{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T04:25:43Z","timestamp":1773980743295,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Objective: To analyze the temporal trend and spatial patterns of schistosomiasis-related morbidity in Northeast Brazil, 2001\u20132017. Methods: Ecological study, of time series and spatial analysis, based on case notifications and hospital admission data, as provided by the Ministry of Health. Results: Of a total of 15,574,392 parasitological stool examinations, 941,961 (6.0%) were positive, mainly on the coastline of Pernambuco, Alagoas and Sergipe states. There was a reduction from 7.4% (2002) to 3.9% (2017) of positive samples and in the temporal trend of the detection rate (APC\u201411.6*; Confidence Interval 95%\u201413.9 to \u22129.1). There was a total of 5879 hospital admissions, with 40.4% in Pernambuco state. The hospitalization rate reduced from 0.82 (2001) to 0.02 (2017) per 100,000 inhabitants. Conclusion: Despite the reduction in case detection and hospitalizations, the persistence of focal areas of the disease in coastal areas is recognized. This reduction may indicate a possible positive impact of control on epidemiological patterns, but also operational issues related to access to healthcare and the development of surveillance and control actions in the Unified Health System.<\/jats:p>","DOI":"10.3390\/tropicalmed6040193","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T23:52:35Z","timestamp":1635465155000},"page":"193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Persistence of Schistosomiasis-Related Morbidity in Northeast Brazil: An Integrated Spatio-Temporal Analysis"],"prefix":"10.3390","volume":"6","author":[{"given":"B\u00e1rbara Morgana da","family":"Silva","sequence":"first","affiliation":[{"name":"Postgraduate Programme in Public Health, School of Medicine, Federal University of Cear\u00e1, Fortaleza 60430-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-9459","authenticated-orcid":false,"given":"Anderson Fuentes","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Postgraduate Programme in Public Health, School of Medicine, Federal University of Cear\u00e1, Fortaleza 60430-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Alexandre Menezes","family":"da Silva","sequence":"additional","affiliation":[{"name":"NHR Brasil\u2014Nederlanse Stichting Voor Leprabestrijding, Fortaleza 60170-001, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-0344","authenticated-orcid":false,"given":"Rebeca Gomes","family":"de Amorim","sequence":"additional","affiliation":[{"name":"NHR Brasil\u2014Nederlanse Stichting Voor Leprabestrijding, Fortaleza 60170-001, Brazil"},{"name":"Department of Nursing, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana L\u00facia Coutinho","family":"Domingues","sequence":"additional","affiliation":[{"name":"Graduate Program in Tropical Medicine, Centre for Health Sciences, Federal University of Pernambuco, Recife 50670-901, Brazil"},{"name":"Clinical Hospital, Federal University of Pernambuco, Recife 50670-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-6964","authenticated-orcid":false,"given":"Marta Cristhiany Cunha","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Laboratory of Research in Molluscan Parasitology and Biology, Department of Clinical and Toxicological Analysis, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Schemelzer","family":"de Moraes Bezerra","sequence":"additional","affiliation":[{"name":"Laboratory of Research in Molluscan Parasitology and Biology, Department of Clinical and Toxicological Analysis, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7845-5510","authenticated-orcid":false,"given":"Jorg","family":"Heukelbach","sequence":"additional","affiliation":[{"name":"Postgraduate Programme in Public Health, School of Medicine, Federal University of Cear\u00e1, Fortaleza 60430-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Alberto Novaes","family":"Ramos","sequence":"additional","affiliation":[{"name":"Postgraduate Programme in Public Health, School of Medicine, Federal University of Cear\u00e1, Fortaleza 60430-140, Brazil"},{"name":"Department of Community Health, School of Medicine, Federal University of Cear\u00e1, Fortaleza 60430-235, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"ref_1","unstructured":"(2020, March 06). World Health Organization. Available online: https:\/\/www.who.int\/neglected_diseases\/news\/schisto-elimination-refocusing-snail-control-sustain-progress\/en\/."