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Ministry of Health calls on society to tackle mosquitoes

Published: Tuesday, 06 December 2016 14:53 | Last Updated: Tuesday, 06 December 2016 16:55

 LIRAa has pointed out 855 municipalities in situations of risk for the outbreak of Dengue Fever, Zika & Chikungunya. The survey is fundamental in guiding control actions for the three diseases

A survey by the Ministry of Health, conducted in conjunction with a number of Brazilian municipalities, shows that some 855 municipalities are in situations of risk for Dengue, Chikungunya and Zika outbreaks. This represents around 37.4% of the participating municipalities, while 2.8%, or 1429 municipalities, are in satisfactory situations. The data are part of a 2016 LIRAa (Rapid Index Survey for Aedes aegypti), published by minister of Health, Mr. Ricardo Barros, on Thursday (24). This year's campaign for tackling the mosquitoes responsible for the spread of these three diseases was also published. The new initiative calls attention to the consequences of the diseases caused by chikungunya, zika and dengue, as well as the importance of eliminating focal points for Aedes.

"This year, we hope to stabilize cases of dengue and zika. As chikungunya is a relatively new disease, and many people are still susceptible, there may be a rise in fresh cases this year. However, for next year, we also hope to stabilize cases of chikungunya", explained Minister Ricardo Barros. He went further to reiterate that SUS (Unified Health System) is qualified and prepared to care for these people.

Of the 3,704 municipalities able to conduct the LIRa – those with more than 2,000 homes – 62.6% (2,284) took part in this year's edition. Compared to 2015, there was an increase of 27.3% in relation to the number of participating municipalities. Conducted in October and November of this year, the survey is a fundamental instrument in the control of Aedes aegypti mosquitoes. Based on the information obtained, the manager is able to identify the types of locations were larva are most commonly found and, consequentially, prioritize suitable measures for controlling Aedes in the municipality.

Currently, the survey is implemented through voluntary participation by municipalities. Minister Ricardo Barros, however, is set to propose that participation in the survey for municipalities with over 2000 homes becomes mandatory as from 2017. The proposal will be presented at the CIT (Tripartite Interagency Commissions) meeting among states, municipalities and the Union, on December 8.

Of the 22 capital cities that provided the Ministry of Health with information about the LIRa, only Cuiabá (MT) presents a high risk. Nine capitals are in a state of alert - Aracajú (SE), Salvador (BA), Rio Branco (AC), Belém (PA), Boa Vista (RR), Vitória (ES), Goiânia (GO), Recife (PE) and Manaus (AM); while 12 are considered satisfactory – São Luiz (MA), Palmas (TO), Fortaleza (CE), João Pessoa (PB), Teresina (PI), Belo Horizonte (MG), São Paulo (SP), Rio de Janeiro (RJ), Macapá (AP), Florianópolis (SC), Campo Grande (MS) and Brasília (DF). The Ministry of Health is yet to receive information about Maceió (AL), Porto Velho (RO) and Curitiba (PR), while the cities of Natal (RN) and Porto Alegre (RS) employ a different methodology.

BREADING SITES - Stagnant water trapped in containers such as drums, canisters and water tanks formed the leading breading sites in the North and South. Residential sites, which include categories like plant pots, bottles, swimming pools and gutters, predominate in the Southeast region. In the North and Midwest regions, garbage was seen as the most common breeding site.

REGION

NORTHEAST

NORTH

SOUTHEAST

SOUTH

MIDWEST

Water deposits

76%

29.1%

33.1%

45.5%

33.2%

Residential deposits

19.1%

28.7%

47.1%

36.4%

30.9%

Garbage

4.9%

42.2%

19.8%

18.2%

35.9%

CAMPAIGN – The new campaign by the Ministry of Health to raise awareness  in tackling mosquitoes, calls attention to the consequences of the diseases caused by chikungunya, zika and dengue, as well as the importance of eliminating focal points for Aedes. "A simple mosquito can leave a mark on your life. A simple gesture can save your life", warns the campaign, which is set to air on TV, radio, Internet, social networks and on urban furniture (bus stops, billboards) from November 24 to December 23. Around BRL 10 million was invested in the campaign.

