Prevalence of hepatitis A virus infection: the paradoxical example of isolated communities in the western Brazilian Amazon region

Braga, Wornei Silva Miranda; Borges, Fabiane Giovanella; Júnior, Gildo Maia Barros; Martinho, Ana Cristina de Souza; Rodrigues, Ivo Seixas; Azevedo, Eliete Pereira de; Davis, Gustavo Henrique Nolasco Grimmer; Queiroz, Manoel Bezerra de; Santos, Simone Helena Derzi dos; Barbosa, Thiago Vitoriano; Castilho, Márcia da Costa

doi:10.1590/s0037-86822009000300008

Cited by 14 publications

(15 citation statements)

References 20 publications

(14 reference statements)

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“…This region is known to be highly endemic for HAV with seroprevalence rates as high as 90% among children that are 10 years old or younger (Bensabath et al 1987, de paula et al 2001, Assis et al 2002. Our results are in agreement with results from Braga et al (2009), who demonstrated an intermediate pattern of HAV infection in isolated communities in the western Brazilian Amazon region. This unexpected intermediate pattern of HAV infection could be explained by the isolation of these small villages, resulting in a decreased contact with the outside world in childhood.…”

Section: Discussionsupporting

confidence: 90%

Declining prevalence of hepatitis A virus antibodies among children from low socioeconomic groups reinforces the need for the implementation of hepatitis A vaccination in Brazil

Vitral

Ospina

Oliveira

et al. 2012

Mem. Inst. Oswaldo Cruz

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“…In Vila Velha, Espírito Santo, 21 there was a correlation between positive serological tests for hepatitis A and lower access to filtered water, lower access to the sewage system, habits of swimming in rivers or the sea and a greater number of people living in the same room. In the Brazilian Western Amazon region, 16 it was also associated with a greater number of people in the family. In Greece, 22 In our series, we observed that a large number of teenagers were at high risk of infection, because even with the gradual increase in prevalence of anti-HAV IgG antibodies, it remained low.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and serological aspects of hepatitis A among children and teenagers in the city of Santos: a cross-sectional study

et al. 2012

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CONTEXT AND OBJECTIVE: Viral hepatitis A is still a concern at public health level in Brazil and around the world, due both to the number of affected subjects and the possibility of complications in the acute forms. The Brazilian Ministry of Health estimates that at least 70% of this country' s population has already had contact with the hepatitis A virus (HAV). The aim here was to discover the prevalence of serological markers for the hepatitis A virus among children and teenagers at daycare facilities, kindergartens and elementary schools in the city of Santos. DESIGN AND SETTING: Cross-sectional study in kindergartens and elementary schools within the municipal education network in several regions of the city of Santos. METHOD: Students' family members were surveyed using a questionnaire and 4,680 finger-prick blood samples were taken and assayed by means of the ELISA technique. RESULTS:The general prevalence of anti-HAV IgG was 9.72% and, of these cases, 74.6% were reactive to anti-HAV IgM. There was higher prevalence of anti-HAV IgG among older children, females, children who played in streams, those whose homes were not connected to the sewage system, those whose parents had low education levels, those with low household income and those who did not live along the seashore. The prevalence of anti-HAV IgM peaked in the early years and subsequently fell, and it was lower on the hills and in the Northwestern Zone. CONCLUSION: The general prevalence of serological markers for hepatitis A was low in Santos. RESUMO CONTEXTO E OBJETIVO:A hepatite viral A continua sendo uma preocupação em nível de saúde pública no Brasil e no mundo, tanto pelo número de indivíduos atingidos, como pela possibilidade de complicação das formas agudas. O Ministério da Saúde estima que pelo menos 70% da população do Brasil já tiveram contato com o vírus da hepatite A. O objetivo foi conhecer a prevalência de marcadores sorológicos do vírus da hepatite A em crianças e adolescentes de creches e escolas de ensino infantil e fundamental na cidade de Santos. TIPO DE ESTUDO E LOCAL: Estudo transversal em pré-escolas e de ensino fundamental da rede municipal em diversas regiões da cidade de Santos. MÉTODO: Foi aplicado um questionário aos familiares dos estudantes e coletadas 4.680 amostras de sangue através de punção capilar para realização da sorologia pela técnica ELISA. RESULTADOS: A prevalência geral do anti-HVA IgG foi de 9,72% e, desses, 74,6% foram anti-HVA IgM reagentes. A prevalência de anti-HVA IgG foi maior entre as crianças mais velhas, meninas, aquelas que brincavam em córregos, sem rede de coleta de esgoto em sua moradia, de pais com baixa instrução, de baixa renda familiar e aquelas que não eram moradoras da orla. A prevalência de anti-HVA IgM teve pico nos primeiros anos e posterior queda e, no morro e Zona Noroeste, foi mais baixa. CONCLUSÃO: A prevalência geral dos marcadores sorológicos para hepatite A foi baixa em Santos.

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“…Although hepatitis A morbidity has declined progressively in Brazil as a whole, it remains high in the Amazon region. In Labrea, the prevalence of anti-HAV was 74.6%, showing associations with age, the presence of outside toilets, history of hepatitis, family history of hepatitis, and the number of people in the family (31) . Other studies conducted in the Brazilian Amazon showed anti-HAV prevalences greater than 90% (32) (33) .…”

Section: Hepatitis Amentioning

confidence: 98%

Progression of the load of waterborne and intestinal parasitic diseases in the State of Amazonas

Martins

Lacerda

Monteiro

et al. 2015

Rev. Soc. Bras. Med. Trop.

