1
|
Mantovani SAS, Delfino BM, Martins AC, Oliart-Guzmán H, Pereira TM, Branco FLCC, Braña AM, Filgueira-Júnior JA, Santos AP, Arruda RA, Guimarães AS, Ramalho AA, Oliveira CSDM, Araújo TS, Arróspide N, Estrada CHML, Codeço CT, da Silva-Nunes M. Socioeconomic inequities and hepatitis A virus infection in Western Brazilian Amazonian children: spatial distribution and associated factors. BMC Infect Dis 2015; 15:428. [PMID: 26471064 PMCID: PMC4608050 DOI: 10.1186/s12879-015-1164-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatitis A is still a neglected health problem in the world. The most affected areas are the ones with disadvantaged socioeconomic conditions. In Brazil, seroprevalence studies showed that 64.7 % of the general population has antibodies against HAV (hepatitis A virus), and the Amazon region has the highest seroprevalence in the country. METHODS In the present study the seroprevalence of total HAV antibodies in children between 1 and 5 years old residing in the urban area of Assis Brasil, Acre was measured and spatial distribution of several socioeconomic inequities was evaluated. RESULTS In the year of 2011, seroprevalence rate was 16.66 %. Factors associated with having a positive serology identified by multivariate analysis were being of indigenous ethnicity [adjusted Odds Ratio (aOR) = 3.27, CI 1.45-7.28], usage of water from the public system (aOR = 8.18, CI 1.07-62.53), living in a house not located in a street (aOR = 3.48, CI 1.54-7.87), and child age over 4 years old (aOR = 2.43, CI 1.23-4.79). The distribution of seropositive children was clustered in the eastern part of the city, where several socioeconomic inequities (lack of flushed toilets, lack of piped water inside the household and susceptibility of the household to flooding during rain, low maternal education, having wood or ground floor at home, and not owning a house, lack of piped water at home, and type of drinking water) also clustered. CONCLUSIONS The findings highlight that sanitation and water treatment still need improvement in the Brazilian Amazon, and that socioeconomic development is warranted in order to decrease this and other infectious diseases.
Collapse
Affiliation(s)
- Saulo A S Mantovani
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Breno Matos Delfino
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Antonio C Martins
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Humberto Oliart-Guzmán
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Thasciany M Pereira
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Fernando L C C Branco
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Athos Muniz Braña
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - José A Filgueira-Júnior
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Ana P Santos
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Rayanne A Arruda
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Andréia S Guimarães
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Alanderson A Ramalho
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Cristieli Sergio de Menezes Oliveira
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Thiago S Araújo
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| | - Nancy Arróspide
- Instituto Nacional de Salud, Cápac Yupanqui 1400 - Jesus María, Lima, 11, Peru.
| | - Carlos H M L Estrada
- Dirección Regional de Salud de Madre de Dios, Av. Ernesto Rivero N° 475, Puerto Maldonado, Peru.
| | - Cláudia T Codeço
- Scientific Computing Program, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Mônica da Silva-Nunes
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
| |
Collapse
|
2
|
Pereira TM, Mantovani SAS, Branco FLCC, Braña AM, Oliart-Guzmán H, Delfino BM, Martins AC, Araújo TS, Oliveira CSM, Muniz PT, da Silva-Nunes M. Hepatitis A seroprevalence in preschool children in Assis Brazil, Acre, Brazil, in 2003 and 2010. Int Health 2015; 8:132-41. [PMID: 26163116 DOI: 10.1093/inthealth/ihv041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/18/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Amazon region has the highest seroprevalence of hepatitis A virus (HAV) in Brazil. METHODS In the present study, the seroprevalence of total HAV antibodies in two groups, composed of 147 and 254 children between 1 and 5 years old in Assis Brasil, Acre, was measured in 2003 and 2010, respectively, and compared with socio-economic changes in the city. RESULTS In 2003, the HAV seroprevalence rate was 26.5%, while in 2010, it was 22.4%. There was an overall improvement in socio-economic and sanitary conditions, with the exception of open sewage. In 2003, factors associated with positive serology were child age (aOR [adjusted odds ratio] 1.84; 95% CI: 1.28-2.64), having a latrine or not having a toilet at home (aOR 4.73; 95% CI: 1.06-21.17) and the treatment of drinking water with chlorine (aOR 0.26; 95% CI: 0.07-0.92). In 2010, the main factors associated with positive serology were using rivers, streams and rainwater as sources of water for domestic purposes (aOR 24.36; 95% CI: 3.69-160.85); having a wooden or ground floor at home (OR 2.51; 95% CI: 1.11-5.69) and child age (aOR 2.33; 95% CI: 1.66-3.28). CONCLUSIONS In the Brazilian Amazon, sanitation and water treatment still require improvement and socio-economic development is warranted in order to decrease hepatitis A transmission.
Collapse
Affiliation(s)
- Thasciany M Pereira
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Saulo A S Mantovani
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Fernando L C C Branco
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Athos M Braña
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Humberto Oliart-Guzmán
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Breno M Delfino
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Antonio C Martins
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Thiago S Araújo
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Cristieli S M Oliveira
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Pascoal T Muniz
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| | - Mônica da Silva-Nunes
- Health Sciences Center, Federal University of Acre, BR 364 km 04, Distrito Industrial, Rio Branco, Acre, Brazil, 69919-769
| |
Collapse
|