"This year, the difference in the campaign is that we are showing the consequences of failing to tackle mosquito focal points. The idea is to raise awareness among people so that they realize it is better to tackle the focal point of mosquito breeding than suffer the consequences of having done nothing. We will further reiterate the need to eliminate breeding sites, calling on society as a whole for this job", emphasized the minister of Health, Ricardo Barros.

Besides the famed "D" Day, to occur on December 2, with national mobilization across Brazil, other actions will be staged to remind people that Fridays are now the day to eliminate mosquito breeding focal points. The main message of the campaign is "Mosquito-free Friday". Every Friday is the day to tackle mosquitoes as a nation".

DENGUE – Up to October 22, Brazil registered some 1,458,355 cases of dengue. In the same period of 2015, the number was 1,543,000 cases, representing a drop of 5.5%. Considering regions of the country, the Southeast and Northeast represent the highest number of cases, with 848,587 cases and 322,067 cases, respectively. They are followed by the Midwest (177,644), South (72,114) and North (37,943).

The new epidemiological bulletin by the Ministry of Health presents 601 disease-related deaths in 2016, compared to 933 in the same period the year before. This represents a reduction of 35.6% in dengue-related deaths in the country. There was also a reduction in severe dengue cases (49.7%), which dropped from 1,616 cases last year to 803, and in the cases with alarming signs, the drop was 62%, falling from 20,352 cases to 7,730, in 2016.

CHIKUNGUNYA - There were 251,051 cases of suspected chikungunya fever, with 134,910 confirmed. In the same period, last year, there were 26,763 suspected cases and 8,528 confirmed cases. In all, 138 deaths were registered in the states of Pernambuco (54), Paraíba (31), Rio Grande do Norte (19), Ceará (14), Bahia (5), Rio de Janeiro (5), Maranhão (5), Alagoas (2), Piauí (1), Amapá (1)  and the Federal District (1). The deaths are being looked into in more detail by states and municipalities in order to determine if there were other associated factors, such as previous illness, comorbidities, use of medication, etc. Currently, 2,281 Brazilian municipalities have registered cases of the disease.

From an epidemiological view, the increase in cases was foreseen, as chikungunya is a recent disease (identified for the first time in Brazil in 2014) and, as such, the population is more susceptible. The Ministry of Health is working with the possibility of an increase in cases over the next few months in certain states not affected by the disease, due to the susceptibility of the population yet to be exposed to the virus and the favorable climate conditions, such as heat and rain, ideal for the proliferation of Aedes aegypti.

ZIKA – 208,867 probably cases of fever caused by the Zika virus throughout the country, registered up to October 22, which represents an occurrence rate of 102.2 cases for each 100,000 inhabitants. Laboratory tests confirmed three death related to the Zika virus in Brazil in 2016.  Regarding pregnant women, 16,696 likely cases were registered throughout the country. Autochthonous transmission of the disease in the country was confirmed in April 2015, through a laboratory in Bahia. The Ministry of Health made notification of Zika virus cases mandatory in February of this year.

The Southeast region registered 83,884 likely cases of the disease, followed by the Northeast (75,762); Midwest (30,969); North (12,200) and South (1,052). Considering the proportion of cases per inhabitant, the Midwest region leads, with a rate of 200.5 cases for every 100,000 inhabitants, followed by the Northeast (133.9); Southeast (97.0); North (69.8); South (3.6).

PERMANENT ACTIONS - Since the Zika virus was identified in Brazil and associated to cases of neurological malformation in the second semester of 2015, the Ministry of Health has treated it as a priority. Federal resources aimed at Health Surveillance, through the PFSV (Basic Fixed Health Surveillance Package), passed on to states, municipalities and the Federal District that include actions to tackle Aedes aegypti, have increased 39% in recent years (2010-2015, rising from BRL 924.1 million to BRL 1.29 billion in 2015. And, in 2016, another BRL 580 million was spent, increasing to a total BRL 1.87 billion. Furthermore, the Ministry of Health relied on the extra support of National Congress, through a parliamentary amendment, to the tone of BRL 500 million. 

By Nivaldo Coelho, from Agência Saúde

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