Prevalence of hepatitis A in the capitals of the States of North, Southeast and South regions of Brazil: decrease in prevalence and some consequences

Hepatitis A virus (HAV) infection has been considered one of the leading causes of acute hepatitis. The aim of the present study was to estimate the prevalence of HAV among children and adolescents in a population-based study in the capitals of the States of the North, Southeast and South of Brazil and identify predictive factors for the infection. A multi-stage sampling was used to select subjects aged between 5-9 and 10-19 years. Individual and household levels aside from the level of variables in the areas were collected. The outcome was the total IgG antibodies to HAV levels detected using a commercial Enzyme Immuno Assay (EIA). The associations between HAV and the independent variables were assessed using the odds ratio. A multilevel analysis was performed by GLLAMM using the Stata software. The prevalence of HAV infection in the 5-9 and 10-19 age groups was 28.7% and 67.5%, respectively for the North, 20.6% and 37.7%, for the Southeast and 18.9% and 34.5% for the South Region. The prevalence of HAV increased according to age in all sites. Variables related to education at the individual level (North and South), family and area level (South and Southeast) and family income level (Southeast and South) were independently associated with HAV infection. This emphasizes the need for individualized strategies to prevent the infection

Peak oxygen uptake responses to training in obese adolescents: a multilevel allometric framework to partition the influence of body size and maturity status

The influence of body size and maturation on the responses in peak oxygen uptake (VO2) to a 12-week aerobic training and nutritional intervention in obese boys (n = 30; 10-16 years) was examined using multilevel allometric regressions. Anthropometry, sexual maturity status, peak VO2, and body composition were measured pre- and postintervention. Significant decrements for body mass, body mass index z-score, and waist circumference and increments for stature, fat-free mass, and peak oxygen uptake were observed after intervention. Partitioning body size on peak VO2, the responses of the individuals to training were positive (11.8% to 12.7% for body mass; 7.6% to 8.1% for fat-free mass). Body mass and fat-free mass were found as significant explanatory variables, with an additional positive effect for chronological. The allometric coefficients (k') in the initial models were k' = 0.883 and k' = 1.058 for body mass and fat-free mass, respectively. The coefficients decreased when age was considered (k' = 0.530 for body mass; k' = 0.860 for fat-free mass). Including maturity indicator in the models was not significant, thus the influence of variability in sexual maturity status in responses to exercise-based intervention in peak VO2 may be mediated by the changes in body dimensions

Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factors in the North, South, and Southeast Regions of Brazil, 10-20 Years After the Beginning of Vaccination

Submitted by Adagilson Silva ([email protected]) on 2017-09-15T17:44:21Z No. of bitstreams: 1 26503280 2015 xim-pop.oa.pdf: 618587 bytes, checksum: 90652e915eb439e2038d71f7659387b2 (MD5)Approved for entry into archive by Adagilson Silva ([email protected]) on 2017-09-15T20:09:36Z (GMT) No. of bitstreams: 1 26503280 2015 xim-pop.oa.pdf: 618587 bytes, checksum: 90652e915eb439e2038d71f7659387b2 (MD5)Made available in DSpace on 2017-09-15T20:09:36Z (GMT). No. of bitstreams: 1 26503280 2015 xim-pop.oa.pdf: 618587 bytes, checksum: 90652e915eb439e2038d71f7659387b2 (MD5) Previous issue date: 2015-12Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, BrasilA 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

Seroprevalence of hepatitis E in adults in Brazil: a systematic review and meta-analysis

Abstract Background Hepatitis E virus (HEV) is a member of the Hepeviridae family; it has four main genotypes and one serotype. While genotypes 1 and 2 cause epidemic hepatitis and are transmitted via water and the fecal-oral route, genotypes 3 and 4 are zoonotic. In the various seroprevalence studies of hepatitis E in Brazil, the numbers reported vary widely and are difficult to interpret. The aim of this study was to analyze existing seroprevalence studies of hepatitis E in adults in Brazil. Main text We searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by HEV in Brazil without time period or language restrictions. We included studies that presented data concerning hepatitis E seroprevalence in adults in Brazil, had a sample size ≥50 patients and whose method used for the detection of anti-HEV was standardized and commercialized. We also evaluated the quality of the articles using a list of criteria that totalized 9 items. Of the 20 studies ultimately analyzed, 10 (50%) were from the southeast region of Brazil, 3 (15%) were from the central-west region, 3 (15%) were from the northern region, 2 (10%) were from the northeast region and 2 (10%) were from the southern region. Regarding the quality evaluation of the studies, the mean score was 5.6 (range: 4–8). The estimated overall seroprevalence of HEV infection in the adult population was 6.0% (95% CI: 5.0–7.0); in subgroup analyses, we observed that the prevalence of anti-HEV antibodies in blood donors was 7.0% (95% CI: 5.0–8.0), whereas in the general population, it was 3.0% (95% CI: 2.0–4.0). Conclusions The results of this systematic review indicate that there should be national investment in the prevention of hepatitis E virus infection in Brazil, including the implementation of improvements in basic sanitation and guidance regarding the appropriate handling of animal waste and the optimal cooking of vegetables, meat and their derivatives

Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factors in the North, South, and Southeast Regions of Brazil, 10-20 Years after the Beginning of Vaccination

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 theage group 10-69 years in each state capital. The prevalence of hepatitis B surface antigen (HBsAg) was lower than1% in the north, southeast, and south regions. Socioeconomic condition was associated with HBV infection in northand south regions. Variables related to the blood route transmission were associated with HBV infection only in thesouth 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 diversityof the potential transmission routes for hepatitis B transmission in Brazil. In one hand, it reinforces the importanceof national control strategies of large impact already in course (immunization of infants, adolescents, and adults up to49 years of age and blood supply screening). On the other hand, it shows that there is still room for further controlmeasures targeted to different groups within each region

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty

Population-based multicentric survey of hepatitis B infection and risk factor differences among three regions in Brazil

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 per cent were not vaccinated. Positivity for HBsAg was less than 1 per cent 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 settingsMinistério da Saúde; Organização Panamericana da Saúde (PAHO); CNPq n. 307963/2004-7, 303049/2007-3 e 300917/2006-