Implementation and Impact of HAV and HBV Vaccination Programs in South America

Paraná, Raymundo; Schinoni, María Isabel

doi:10.1007/s11901-013-0186-2

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…Data encompassed the annual vaccination per municipality for the period between 2014 and 2017. Prior to that period, Brazilian government would provide hepatitis-A vaccine only for vulnerable individuals and individuals with high risk of severe chronic disease, as patients co-infected with HIV, with chronic hepatitis-B and hepatitis-C, cirrhotic patients of all etiologies (Paraná & Schinoni, 2013). As a consequence, Brazil possessed a very low vaccination coverage with less than 1% of children of one to four years old receiving vaccination to hepatitis-A during that time according to those authors.…”

Section: Sociodemographic Datamentioning

confidence: 99%

Assessment of the spatio-temporal distribution of Hepatitis-a virus transmission in the state of Pará, Brazil

Leal

Kampel

Guimarães

2020

Preprint

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The hepatitis-A virus (HAV) is a worldwide healthcare problem, mainly affecting countries with poor sanitation and socioeconomic conditions. Spatio-temporal analyses have become an important scientific asset for identifying the clustering of disease infection, providing support for planning interventions and control strategies. This study aims to determine the spatio-temporal variability of HAV infection and related population-based demographic factors in a endemic region. The selected area of study was Pará state, Brazil. Brazilian Ministry of Health Notifiable Diseases Information System (SINAN) epidemiological report, MS vaccination coverage and Brazilian National Sanitation System (SNIS) sanitation condition datum have been analyzed. Spatial (Moran and Local Moran index)and space-time scan statistics techniques have been applied over Pará state using SINAN database for the assessment of the hepatitis-A incidence for a period of 10 years (from 2008 up to 2017). A total of 5500 cases has been reported. Gender specific incidence analysis indicated that men have higher risk of contamination than women. Sociodemographic (lack of sanitation), socioeconomic (municipality governments investments in infra-structure) presented relationship with the disease incidence. There have been evidences that extreme events of severe precipitation and severe droughs were also related to increase in hepatitis-A notification cases. Spatial statistics denoted a heterogeneous geographical structure in the disease`s incidence: isolated high and low HAV incidence clusters through the years, implying in a complex disease outbreak system that is partially controlled by public vaccination actions. Space-time scan statistics denoted that hepatitis-A incidence is highly attached to the public HAV vaccination program and to municipality specific social infrastructure.Lower incidence risk were majorly aggregated over the Nordeste Paraense and Metropolitana de Belém meso-regions. Distinct clusters of hepatitis-A incidence have been found over the studied area (Pará state), and these clusters varied over the years centered at northwest and northeast mesoregions, mainly time-located prior to the national vaccination program start (prior to 2014). National public vaccination program has not been capable of erradicating the disease in the state. Further studies are required to better assess the relationship between climate change efffects over weather events and their relation to HAV transmission outbreaks.

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Section: Sociodemographic Datamentioning

confidence: 99%

Assessment of the spatio-temporal distribution of Hepatitis-a virus transmission in the state of Pará, Brazil

Leal

Kampel

Guimarães

2020

Preprint

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“…The vaccine is indicated for vulnerable people, such as those with immunodeficiency, chronic liver disease, coagulopathy, cystic fibrosis, those with HIV infection aged ≤13 years, carriers of hepatitis B or C virus, organ donors, etc. (MS, 2006;WHO, 2009a;Sartori et al, 2012;Paraná and Schinoni, 2013). Universal vaccination is recommended for countries with intermediate-level endemicity, such as Brazil (WHO, 2000;Sartori et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic and spatiotemporal profiles of hepatitis-A in the state of Pará, Brazil, based on reported notified cases

Leal

Guimarães²,

Kampel

2021

Geospat Health

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Hepatitis-A virus is a worldwide healthcare problem, mainly affecting countries with poor sanitary and socioeconomic conditions. This communication evaluates the spatiotemporal variability of the disease’s socioepidemiological profile in one of the endemic Brazilian regions (Pará State) prior to (2008-2013) and after (2014-2017) the launch of the national public vaccination programme. Hepatitis-A epidemiological reports concerning Pará State - Brazil - were used for this study including municipalitylevel data of the disease’s reported positive notification cases (PNCs). The analyses involved socioepidemiological profiling and space-time scan statistics. A total of 5500 PNCs were reported in the study period. On average, PNCs decreased over time throughout the state, with strongest drops after 2015. The PNCs were specific for gender, race/ethnic origin and age group. The predominant gender and race/ethnic groups was male and brown, respectively. While children were the most susceptible age group prior to 2015, there was a shift towards older ages (young and adults) in later years. Those found to be the most affected by the disease, as shown by space-time scan statistics, were people in densely populated municipalities with unsatisfactory sanitary conditions and also less well covered by the public vaccination programme. Despite drops in the number of hepatitis-A PNCs, thanks to the national vaccination programme, the disease still persists in Pará State and elsewhere in Brazil. The present study reinforces the need of continuous prevention and control strategies for effective control and erradication of hepatitis-A.

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Screening for hepatitis D and PEG-Interferon over Tenofovir enhance general hepatitis control efforts in Brazil

Goyal

Romero-Severson

2018

PLoS ONE

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BackgroundHepatitis D virus (HDV), which requires the presence of hepatitis B virus (HBV), is a deadly yet neglected disease that rapidly leads to liver cancer and disease-induced mortality. This co-dependence creates complex transmission dynamics that make it difficult to predict the efficacy of interventions aimed at HBV and/or HDV control in endemic regions, such as certain municipalities of Brazil, where up to 65% of HBV-infected persons are co-infected.MethodologyWe created a mathematical model that captures the joint transmission dynamics of HBV and HDV, incorporating mother-to-child, sexual and household transmission. With an aim to minimize the number of total infections and disease-induced mortality in 2027, we then determined optimal strategies for Brazil and its sub-regions under a constrained budget, which was dynamically allocated among HBV and HDV screening, HBV and HDV treatment, HBV newborn and adult vaccination, and awareness programs. Three treatment options were considered, namely: Tenofovir, PEGylated-Interferon, and nucleic acid polymers (NAP).ResultsThe additional cost of HDV screening and the use of a more expensive PEGylated-Interferon are offset by not wasting resources on treating co-infected persons with Tenofovir. The introductory price of NAP treatment must be less than $16,000 per course to become competitive with Tenofovir and PEGylated-Interferon in Brazil.ConclusionAdditional screening for HDV is beneficial, even in a low HBV and HDV endemic regions of Brazil. We recommend PEGylated-Interferon, wherever possible, for both HBV and HDV. If PEGylated-Interferon is not available in abundance, PEGylated-Interferon for co-infections and 4-year Tenofovir treatment for mono-infections is recommended.

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Implementation and Impact of HAV and HBV Vaccination Programs in South America

Cited by 3 publications

References 38 publications

Assessment of the spatio-temporal distribution of Hepatitis-a virus transmission in the state of Pará, Brazil

Assessment of the spatio-temporal distribution of Hepatitis-a virus transmission in the state of Pará, Brazil

Sociodemographic and spatiotemporal profiles of hepatitis-A in the state of Pará, Brazil, based on reported notified cases

Screening for hepatitis D and PEG-Interferon over Tenofovir enhance general hepatitis control efforts in Brazil

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