Situação da Vigilância da Doença de Chagas em região endêmica em Minas Gerais, Brasil

Abstract

Chagas disease (CD) is a serious public health problem, which predominantly affects populations in situations of social vulnerability. Vector control is one of the main tools for coping with CD, however the Chagas Disease Control Program (PCDCh) is in discontinuous actions. The objective of this dissertation was to characterize the situation of dc surveillance activities in the endemic municipalities of the North of Minas Gerais and Jequitinhonha Valley in Minas Gerais (MG). For this, a scientific article and thematic maps were produced regarding the characterization of the municipalities. The first product is a cross-sectional study, with retrospective and prospective data collection. Data collection included a questionnaire directed to the 22 environmental surveillance coordinators of the North of Minas Gerais and Jequitinhonha Valley, in activity in 2020, 21 municipalities belonging to the SaMi-Trop research project, including the municipality of Montes Claros. Descriptive analysis of the variables was performed. For the characterization of the active municipalities, the explanatory variables collected in the questionnaire were compared with the dichotomous variable (yes or no) and the bivariate analysis was performed. Finally, the geoprocessing technique was used to spatialize the vulnerability index. We observed that 54.5% of environmental surveillance coordinators are hired. These professionals stated that 81.1% of the municipalities developed actions related to Primary Health Care (PHC). The results showed that in 90.9% of the municipalities there was no specific team for the actions of vector control of CD. Of the 22 municipalities participating in this study, nine were active (41.1%) and only 25% (n=2) of these, met the visit target of 50% of home units per year. Most of the coordinators reported that they did not have difficulties in carrying out passive surveillance, on the other hand, they said that there was no specific person in the surveillance to receive the triatomines. The results suggest an insufficient record of activities in the information system, considering that there are municipalities that reported performing the control activities, but no production record was observed in the system. The specialization of the vulnerability index for CD was also performed in these municipalities and it was observed that most of them have the highest rates. The second product is the elaboration of thematic maps on the prevalence of CD in 1984, and self-declared cases with CD in 2018, coming from the last serological survey and network the telehealth of MG, respectively. The results showed that the municipalities in the study had a prevalence higher than the national average, and still have cases of CD reported. According to these results, it is concluded that the situation of DC surveillance in an endemic area is weakened. Few municipalities have a team for DC surveillance, active and passive surveillance activities are discontinuous and there is no fulfillment of the program's goal. The spatialization of vulnerability to CD, as well as the prevalence and distribution of self-reported cases of patients with the disease allows us to better understand the situation, being an important tool to determine priority areas. The strengthening of the PCDCh and the prioritization of public policies in these regions can consolidate and structure dc surveillance control actions.