Regional differences and temporal trend analysis of Hepatitis B in Brazil

Abstract

Background Burden disease related to chronic HBV infection is increasing worldwide. Monitoring Hepatitis B occurrence is difficult due to intrinsic characteristics of the infection, nonetheless analyzing this information improves strategic planning towards reducing the burden related to chronic infection. In this line of thought, this study aims to analyze national and regional epidemiology of Hepatitis B and it’s temporal trends based on Brazilian reported cases. Methods Data obtained from the Brazilian National Notifiable Disease Reporting System (SINAN) from 2007 to 2018 were classified by infection status with an original classification algorithm, had their temporal trends analyzed by Joinpoint regression model and were correlated with gender, age and region. Results Of the 487,180 hepatitis B cases notified to SINAN, 97.65% had it infection status correctly classified by the new algorithm. Hepatitis B detection rate, gender and age-distribution were different among Brazilian regions. Overall, detection rates remained stable from 2007 to 2018, achieving their maximal value (56.1 cases per 100,000 inhabitants) in North region. However, there were different temporal trends related to different hepatitis B status and age. Women mean age at notification were always inferior to those of men and the difference was higher in Central-West, North and Northeast regions. Conclusion Hepatitis B affects heterogeneously different populations throughout Brazilian territory. The differences shown in its temporal trends, regional, gender and age-related distribution helps the planning and evaluation of control measures in Brazil.

Tendência temporal, distribuição espacial e fatores associados à detecção e mortalidade por hepatites virais B e C no Brasil (2010–2019)

“…On the other hand, there was a growing trend in the detection of HBV and HCV in some states of the North and Northeast regions, possibly due to greater access to rapid testing actions [25][26][27] . The expansion of diagnostic actions and campaigns aimed at priority regions and populations may lead to substantial increases in the number of reported cases of viral hepatitis 13 .…”

“…The better organization and accessibility of health services, with the possibility of offering diagnostic tests, can boost the highest detection rates, whether by active or passive search for cases. This possibly more favored scenario may be responsible for the higher burden of viral hepatitis in states with better socioeconomic indicators 27 . These conditions shape the local elimination responses and imply the different epidemiological behaviors evidenced.…”