NDLI: Assessment of a Brazilian public policy intervention to address schistosomiasis in Pernambuco state: the SANAR program, 2011

Content Provider	Springer Nature : BioMed Central
Author	Facchini, Luiz Augusto Nunes, Bruno Pereira Felisberto, Eronildo da Silva, José Alexandre Menezes da Silva Junior, Jarbas Barbosa Tomasi, Elaine
Abstract	Background Brazil is an endemic country for schistosomiasis in the Latin American and Caribbean countries. Pernambuco is a higher-endemic Brazilian state among the 19 states reporting the disease in the country; schistosomiasis affects 102 (55%) of its 185 municipalities. Our objective was to evaluate the effectiveness of the treatment cycles of the SANAR Program (Plan to Reduce and Eliminate Neglected Diseases) in Pernambuco State in Northeast Brazil. Methods A cross-sectional population-based study was conducted in 2014 via a household survey in 117 hyperendemic locations in the state of Pernambuco. We compared the schistosomiasis prevalence rates in hyperendemic locations, aggregated by geographical region, before and after the intervention. The dependent variable was a positive stool test result by the Kato-Katz method, and the main exposure variable was the number of treatment cycles (one/two). The covariables were the regions of the state and socioenvironmental, socioeconomic, demographic and behavioral characteristics. Results In all, 12,969 individuals were interviewed, 8932 of whom had stool tests. Of these, 4969 (55.6%) underwent two cycles of collective treatment. Changes in the environmental conditions since 2011 were minimal. Comparison before (2011) and after (2014) treatment showed an average schistosomiasis prevalence of 18.6%, decreasing to 4.1% and 2.0% in locations with one and two treatment cycles, respectively. In 2014, the highest schistosomiasis prevalence was found in the forest area (2.8%), while the lowest was found in the northern region (1.2%) of the state. The adjusted analysis showed a lower occurrence of schistosomiasis in individuals living in areas with two treatment cycles than in individuals from areas with just one cycle (PR 0.65, 95% CI: 0.47–0.89). Conclusions The political decision made in Pernambuco to implement the SANAR Program in 2011 greatly impacted the burden of schistosomiasis. This program was effective in reducing the occurrence of schistosomiasis in hyperendemic areas in Pernambuco, with a stronger response in areas with two cycles of collective treatment.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-018-6102-5.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-018-6102-5
Journal	BMC Public Health
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-10-25
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Schistosomiasis Collective treatment Parasitic diseases Prevalence Health policy Brazil Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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