Temporal trends and spatial and spatiotemporal distribution of schistosomiasis mansoni in northeast Brazil between 2005 and 2016

Vitória Jordana Bezerra Alencar, Pedro Dantas Lima, João Paulo Vieira Machado, Maria Wilma da Silva Lima, Sheilla da Conceição Gomes, Wandklebson Silva da Paz, Rosália Elen Santos Ramos, Letícia Pereira Bezerra, Israel Gomes de Amorim Santos
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Abstract

Background Schistosoma mansoni is a parasitic disease of great magnitude for Brazilian public health. We aimed to analyse the temporal trend and spatial and spatiotemporal distribution of positivity rates for schistosomiasis mansoni in northeast Brazil. Methods This is a descriptive study with an ecological approach, carried out between 2005 and 2016. We calculated the positivity rate for the disease and then performed a segmented trend analysis (Joinpoint). For spatial analysis, we smoothed the positivity rates using the local empirical Bayesian method. We checked for spatial autocorrelation using Moran’s global and local. Subsequently, we performed Kulldorff’s space time sweep analysis. Results In the period under review, 7 745 650 tests were performed in the northeast, of which 577 793 were positive for Schistosoma mansoni. In the historical series of positivities, it is noted that the highest rates were in Sergipe, Alagoas and Pernambuco. The states of Alagoas and Sergipe showed higher positivity in relation to the average positivity of the northeast and of Brazil. The spatial analysis maps identify clusters of high risk of schistosomiasis cases, mainly in coastal municipalities. There was also stability in positivity rates in some states and the maintenance of endemic areas. Conclusions Thus effective public health policies are needed in health education in order to reduce schistosomiasis positivity and improve the health conditions of the northeastern population.
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2005 至 2016 年间巴西东北部曼氏血吸虫病的时间趋势及空间和时空分布情况
背景曼氏血吸虫病是一种对巴西公共卫生具有重大影响的寄生虫病。我们旨在分析巴西东北部曼氏血吸虫病阳性率的时间趋势和时空分布。方法 这是一项采用生态学方法的描述性研究,在 2005 年至 2016 年期间进行。我们计算了该疾病的阳性率,然后进行了分段趋势分析(Joinpoint)。在空间分析中,我们使用局部经验贝叶斯方法对阳性率进行了平滑处理。我们使用莫兰全局和局部检验了空间自相关性。随后,我们进行了库尔多夫时空扫描分析。结果 在本报告所述期间,东北地区共进行了 7 745 650 次检测,其中 577 793 次对曼氏血吸虫呈阳性反应。从阳性率的历史序列来看,塞尔希培、阿拉戈斯和伯南布哥的阳性率最高。与巴西东北部和巴西的平均阳性率相比,阿拉戈斯州和塞尔希培州的阳性率较高。空间分析图确定了血吸虫病病例的高风险群,主要集中在沿海城市。此外,一些州的阳性率保持稳定,地方病流行区也保持稳定。结论 因此,需要在健康教育方面采取有效的公共卫生政策,以降低血吸虫病阳性率,改善东北部人口的健康状况。
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