and in the metropolitan region of the State. Altogether, our findings suggest that schistosomiasis has been underreported and it is still a serious public health concern in Sergipe. In addition, there are significant failures in the conduction of PCE's activities by the municipalities.

Análise da qualidade da informação sobre óbitos por neoplasias no Brasil, entre 2009 e 2019 / Analysis of quality of information about deaths from neoplasms in Brazil between 2009 and 2019

RESUMO Objetivo: Avaliar a qualidade das informações sobre mortalidade por neoplasias no âmbito do Sistema de Informação sobre Mortalidade. Métodos: Estudo descritivo observacional com avaliação da qualidade do Sistema de Informação sobre Mortalidade, com desfecho referente aos dados de óbitos por neoplasias ocorridos entre os anos de 2009 e 2019 na população brasileira (≥15 anos). A qualidade da informação (QI) foi mensurada para o Brasil e para as Unidades Federativas por meio das dimensões: cobertura, especificidade e completude dos dados. Resultados: A qualidade da dimensão cobertura variou entre "boa" e "excelente" nas abrangências nacional e estadual. A dimensão especificidade foi classificada como inadequada predominantemente nos Estados das Regiões Norte e Nordeste. A proporção de causas mal definidas foi classificada como de "baixa" qualidade na maioria das unidades de análise ao longo da série. A completude dos dados variou de acordo com o indicador utilizado, os indicadores sexo e idade mostraram-se "excelentes" para todo o período e unidades de análise, a escolaridade apresentou variação de qualidade tanto nas unidades como nos períodos e o estado civil apresentou melhoria da qualidade de seu registro ao longo do período, assim como o indicador raça/cor. Conclusões: A qualidade dos dados de mortalidade por neoplasias na população brasileira (≥15 anos) é, em sua maioria, adequada, mas há lacunas importantes que merecem ser preenchidas, pois a ampliação da QI busca dar visibilidade à condição de saúde da população brasileira, bem como propor ações públicas para sua melhoria.

ABSTRACT Objective To assess the quality of information about mortality from neoplasm within the Mortality Information System. Methods: Descriptive observational study evaluating the quality of the Mortality Information System, with an outcome referring to data on deaths from neoplasm between 2009 and 2019 in the Brazilian population (≥15 years). Information Quality (IQ) was measured through coverage, specificity and completeness of data, at national and state level. Results: The quality of the coverage dimension ranged from "good" to "excellent" in the national and state coverages. Specificity was classified as inadequate mainly in the states of the North and Northeast regions. The proportion of ill-defined causes was classified as "poor" quality in most units of analysis throughout the series. Data completeness varied according to indicator. Gender and age indicators were proven "excellent" for the entire period and units of analysis, while educational level varied in quality across units and periods, marital status had its quality improved over the period, as well as ethnicity/skin color. Conclusions: The quality of data on mortality from neoplasm in the Brazilian population (≥15 years) is mostly adequate, but there are important gaps to be filled, as the expansion of IQ seeks to give visibility to the health condition of the Brazilian population and to propose public actions for its improvement.

Primary school educational intervention r egarding schistosomiasis in a riverside community, northeastern Brazil

Schistosomiasis is still a serious public health concern in Brazil and Sergipe State presents the highest prevalence rate of the disease. Brazil implemented the Schistosomiasis Control Program (PCE) with several strategies to control the disease, including health education actions in endemic areas. Herein, we assessed the impact of an educational intervention on knowledge concerning schistosomiasis in students from a riverside village of Sergipe, Northeastern Brazil. The study was carried out in 3 phases. 1) A questionnaire was applied to assess the students' knowledge about the biological, clinical, and epidemiological aspects of schistosomiasis mansoni (pre-test). 2) Next, an educational intervention was conducted. Pamphlets about schistosomiasis were distributed to the entire school community, who were then invited to a lecture. 3) A post-test was performed using the questionnaire to assess acquired knowledge. 151 elementary school students were interviewed. 2.6% of the pre-test students and 4.3% of the post-test group had already been diagnosed with schistosomiasis. In the pre-test, only 24.5% knew the cause of the disease and 48.3% the transmission sites. In the post-test, 74.3% (OR= 8.9; p-value<0.0001) knew the etiology and 77.1% the possible transmission sites (OR= 3.6; p-value<0.0001). There was also significant improvement in knowledge regarding signs, symptoms and prophylactic measures. Most students were unaware of the risk of reinfection by Schistosoma mansoni after treatment. The educational intervention proved quite effective in increasing information on schistosomiasis. These results reinforce the importance of health education as an auxiliary tool in the control of schistosomiasis.