Tentativa de avaliação do programa especial de controle da esquistossomose (PECE) no Estado da Paraíba, Brasil

Foi feita uma tentativa de avaliação do Programa Especial de Controle da Esquistossomose (PECE) do Ministério da Saúde do Brasil, desenvolvido pela SUCAM no Estado da Paraíba, a partir de 1976. Foram tomadas como base as 5 primeiras avaliações do Programa de 1978 a 1983 e posteriormente em 1984/85 realizados exames quantitativos de fezes em uma amostra de 9.155 indivíduos e exame clínico em 1.036 positivos, em 3 municípios selecionados nas principais regiões hidrográficas, onde o programa vem sendo realizado. As 5 primeiras avaliações realizadas pela SUCAM de 1978 a 1983 nos 47 municípios trabalhados, 23 na região do Mamanguape, 18 na região do Paraíba, 5 na região Litoral Sul e um na região do Curimataú, demonstraram uma queda da prevalência média inicial da esquistossomose de 28% para 4,9% na região do Mamanguape, de 20,9% para 5,9% na região do Paraíba, de 40,2%para 18,9% na região Litoral Sul e de 4,9para 1,4% na região do Curimataú. Em nível de localidade, entretanto, permaneciam com prevalência igual ou superiora 20%, 36(10,9%) das 329 avaliadas na região do Mamanguape, 40(13,6%) das 293 na região do Paraíba e 43 (47,2%) das 91 da região Litoral Sul. Nos municípios tomados como amostra para exame clínico e quantitativo de fezes no ano de 1985 verificou-se que em Cuitegi, na região do Mamanguape, dos 3.494 examinados 154 (4,4%) eliminavam em média 123 ovos de S. mansoni por grama de fezes, nenhum tinha a forma hepatoesplênica e 20(12,9%) tinham fígado palpável. Em Mari, na região do Paraíba, dos 3.735 examinados 410 (10,9%) estavam positivos eliminando em média 165,9 ovos de S. mansoni por grama de fezes; apenas um (0,24%) tinha a forma hepatoesplênica e 48 (11,7%) tinham fígado palpável. Em Alhandra, na região Litoral Sul, dos 1.926 examinados 472 (24,5%) eliminavam em média 115,4 ovos de S. mansoni por grama de fezes, 3,6% eram hepatoesplênicos e 81 (17,1%) tinham fígado palpável. Em estudo anterior realizado na sede desse município em 1979, 24,2% da população era positiva, eliminando em média 211 ovos de S. mansoni por grama de fezes, 2,4% tinham a forma hepatoesplênica e apenas 3% tinham fígado palpável.<br>An attempt was made to evaluate the efficacy of the Special Programme for Schistosomiasis Control (PECE) carried out in the state of Paraíba since 1976 by Superintendência das Campanhas de Saúde Pública (SUCAM), Ministry of Health of Brazil. The evaluation was based on five stool examinations done by SUCAM in the school children of the endemic area from 1978 to 1983 and on a clinical and quantitative stool examination performed in 1984 and 1985 in a sample of 9155 persons living in three selected municipalities each one in a different region of the endemic area: Mamanguape, Paraíba and Litoral Sul. The stool examinations performed from 1978 to 1983 showed a drop of S. mansoni infection from 28% to 4.9% in Mamanguape, 20.9% to 5.9% in Paraíba 40.2% to 18.9% in Litoral Sul and 4.9% to 1.4% in Curimataú. At the local level, however, the prevalence of the infection in 1983 was 20% or higher in 36(10.9%) of329 localities evaluated in Mamanguape, 40 (13.6%) of293 in Paraíba and 43(47.2%) of 91 localities of Litoral Sul. The sample of the population submitted to clinical and a quantitative stool examination showed 4.4% passing an average of 123 eggs of S. mansoni per gram of feces in Mamanguape where 12.9% of the positive cases had a palpable liver and none had the hepatosplenic form of the disease. In Paraíba 10.9% of the sample was positive for S. mansoni, with an average of 165.9 eggs per gram offices; 11.7% of the positives had a palpable liver and only one (0.24%) had the hepatosplenic form. In Litoral Sul 24.5% of the sample passed an average of 115.4 eggs per gram of feces, 17.1% of the positives had a palpable liver and 3.6% had the hepatosplenic form of the disease. The authors conclude that the programme was able to reduce the prevalence of the infection and possibly to reduce the morbidity of the disease in Mamanguape, Paraíba and Curimataú, but was less efficient in reducing the prevalence of infection and unable to reduce the morbidity of the disease in the population of Litoral Sul

Cross-sectional and evolutive studies of schistosomiasis mansoni in untreated and mass treated endemic areas in the southeast and northeast of Brazil

Cross-sectional and evolutive studies on schistosomiasis mansoni were carried out before and after mass treatment in the endemic areas of Capitao Andrade and Padre Paraíso, state of Minas Gerais, Riachuelo, state of Sergipe, Alhandra, state of Paraíba, and Aliança, Alegre and Coroatá, lowland of the state of Maranhao, Brazil, in the last eighteen years. The studies included clinical and fecal examination by the Kato-Katz quantitative technique, skin testfor Schistosoma mansoni infection, evaluation of man-water contact and other epidemiological investigations such as infection rate and dynamic of the snail population. Results showed: (1) Higher prevalence of S. mansoni infection, greater egg load elimination and higher and earlier morbidity of the chronic froms of the disease in the southeast areas of Capitao Andrade and Padre Paraíso; (2) The incidence of hepatosplenic form is higher in some family clusters, in whites and mullattos in all the endemic areas but develop earlier in the southeast; (3) The prevalence and morbidity of schistosomiasis are decreasing both in the mass treated northeast and in the untreated southeast areas; (4) The mass treatment reduces rapidily the prevalence of the infection and the morbidity of the disease but can not control it because of the frequent reinfections due to the intensity of man-water contact