Challenges to Schistosomiasis Control Program in Brazil: setbacks in the control program and critical analysis of the disease notification.

ABSTRACT

BACKGROUND: In 1970, Brazil implemented the Schistosomiasis Control Program (PCE, Portuguese acronym for Programa de Controle da Esquistossomose) was implemented in Brazil, where, through successive treatment interventions, the epidemiology and transmission of schistosomiasis have changed significantly over time. This study aimed to evaluate the PCE's effectiveness by critically analyzing the disease notification system. METHODS: An ecological study was conducted using data on reported schistosomiasis cases in Brazil between 2007 and 2020. RESULTS: The highest number of municipalities actively participating in the PCE was 750, recorded in 2007. Conversely, participation reached its lowest point in 2020, with only 259 municipalities involved. Over the past decade, there has been a drastic decline in the number of municipalities with active schistosomiasis control programs. During the same period, there was an observed increase in the number of deaths caused by schistosomiasis, while the number of reported cases decreased. This suggests an inverse correlation. CONCLUSIONS: The present data suggest that schistosomiasis cases are not correctly diagnosed or reported, reflecting a twisted image of the magnitude of this public health problem in Brazil.