},{"key":"ref_2","first-page":"1","article-title":"The burden of neglected tropical diseases in Brazil, 1990\u20132016: A subnational analysis from the global burden of disease study 2016","volume":"12","author":"Carneiro","year":"2018","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Oliveira, E.C.A., Pimentel, T.J.F., Araujo, J.P.M., Oliveira, L.C.D.S., Fernando, V.C.N., Loyo, R.M., Gomes, E.C.S., Moreira, R.S., and Barbosa, C.S. (2018). Investigation of schistosomiasis cases and deaths in the city of Recife, Pernambuco, Brazil, 2005\u20132013. Epidemiol. Serv. Sa\u00fade, 27.","DOI":"10.5123\/S1679-49742018000400010"},{"key":"ref_4","unstructured":"World Health Organization (2020, December 05). Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation: Executive Summary. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/70809."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Casulli, A. (2021). New global targets for NTDs in the WHO roadmap 2021\u20132030. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009373"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1590\/S0074-02761998000700005","article-title":"Schistosomiasis control in Brazil","volume":"93","author":"Katz","year":"1998","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1590\/S0037-86822011000100020","article-title":"Epidemiological characteristics and geographical distribution of schistosomiasis and geohelminths, in the State of Sergipe, according to data from the Schistosomiasis Control Program in Sergipe","volume":"44","author":"Rollemberg","year":"2011","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/0037-8682-0458-2018","article-title":"Schistosomiasis mansoni in the northeast region of Brazil: Temporal modeling of positivity, hospitalization, and mortality rates","volume":"52","author":"Silva","year":"2019","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_9","unstructured":"Brazil Ministry of Health (2014). Vigil\u00e2ncia da Esquistossomose Mansoni: Diretrizes T\u00e9cnicas, Editora do Minist\u00e9rio da Sa\u00fade. (In Portuguese)."},{"key":"ref_10","first-page":"243","article-title":"Prevalence and worm burden of Schistosomiasis mansoni before and after collective treatment in Jaboat\u00e3o dos Guararapes, Pernambuco, Brazil","volume":"25","author":"Gomes","year":"2016","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"key":"ref_11","first-page":"e10","article-title":"Infectious and parasitic diseases in Brazil, 2010 to 2017: Considerations for surveillance enfermedades infecciosas y parasitarias en Brasil de 2010 a 2017: Aspectos para la vigilancia sanitaria","volume":"44","author":"Santos","year":"2020","journal-title":"Rev. Panam. Salud P\u00fablica"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.3201\/eid2110.141438","article-title":"Spatiotemporal patterns of schistosomiasis-related deaths, Brazil, 2000\u20132011","volume":"21","author":"Pinheiro","year":"2015","journal-title":"Emerg. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1590\/0037-8682-0299-2017","article-title":"Detection of schistosomiasis in an area directly affected by the S\u00e3o Francisco River large-scale water transposition project in the northeast of Brazil","volume":"50","author":"Pinheiro","year":"2017","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e00101417","DOI":"10.1590\/0102-311x00101417","article-title":"O conceito de vulnerabilidade e seus sentidos para as pol\u00edticas p\u00fablicas de sa\u00fade e assist\u00eancia social","volume":"34","author":"Carmo","year":"2018","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_15","unstructured":"(2021, October 04). Neglected Diseases in Brazil: Vulnerability and challenges, Health Brazil 2017: An Analysis of the Health Situation and Challenges to the Achievement of the Sustainable Development Goals, Available online: https:\/\/bvsms.saude.gov.br\/bvs\/publicacoes\/saude_brasil_2017_analise_situacao_saude_desafios_objetivos_desenvolvimento_sustetantavel.pdf."},{"key":"ref_16","unstructured":"Funda\u00e7\u00e3o Instituto Oswaldo Cruz (2021, October 04). Escola Nacional de Sa\u00fade P\u00fablica. Centro de Estudos, Pol\u00edticas e Informa\u00e7\u00e3o Sobre Determinantes Sociais da Sa\u00fade. Available online: https:\/\/dssbr.ensp.fiocruz.br\/."},{"key":"ref_17","unstructured":"Brazil Ministry of Health (2020, February 10). Esquistossomose: Causas, Sintomas, Tratamento, Diagn\u00f3stico e Preven\u00e7\u00e3o, Available online: http:\/\/antigo.saude.gov.br\/saude-de-a-z\/esquistossomose."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e180347","DOI":"10.1590\/0074-02760180347","article-title":"The cost of a disease targeted for elimination in Brazil: The case of schistosomiasis mansoni","volume":"114","author":"Nascimento","year":"2019","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/S0140-6736(17)32130-X","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Hay","year":"2017","journal-title":"Lancet"},{"key":"ref_20","first-page":"103","article-title":"Mortality from neglected tropical diseases in Brazil, 2000\u20132011","volume":"2","author":"Ramos","year":"2016","journal-title":"Bull. World Health Organ."