Monday, December 21, 2015

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

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.

Below: Distribution of population aged 13–69 years in the state capitals of the North, South and Southeast Regions of Brazil and of the census tracts, households and individuals sampled.




Table 6

Factors associated with hepatitis B infection in three regions of Brazil, 2005
CharacteristicsNorthSoutheastSouth
OR (95% CI)*P valueOR (95% CI)P valueOR (95% CI)P value
Sex
 Female––1.0–––
 Male––1.49 (1.02–2.19)0.041––
Age (in years)1.05 (1.03–1.06)0.0001.06 (1.05–1.08)0.0001.04 (1.03–1.05)0.000
Read and write
 Yes1.0–––––
 No3.14 (1.53–6.46)0.002––––
Schooling
 Illiterate––––1.0–
 Basic level––––0.78 (0.53–1.15)0.214
 2nd level & univ––––0.51 (0.32–0.81)0.004
Paid work past week
 Yes1.0–––––
 No0.56 (0.40–0.76)0.000––––
Sewage disposal
 Pubic system1.0–––1.0–
 Septic tanks0.61 (0.40–0.93)0.021––1.71 (1.28–2.29)0.000
 Other destination0.83 (0.40–1.72)0.617––––
Blood transfusion
 Never––––1.0–
 Past 12 months––––2.28 (1.11–4.67)0.024
 Ever––––0.68 (0.41–1.15)0.152
Endoscopy
 Never––––1.0–
 Past 12 months––––1.27 (0.80–2.05)0.311
 Ever––––1.33 (0.99–1.80)0.059
Share toothbrush
 No––––1.0–
 Yes––––1.81 (1.05–3.12)0.032
Condom use
 Not started sex life––––1.0–
 Yes, regularly––––2.41 (0.96–6.06)0.060
 Yes, sometimes––––3.68 (1.65–8.22)0.001
 Never––––3.90 (1.54–9.88)0.004
Bisexual partner
 Not started sex life1.0 ––––
 No2.37 (0.87–6.42)0.089––––
 Yes1.68 (1.17–2.41)0.005––––
Ever used smoked drugs
 No1.0–––––
 Yes1.58 (1.05–2.36)0.026––––
Ever used inhaled drugs
 No––1.0–––
 Yes––3.85 (1.19–12.4)0.024––
Ever sniffed drugs
 No––––1.0–
 Yes––––1.73 (1.01–2.97)0.048
Ever injecting drugs
 No––––1.0–
 Yes––––2.49 (0.82–7.54)0.106
Classification elitism
 Abstemious––––––
 Light drinker––0.95 (0.63–1.44)0.815––
 Heavy drinker––1.96 (1.06–3.59)0.030––
CI = confidence interval; OR = odds ratio.

Full article at:   http://goo.gl/KfU31K

Hospital Universitário Oswaldo Cruz, Faculdade de Ciências Médicas de Pernambuco, Universidade de Pernambuco, Pernambuco, Brazil; Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Cidade Universitária, Pernambuco, Brazil; Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil; Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Brazil; Instituto Adolfo Lutz, São Paulo, Brazil; Secretaria de Saúde Pública do Estado do Pará, Pará, Brazil; Instituto Bioestatístico, Pará, Brazil; Instituto de Ciências Biológicas, Universidade de Pernambuco, Pernambuco, Brazil; Fundação Oswaldo Cruz, Centro de Pesquisas Aggeu Magalhães, Cidade Universitária, Pernambuco, Brazil; Instituto do Fígado de Pernambuco, Pernambuco, Brazil
*Address correspondence to Ricardo A. A. Ximenes, Faculdade de Ciências Médicas de Pernambuco, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, CEP 50100-130, Recife, Pernambuco, Brazil. E-mail:rb.moc.lou@senemixaar
 

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