A critical perspective of Prion Disease surveillance in Brazil

Introduction: Prion Diseases (PrD) are a group of rapidly progressive dementias. Among its subtypes, Creutzfeldt-Jakob Disease (CJD) is the most common, affecting around 1 to 2 individuals per million inhabitants yearly. In 2005, Brazil's Ministry of Health (MH) initiated a surveillance program for CJD, creating a protocol to report the cases. Despite advances, the MH still struggles to make a reliable database to determine PrD profile in Brazil. Objectives: To understand the Brazilian PrD surveillance system. Methods: This is a retrospective and descriptive study based on the epidemiological records of CJD surveillance from 2005 to 2021 in the Ministry of Health's Epidemiological Bulletin published in 2022. Results/Discussion: 1.576 suspected cases of CJD were reported, concentrated in the Southeast, South and Northeast regions of Brazil. Among the notifications, the following age groups predominated: 55 to 74 years (60.2%), 45 to 54 years (15%), and 75 to 85 years (11.8%). Suspected cases were mainly represented by women (53.6%), white individuals (61.4%), and residents of urban areas (90%). In this period, the expected number of cases for the Brazilian population would be 3.200. Additionally to underreporting, the data shared by MH are limited due to the use of a database destined to mainly observe epidemic outbreaks and mismatches between official documents. Conclusion: Despite some progress since 2005, PrD surveillance in Brazil faces significant problems, due to the inaccurate treatment of these data and the lack of a specific database for CJD.