INTESTINAL PARASITIC INFECTIONS AND SANITATION CONDITIONS IN THE SÃO FRANCISCO VALLEY: ANALYSIS OF DISEASE BURDEN AND IMPLICATIONS FOR THE UNIFIED HEALTH SYSTEM

Abstract

Objective: To analyze the magnitude of intestinal parasitic infections and their relationship with basic sanitation conditions in the municipalities of the Integrated Development Region (RIDE) of the Petrolina-Juazeiro Hub (São Francisco Valley), and to discuss the implications for the organization of the Unified Health System (SUS). Methods: A descriptive-analytical ecological study using a quantitative approach and time-series analysis, based on secondary data from the 2022 Demographic Census (IBGE), the National Sanitation Information System (SNIS, 2012–2022), DATASUS, and parasitological surveys published in scientific literature. Indicators regarding water supply, sanitation (sewage) systems, solid waste collection, and the prevalence of intestinal parasitic infections were analyzed. The analysis included descriptive statistics, temporal trend analysis, and Spearman's ecological correlation between sanitation indicators and parasitic infections. Results: The RIDE is home to approximately 700,000 inhabitants. In Petrolina, 83% of the population has access to water supply and 64.7% to sanitation systems; however, 17.6% of inhabitants use rudimentary septic tanks or open pits, and 921 people lack access to a bathroom. In Juazeiro, urban water service coverage ranges from 93% to 100%, with a sewage treatment rate exceeding 80%. Regional literature reports an intestinal parasite prevalence ranging from 22% to 57%, with a predominance of protozoa (*Entamoeba coli*, *Endolimax nana*, *Giardia lamblia*) and hookworms. The absence of *Trichuris trichiura* and the low frequency of *Ascaris lumbricoides* in the more arid areas suggest a climatic influence on the distribution of geohelminths. Ecological correlation analysis indicated an inverse association between sanitation coverage and the prevalence of parasitic infections (rs = -0.72; p < 0.05). Conclusion: The persistence of intestinal parasitic infections in the São Francisco Valley reflects structural inequalities in sanitation. The organization of the Unified Health System (SUS) in the region requires the integration of epidemiological surveillance, sanitation policies, and primary care, in accordance with the guidelines of Brazilian medical societies.