Mortality due to schistosomiasis in an endemic area of Brazil: a population-based ecological study.

BACKGROUND: Schistosomiasis is a communicable disease of neglected populations. The aim of this study was to analyze the temporal trend and spatial distribution of schistosomiasis mortality in an endemic area of Brazil. METHODS: This is a study involving all deaths from schistosomiasis in residents of the state of Pernambuco, Brazil, from 2008 to 2021. The data were extracted from the Mortality Information System. The study was done in three steps: description of the sociodemographic profile before (2008-2019) and during the Covid-19 pandemic (2020-2021); time series analysis, using joinpoint regression; and spatial dynamics of schistosomiasis before (2015-2019) and during the Covid-19 pandemic (2020 and 2021), using Moran statistics. RESULTS: The majority of deaths occurred in females (53.4%; n = 1222), aged 60 years or older (74.5%; n = 1704), and of brown race (61.18%; n = 1398). Time series analysis showed linear declining trends in the state rate (APC -1.96%; 95% CI -3.65 to -0.25; p = 0.028) and in the regions of Palmares (APC -4.73%; 95% CI -7.45 to -1.93; p = 0.003) and Caruaru (APC -4.05%; 95% CI -7.95 to -0.54; p = 0.025). In the other regions, the time trend was stationary. Moran's spatial statistics showed a heterogeneous spatial distribution in all study years. The number of municipalities in quadrant 1 (high-high) of the Moran diagram varied between 31 in 2016 and 10 in 2020. CONCLUSIONS: The study showed a decreasing mortality trend, heterogeneous spatial distribution, and no apparent impact of the Covid-19 pandemic on schistosomiasis mortality in Pernambuco, Brazil.