Atuação da atenção primária em saúde para o enfrentamento da esquistossomose mansônica: uma revisão sistemática no Brasil / Action of primary health care for the coping of schistosomiasis mansoni: a systematic review in Bra-zil / Acción de la atención primaria de salud para combatir la esquistosomiasis mansoni: una revisión sis-temática en Brasil

Objetivo: Investigar, estimar e diagnosticar a atuação da Atenção Primária a Saúde (APS) no enfrentamento da esquistossomose mansônica no Brasil. Métodos: Trata-se de um estudo de revisão sistemática para avaliar a atuação da APS no contexto da esquistossomose, desde a criação do Programa de Agentes Comunitários de Saúde (PACS). Os dados foram obtidos por meio da metodologia do PRISMA (1991- abril/ 2021). Resultados: A busca identificou 14 trabalhos, a maioria desenvolvida no estado de Pernambuco. Os achados deste estudo mostram um quantitativo relativamente baixo de trabalhos abordando a Atenção Primária como principal política de saúde de cuidados básicos para esquistossomose, assim como a fragilidade de articulação da vigilância com a APS. Conclusões: Identificou-se a necessidade de mais estudos que discutam a APS como importante nível de atenção e estratégia viável para o controle da esquistossomose, que ainda mantém ações incipientes contribuindo para que a doença persista como um problema de saúde pública no Brasil (AU).

Objective: To investigate, estimate and diagnose the role of Primary Health Care (PHC) in coping with schistosomiasis mansoni in Brazil. Methods: This is a systematic review study to evaluate the performance of PHC in the context of schistosomiasis, since the creation of the Community Health Agents Program (PACS). Data were obtained using the PRISMA methodology (1991-April/2021). Results: The search identified 14 works, most of them developed in the state of Pernambuco. The findings of this study show a relatively low number of studies addressing Primary Care as the main health policy for basic care for schistosomiasis, as well as the fragility of articulation between surveillance and PHC. Conclusions: It was identified the need for more studies that discuss PHC as an important level of care and a viable strategy for the control of schistosomiasis, which still maintains incipient actions contributing to the disease persisting as a public health problem in Brazil (AU).

Objetivo: investigar, estimar y diagnosticar el papel de la Atención Primaria de Salud (APS) en el enfrentamiento de la esquistosomiasis mansoni en Brasil. Métodos: Se trata de un estudio de revisión sistemática para evaluar el desempeño de la APS en el contexto de la esquistosomiasis, desde la creación del Programa de Agentes Comunitarios de Salud (PACS). Los datos se obtuvieron mediante la metodología PRISMA (1991-abril/2021). Resultados: La búsqueda identificó 14 obras, la mayoría desarrolladas en el estado de Pernambuco. Los hallazgos de este estudio muestran un número relativamente bajo de estudios que abordan la Atención Primaria como la principal política de salud para la atención básica de la esquistosomiasis, así como la fragilidad de la articulación entre la vigilancia y la APS. Conclusiones: Se identificó la necesidad de más estudios que discutan la APS como un importante nivel de atención y una estrategia viable para el control de la esquistosomiasis, que aún mantiene acciones incipientes contribuyendo a que la enfermedad persista como problema de salud pública en Brasil (AU).

Urban schistosomiasis: An ecological study describing a new challenge to the control of this neglected tropical disease.

Background: Social and environmental vulnerabilities contribute to the persistence and increase of Schistosomiasis, which has been a public health problem in Brazil and worldwide. In this study, we aimed to monitor the entry, installation, and maintenance of schistosomiasis transmission in an urban area on the Brazilian coast over two decades (2000-2010/2010-2020). Methods: This population-based cross-sectional study was conducted in Porto de Galinhas, state of Pernambuco, Brazil, to investigate the dynamics of schistosomiasis transmission in the urban area. Through 3 malacological and parasitological surveys and using geoprocessing technologies, schistosomiasis transmission foci (STF), as well as cases of the disease were identified and quantified. Statistical and geoprocessing tools were used to analyse the data. Findings: Overall, the number of STF decreased from 15 (2000) to 11 (2010) and then to 9 (2020). Although the infection ratio of snails in 2000 has decreased from 16·1% to 5·8% in 2010, we observed an increase to 7·2% in 2020. Additionally, 6,499 individuals were analysed (2012 in 2000; 2459 in 2010, and 2028 in 2020) and the prevalence of human infection has decreased over years, from 32·5% (2000), 16·6% (2010) to 8·8% (2020). The disorderly urbanization process was directly related to the spatial distribution of STF and schistosomiasis cases, causing a new scenario where people became infected by walking on unpaved and flooded streets. Interpretation: Although we observed a decreasing in schistosomiasis cases and STF, this NTD became a health problem related to urbanization in the study area. The challenge to overcome this new sort of transmission will require a greater understanding of the disorderly migration, spatial occupation, and degradation of the environment. Funding: National Council for Scientific and Technological Development (CNPq), Ministry of Science, Technology, Innovations and Communications, Brazil.