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1093\/trstmh\/try038","article-title":"Quality of life and quality-adjusted life years of chronic schistosomiasis mansoni patients in Brazil in 2015","volume":"112","author":"Nascimento","year":"2018","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_22","unstructured":"Brazilian Institute of Geography and Statistics (2021, February 18). Brasil em S\u00edntese, (In Portuguese)."},{"key":"ref_23","unstructured":"Institute of Applied Economic Research (2021, February 18). Atlas da Vulnerabilidade Social nos Munic\u00edpios Brasileiros, (In Portuguese)."},{"key":"ref_24","unstructured":"National Sanitation Information System (2020, December 05). Painel de Informa\u00e7\u00f5es sobre Saneamento, (In Portuguese)."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"202","DOI":"10.2307\/622202","article-title":"The moving average model for spatial interaction","volume":"3","author":"Haining","year":"1978","journal-title":"Trans. Inst. Br. Geogr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1002\/sim.4780110802","article-title":"Empirical bayes versus fully Bayesian analysis of geographical variation in disease risk","volume":"11","author":"Bernardinelli","year":"1992","journal-title":"Stat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.17648\/diversitas-journal-v5i3-1056","article-title":"Spatio-temporal dynamics of mansonic schistosomiasis in Alagoas (2007\u20132017)","volume":"5","author":"Silva","year":"2020","journal-title":"Divers. J."},{"key":"ref_28","first-page":"1","article-title":"Setback of the schistosomiasis control program in the Brazilian state with the highest prevalence of the disease","volume":"11","author":"Cruz","year":"2020","journal-title":"Rev. Pan. Amaz. Sa\u00fade"},{"key":"ref_29","first-page":"1","article-title":"Epidemiological aspects and distribution of infection cases by Schistosoma mansoni in municipalities in the Alagoas State, Brazil","volume":"2","author":"Rocha","year":"2016","journal-title":"Rev. Pan. Amaz. Sa\u00fade"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0037-86821980000100002","article-title":"Sectional study on schistosomiasis mansoni in the municipality of Riachuelo, State of Sergipe","volume":"13","author":"Menezes","year":"1980","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_31","unstructured":"Katz, N. (2020, April 06). National Survey on the Prevalence of Schistosomiasis Mansoni and Geo-Helminths. Available online: https:\/\/www.arca.fiocruz.br\/handle\/icict\/25662."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Facchini, L.A., Nunes, B.P., Felisberto, E., da Silva, J.A.M., da Silva, J.B., and Tomasi, E. (2018). Assessment of a Brazilian public policy intervention to address schistosomiasis in Pernambuco state: The SANAR program, 2011\u20132014. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-6102-5"},{"key":"ref_33","first-page":"e2019252","article-title":"Epidemiological situation and control of schistosomiasis in Pernambuco, Brazil: A descriptive study, 2010\u20132016","volume":"29","author":"Brito","year":"2020","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"key":"ref_34","first-page":"1","article-title":"Public access to health information concerning neglected diseases in Brazil","volume":"6","author":"Nascimento","year":"2012","journal-title":"Rev. Eletr\u00f4nica Comun. Inf. Inova\u00e7\u00e3o Sa\u00fade"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1590\/S0037-86822011000600004","article-title":"Epidemiological aspects of dengue in Aracaju, State of Sergipe, Brazil","volume":"44","author":"Alves","year":"2011","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1590\/0037-8682-0137-2016","article-title":"Spatial analysis for the identification of risk areas for schistosomiasis mansoni in the State of Sergipe, Brazil, 2005\u20132014","volume":"49","author":"Lima","year":"2016","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1093\/cid\/ciaa933","article-title":"Predicted impact of COVID-19 on neglected tropical disease programs and the opportunity for innovation","volume":"72","author":"Toor","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_38","first-page":"209","article-title":"Migration and urban schistosomiasis","volume":"42","author":"Ximenes","year":"2000","journal-title":"The case of S\u00e3o Louren\u00e7o da Mata, northeast of Brazil. Rev. Inst. Med. Trop."