This multicentric population-based study in Brazil is the first national effort to estimate the prevalence of hepatitis B (HBV) and risk factors in the capital cities of the Northeast, Central-West, and Federal Districts (2004-2005). Random multistage cluster sampling was used to select persons 13-69 years of age. Markers for HBV were tested by enzyme-linked immunosorbent assay. The HBV genotypes were determined by sequencing hepatitis B surface antigen (HBsAg). Multivariate analyses and simple catalytic model were performed. Overall, 7,881 persons were included; < 70% were not vaccinated. Positivity for HBsAg was less than 1% among non-vaccinated persons and genotypes A, D, and F co-circulated. The incidence of infection increased with age with similar force of infection in all regions. Males and persons having initiated sexual activity were associated with HBV infection in the two settings; healthcare jobs and prior hospitalization were risk factors in the Federal District. Our survey classified these regions as areas with HBV endemicity and highlighted the risk factors differences among the settings.

Background: To study the effects of household crowding upon the respiratory health of young children living in the city of São Paulo, Brazil.

Summary:Influenza vaccine is recommended yearly for recipients after the sixth month of BMT. Although a higher risk of complications of influenza is expected to occur in BMT patients, no study has addressed the clinical efficacy of influenza vaccination in this setting. Focusing on the clinical benefits of influenza vaccination, we evaluated the risk factors for influenza infection in a cohort of 177 BMT recipients followed up for 1 year. Influenza was diagnosed in 39 patients. Multivariate analyses showed that seasonal exposure and more aggressive conditioning regimens were independently associated with increased risk for influenza. Influenza vaccination and steroid use showed a protective role. Of the 43 patients who had received BMT longer than 6 months, 19 were vaccinated (compliance rate ¼ 44.2%) and vaccine efficacy was 80%. We conclude that influenza vaccination plays an important role in protecting BMT recipients against influenza and all efforts should be made to ensure good compliance with vaccination. Bone Marrow Transplantation (2005) 36, 897-900.

We report an investigation for 16 bacteria and viruses among 184 children hospitalized with pneumonia in Salvador, Brazil. Etiology was established in 144 (78%) cases. Viral, bacterial, and mixed infections were found in 110 (60%), 77 (42%), and 52 (28%) patients, respectively. Rhinovirus (21%) and Streptococcus pneumoniae (21%) were the most common pathogens. Our results demonstrate the importance of viral and pneumococcal infections among those patients.

OBJETIVO: Investigar os efeitos causados pela poluição atmosférica na morbidade por pneumonia e por gripe em idosos entre 1996 e 1998. MÉTODOS: Foram obtidos dados diários de atendimentos por pneumonia e gripe para idosos em pronto-socorro médico de um hospital-escola de referência no Município de São Paulo, SP, Brasil. Os níveis diários de CO, O3, SO2, NO2 e PM10 foram obtidos na Companhia de Tecnologia de Saneamento Ambiental, e os dados diários de temperatura e umidade relativa do ar foram obtidos no Instituto Astronômico e Geofísico da USP. Para verificar a relação existente entre pneumonia e gripe e poluição atmosférica, utilizou-se o modelo aditivo generalizado de regressão de Poisson, tendo como variável dependente o número diário de atendimentos por pneumonia e gripe e como variáveis independentes as concentrações médias diárias dos poluentes atmosféricos. A análise foi ajustada para sazonalidade de longa duração (número de dias transcorridos), sazonalidade de curta duração (dias da semana), temperatura mínima, umidade média, períodos de rodízio e os atendimentos por doenças não-respiratórias em idosos. RESULTADOS: O3 e SO2 estão diretamente associados à pneumonia e à gripe, independentemente das variáveis de controle. Porém, na análise conjunta, eles perdem sua significância estatística. Pôde-se observar que um aumento interquartil (25%-75%) para o O3 (38,80 mig/m³) e SO2 (15,05 mig/m³) levaram a um acréscimo de 8,07% e 14,51%, respectivamente, no número de atendimentos por pneumonia e gripe em idosos. CONCLUSÕES: Os resultados sugerem que a poluição atmosférica promove efeitos adversos para a saúde de idosos.

Although HIV/hepatitis C virus (HCV) coinfection has been recognized worldwide in individuals exposed to blood-borne and sexually transmitted diseases (STD), limited data are available on the epidemiology of this coinfection in Brazil. A cross-sectional study was carried out to estimate the prevalence of HCV seropositivity in a cohort of people living with HIV/AIDS in Santos, Brazil, and to investigate potential risk factors for HCV infection. Anti-HCV antibodies were sought by using two immunoenzymatic assays. Overall HCV seroprevalence was 36.2% (95% confidence interval [CI] 31.9-40.4%). However, it was significantly higher (84.8%, 95% CI 78.2-91.3%) among intravenous drug users (IDU) as compared to non-IDU (20.9%, 95% CI 16.8-25.1%) (p < 0.001). Multiple logistic regression analysis revealed that HCV seropositivity among IDU was independently associated with needle sharing (adjusted odds ratio [adjOR] = 4.28, p = 0.07) and with serologic evidence of exposure to other bloodborne agents: HBV (adjOR = 4.39, p = 0.01) and HTLV-I/II (adjOR = 6.43, p = 0.02). In contrast, no association with lifetime number of sexual partners, history of STD, or of sex with commercial sex workers (CSW) could be demonstrated. Among non-IDU, HCV seropositivity was independently associated with sexual partnership with IDU (adjOR = 2.15, p = 0.08) and with HBV seropositivity (adjOR = 1.71, p = 0.05), but not with engaging in oral or anal receptive intercourse or having sex with CSW. Results indicate that exposure to blood and sexual partnership with IDU constitute the main risk factors for HCV acquisition among HIV-positive patients in Santos, Brazil. Prevention of HCV spread in this population should thus include harm reduction measures and information on safer sex practices for both IDU and their sexual partners.

No abstract

A population-based hepatitis survey was carried out to estimate the prevalence of hepatitis B virus (HBV) infection and its predictive factors for the state capitals from the north, south, and southeast regions of Brazil. A multistage cluster sampling was used to select, successively, census tracts, blocks, households, and residents in the age group 10–69 years in each state capital. The prevalence of hepatitis B surface antigen (HBsAg) was lower than 1% in the north, southeast, and south regions. Socioeconomic condition was associated with HBV infection in north and south regions. Variables related to the blood route transmission were associated with HBV infection only in the south whereas those related to sexual behavior were associated with HBV infection in the north and south regions. Drug use was associated in all regions, but the type of drug differed. The findings presented herein highlight the diversity of the potential transmission routes for hepatitis B transmission in Brazil. In one hand, it reinforces the importance of national control strategies of large impact already in course (immunization of infants, adolescents, and adults up to 49 years of age and blood supply screening). On the other hand, it shows that there is still room for further control measures targeted to different groups within each region.