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42www.scielo.br/rsbmt I www.rsbmt.org.br Revista da Sociedade Brasileira de Medicina Tropical 48(Suppl I):42-54, 2015http://dx.doi. org/10.1590/0037-8682-0162-2014 Review Article ABSTRACT In the State of Amazonas, Brazil, urban expansion together with precarious basic sanitation conditions and human settlement on river banks has contributed to the persistence of waterborne and intestinal parasitic diseases. Time series of the recorded cases of cholera, typhoid fever, hepatitis A and leptospirosis are described, using data from different levels of the surveillance systems. The sources for intestinal parasitosis prevalence data (non-compulsory reporting in Brazil) were Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana (LILACS) and the annals of major scientifi c meetings. Relevant papers and abstracts in all languages were accessed by two independent reviewers. The references cited by each relevant paper were scrutinized to locate additional papers. Despite its initial dissemination across the entire State of Amazonas, cholera was controlled in 1998. The magnitude of typhoid fever has decreased; however, a pattern characterized by eventual outbreaks still remains. Leptospirosis is an increasing cause of concern in association with the annual fl oods. The overall prevalence of intestinal parasites is high regardless of the municipality and the characteristics of areas and populations. The incidence of hepatitis A has decreased over the past decade. A comparison of older and recent surveys shows that the prevalence of intestinal parasitic diseases has remained constant. The load of waterborne and intestinal parasitic diseases ranks high among the health problems present in the State of Amazonas. Interventions aiming at basic sanitation and vaccination for hepatitis A were formulated and implemented, but assessment of their effectiveness in the targeted populations is still needed.

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“…Nevertheless, prevalence close to 90% among adolescent and adults were found in and isolated communities in the North and Central West parts of Brazil [7]–[10].…”

Section: Introductionmentioning

confidence: 99%

Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions

et al. 2014

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BackgroundThis study aimed to identify the transmission pattern of hepatitis A (HA) infection based on a primary dataset from the Brazilian National Hepatitis Survey in a pre-vaccination context. The national survey conducted in urban areas disclosed two epidemiological scenarios with low and intermediate HA endemicity.MethodsA catalytic model of HA transmission was built based on a national seroprevalence survey (2005 to 2009). The seroprevalence data from 7,062 individuals aged 5–69 years from all the Brazilian macro-regions were included. We built up three models: fully homogeneous mixing model, with constant contact pattern; the highly assortative model and the highly assortative model with the additional component accounting for contacts with infected food/water. Curves of prevalence, force of infection (FOI) and the number of new infections with 99% confidence intervals (CIs) were compared between the intermediate (North, Northeast, Midwest and Federal District) and low (South and Southeast) endemicity areas. A contour plot was also constructed.ResultsThe anti- HAV IgG seroprevalence was 68.8% (95% CI, 64.8%–72.5%) and 33.7% (95% CI, 32.4%–35.1%) for the intermediate and low endemicity areas, respectively, according to the field data analysis. The models showed that a higher force of infection was identified in the 10- to 19-year-old age cohort (∼9,000 infected individuals per year per 100,000 susceptible persons) in the intermediate endemicity area, whereas a higher force of infection occurred in the 15- to 29-year-old age cohort (∼6,000 infected individuals per year per 100,000 susceptible persons) for the other macro-regions.ConclusionOur findings support the shift of Brazil toward intermediate and low endemicity levels with the shift of the risk of infection to older age groups. These estimates of HA force of infection stratified by age and endemicity levels are useful information to characterize the pre-vaccination scenario in Brazil.

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“…[12][13][14] Apesar da falta de saneamento, regiões rurais têm apresentado taxas de infecção mais baixas que regiões urbanas. 15,16 Na cidade de Limeira, São Paulo, Brasil, constatouse que 48,0% das amostras de água coletada de esgotos domésticos ao longo do período de estudo foram positivas para o vírus da hepatite A, evidenciando que a falta de tratamento adequado desse material antes da disposição no meio ambiente facilita o ciclo de contágio da doença. 17 Essas questões têm contribuído para mudar o perfil epidemiológico de uma doença que hoje se manifesta de forma esporádica, como surtos em cidades de pequeno e médio porte, assim como em escolas e creches, 8 …”

Section: Introductionunclassified

Investigação de surto de hepatite A no Município de Ibiracatu, Estado de Minas Gerais, Brasil, 2008

Oliveira¹,

Oliveira²,

Gomes³

et al. 2012

Epidemiol. Serv. Saúde

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Prevalence of hepatitis A virus infection: the paradoxical example of isolated communities in the western Brazilian Amazon region

Cited by 14 publications

References 20 publications

Declining prevalence of hepatitis A virus antibodies among children from low socioeconomic groups reinforces the need for the implementation of hepatitis A vaccination in Brazil

Epidemiological and serological aspects of hepatitis A among children and teenagers in the city of Santos: a cross-sectional study

Progression of the load of waterborne and intestinal parasitic diseases in the State of Amazonas

Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions

Investigação de surto de hepatite A no Município de Ibiracatu, Estado de Minas Gerais, Brasil, 2008

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