Schistosomiasis in Brazil: An epidemiological analysis of the clinical repercussions on the digestive system and Public Health parameters

Abstract

Diseases caused by gastrointestinal (GI) parasites are associated with socio-environmental issues, thereby amplifying population mortality. This study aimed to discuss the intrinsic characteristics of Schistosomiasis in Brazil, exploring its clinical, pathophysiological, diagnostic, therapeutic, and preventive nuances. To construct this article, we consulted scientific publications available for free in the following databases: PubMed, BVS, as well as grey literature, covering a ten-year period with the keywords: “Schistosomiasis,” “Epidemiology”, “Clinical Manifestations” and “Brazil”. Additionally, DataSUS was consulted for the epidemiological analysis of public health parameters, such as the profile of parasitic infection (age, gender, and education level). In this context, the trematode Schistosoma mansoni is responsible for causing clinical manifestations in all organs of the GI tract, with complications that can ultimately lead to the individual’s death. The pathophysiology of the disease involves a penetration phase where Schistosoma mansoni cercariae penetrate human skin upon contact with contaminated water, followed by a migration phase where it transforms into schistosomula, maturing into adult worms that produce eggs, characterizing the acute and chronic phases of this pathology. The diagnosis of the disease remains underreported, posing a public health problem that reflects neglect in environmental care and overall quality of life. Therefore, to determine if a patient is affected by this pathology, techniques such as Kato-Katz, which analyzes the presence of parasite eggs in the individual's stool, or the ELISA technique identifying specific antigens in the blood, are necessary. The epidemiological analysis allowed for a better understanding of the health reality in the country, given that from 2014 to 2023, there were 40,410 reported cases of the disease in Brazil, with higher incidence in the southeastern region due to climatic and rainfall factors. Moreover, the article noted that the highest number of cases occurs in individuals with lower levels of education, which is related to a lack of knowledge regarding health care. Therefore, it is concluded that the prophylactic approach should involve a multidisciplinary team capable of understanding the various factors contributing to the health-disease process. The importance of health education, basic sanitation, and epidemiological surveillance is further inferred as factors that can mitigate the severity of the national scenario.