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1590\/0037-8682-0243-2015","article-title":"Assessment of schistosomiasis in the semi-arid Northeast region of Brazil: The S\u00e3o Francisco River large-scale water transposition project","volume":"49","author":"Favre","year":"2016","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"105668","DOI":"10.1016\/j.actatropica.2020.105668","article-title":"Spatiotemporal clusters of schistosomiasis mortality and association with social determinants of health in the Northeast region of Brazil (1980\u20132017)","volume":"212","author":"Gomes","year":"2020","journal-title":"Acta Trop."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4081\/gh.2015.303","article-title":"Predicting frequency distribution and influence of sociodemographic and behavioral risk factors of Schistosoma mansoni infection and analysis of co-infection with intestinal parasites","volume":"10","author":"Rollemberg","year":"2015","journal-title":"Geospat. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"327","DOI":"10.5123\/S1679-49742011000300007","article-title":"Epidemiologic aspects of hepatosplenic schistosomiasis in the State of Pernambuco, Brazil","volume":"20","author":"Silva","year":"2011","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1590\/0037-8682-0110-2013","article-title":"Treatment and education reduce the severity of schistosomiasis periportal fibrosis","volume":"46","author":"Silva","year":"2013","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1590\/S0074-02762010000400034","article-title":"Current epidemiological status of schistosomiasis in the state of Pernambuco, Brazil","volume":"105","author":"Barbosa","year":"2010","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_45","first-page":"436","article-title":"Epidemiology of schistosomiasis in coastal areas of Pernambuco State, Brazil","volume":"43","author":"Barbosa","year":"2015","journal-title":"Rev. Patol. Trop."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1590\/0037-8682-0411-2016","article-title":"Spatial analysis of viral hepatitis and schistosomiasis coinfection in an endemic area in Northeastern Brazil","volume":"50","author":"Santos","year":"2017","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11606\/S1518-8787.2017051000069","article-title":"Geographic information systems under study on schistosomiasis in Pernambuco","volume":"51","author":"Barbosa","year":"2017","journal-title":"Rev. Saude Publica"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1590\/S0102-311X2005000500011","article-title":"Hospitalization and mortality from mansoni schistosomiasis in the state of Pernambuco, Brazil, 1992\/2000","volume":"21","author":"Resendes","year":"2005","journal-title":"Cad. Saude Publica"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1111\/tmi.13483","article-title":"Burden of schistosomiasis-related mortality in Brazil: Epidemiological patterns and spatial-temporal distribution, 2003\u20132018","volume":"25","author":"Pinheiro","year":"2020","journal-title":"Trop. Med. Int. Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.actatropica.2016.06.024","article-title":"Morbidity of mansoni schistosomiasis in Pernambuco\u2014Brazil: Analysis on the temporal evolution of deaths, hospital admissions and severe clinical forms (1999\u20132014)","volume":"164","author":"Barbosa","year":"2016","journal-title":"Acta Trop."},{"key":"ref_51","first-page":"103","article-title":"Varicel upper gastrointestinal bleeding in emergency hospital in Recife\u2014PE","volume":"32","author":"Almeida","year":"2013","journal-title":"Gastroenterol. Endosc. Diag."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"102051","DOI":"10.1016\/j.parint.2020.102051","article-title":"Schistosomiasis and hookworm infection in humans: Disease burden, pathobiology and anthelmintic vaccines","volume":"75","author":"Anisuzzaman","year":"2020","journal-title":"Parasitol. Int."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Zoni, A.C., Catal\u00e1, L., and Ault, S.K. (2016). Schistosomiasis prevalence and intensity of infection in Latin America and the Caribbean countries, 1942\u20132014: A systematic review in the context of a regional elimination goal. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004493"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/193\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:22:12Z","timestamp":1760167332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,28]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["tropicalmed6040193"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed6040193","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,28]]}}}