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Jaisli S, Mayorga O, Flores N, de Berti S, Frösner G, Herzog C, Zwahlen M, Herzog SA. Clinical, serological and epidemiological features of hepatitis A in León, Nicaragua. PeerJ 2021; 9:e11516. [PMID: 34221712 PMCID: PMC8223896 DOI: 10.7717/peerj.11516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives To monitor and document the endemicity and disease burden of acute hepatitis A in the area of an ongoing vaccine effectiveness study in León, Nicaragua. Methods At community health centres in León, all children, adolescents and young adults presenting with jaundice and/or other clinical signs of hepatitis were offered free serologic screening (hepatitis A, B and C) and blood tests for liver enzymes and bilirubin. Clinical and socioeconomic data were collected with a structured questionnaire. Diagnosis of acute hepatitis A was confirmed by anti-HAV IgM testing. Using logistic regression we compared the characteristics and living conditions of acute hepatitis A cases with those of non-cases. Results Of 557 eligible subjects enrolled between May 2006 and March 2010, 315 (56.6%) were diagnosed with hepatitis A, 80.6% of them ≤10 years and five >18 years of age. No severe cases were encountered. Apart from jaundice (95.6%) and other signs of hepatitis A (fever, pale stool, dark urine, nausea, vomiting, anorexia), two thirds of patients had moderately raised liver enzymes. Cases occurred throughout the year, with highest incidences from August to March. Poor sanitary conditions and crowding were the main risk factors. Conclusions In the study area, hepatitis A is still highly endemic in young and school age children living in low socioeconomic conditions. There are, however, first indications that the endemicity level is shifting from high to high-intermediate.
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Affiliation(s)
- Sophie Jaisli
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Orlando Mayorga
- Department of Microbiology & Parasitology, Faculty of Medical Sciences, National Autonomous University, León, Nicaragua
| | - Nadia Flores
- Department of Microbiology & Parasitology, Faculty of Medical Sciences, National Autonomous University, León, Nicaragua
| | | | - Gustav Frösner
- Institute of Virology, Technical University, Munich, Germany
| | - Christian Herzog
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Medical Department, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sereina A Herzog
- Centre for Health Economics Research and Modelling of Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium.,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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2
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Ayouni K, Kharroubi G, Mallekh R, Hammami W, Marouani R, Mhamdi M, Ben Salah A, Triki H, Bettaieb J. Seroprevalence of hepatitis A virus infection in Central-West of Tunisia. J Med Virol 2021; 93:3666-3671. [PMID: 32986240 DOI: 10.1002/jmv.26563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/28/2020] [Accepted: 09/23/2020] [Indexed: 11/06/2022]
Abstract
Hepatitis A infections still represent a major global health concern. During the past years, a transition pattern of the hepatitis A epidemiology was noted in many parts of the world. In Tunisia, there is not a recent survey on age-specific hepatitis A virus seroprevalence. This study aimed to investigate the seroprevalence of hepatitis A virus infection in Central-West Tunisia, representative of regions with lowest socioeconomic level in the country, before vaccine implementation. Sera obtained from the blood samples of subjects were screened for the detection of hepatitis A virus. The seroprevalence was evaluated by detection of total antibodies to hepatitis A virus using commercially available immunoassay kits. A total of 1379 subjects, aged 5-75 years (mean age: 29.0 ± 17.3 years) were studied. The global anti-hepatitis A virus seroplevalence was 84.7% (95% confidence interval: [82.6-86.5]). A higher hepatitis A virus seroprevalence was showed in subjects aged 10-14 years compared to those aged less than 10 years (50.0% vs. 31.0%). In subjects aged 20-29 years, a rapid increase in the hepatitis A virus prevalence was noted; it reached 97.0%. The seroprevalence of anti-hepatitis A virus differed by zone of residence (81.1% in rural area vs. 72.4% in urban area, p = .005) and increased significantly with lower level of education (p = .019). There was no statistical significant seroprevalence difference between male and female: 84.2% versus 85.2%, respectively. Our study confirm the transition pattern of the hepatitis A virus endemicity in Tunisia from high to intermediate and provide an evaluation of the hepatitis A virus epidemiological situation before vaccine implementation.
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Affiliation(s)
- Kaouther Ayouni
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ghassen Kharroubi
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Rym Mallekh
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Walid Hammami
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | | | - Moncef Mhamdi
- Regional Health Direction of Kasserine, Kasserine, Tunisia
| | - Afif Ben Salah
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Henda Triki
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Jihène Bettaieb
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Pereira LMMB, Stein AT, Figueiredo GM, Coral GP, Montarroyos UR, Cardoso MRA, Braga MC, Moreira RC, Santos AAD, Ximenes RA. Prevalence of hepatitis A in the capitals of the States of North, Southeast and South regions of Brazil: decrease in prevalence and some consequences. Rev Inst Med Trop Sao Paulo 2021; 63:e34. [PMID: 33909848 PMCID: PMC8075615 DOI: 10.1590/s1678-9946202163034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 03/26/2021] [Indexed: 12/03/2022] Open
Abstract
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.
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Affiliation(s)
- Leila M M B Pereira
- Universidade de Pernambuco, Instituto do Fígado de Pernambuco, Recife, Pernambuco, Brazil
| | - Airton T Stein
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Porto Alegre, Brazil
| | - Gerusa Maria Figueiredo
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil
| | - Gabriela Perdomo Coral
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Porto Alegre, Brazil
| | - Ulisses R Montarroyos
- Universidade de Pernambuco, Instituto de Ciências Biológicas, Recife, Pernambuco, Brazil
| | - Maria Regina Alves Cardoso
- Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Epidemiologia, São Paulo, São Paulo, Brazil
| | - Maria Cynthia Braga
- Fundação Oswaldo Cruz, Centro de Pesquisas Aggeu Magalhães, Recife, Pernambuco, Brazil
| | | | | | - Ricardo Alencar Ximenes
- Universidade de Pernambuco, Faculdade de Ciências Médicas, Recife, Pernambuco, Brazil.,Universidade Federal de Pernambuco, Departamento de Medicina Tropical, Recife, Pernambuco, Brazil
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Andani A, van Elten TM, Bunge EM, Marano C, Salgado F, Jacobsen KH. Hepatitis A epidemiology in Latin American countries: a 2020 view from a systematic literature review. Expert Rev Vaccines 2020; 19:795-805. [PMID: 32955965 DOI: 10.1080/14760584.2020.1813575] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The World Health Organization recommends vaccination against hepatitis A virus (HAV) for children aged 1 year and older in areas where endemicity has shifted from high to intermediate. There are no recent comprehensive reviews of the epidemiology of HAV infection in Latin America, but seroprevalence and socioeconomic data suggest that, with improved clean water and sanitation systems, countries are transitioning to intermediate endemicity. AREAS COVERED We conducted a systematic literature review of the epidemiology of HAV infection in 25 countries in the Latin American region, which included gray literature. We compiled data on HAV incidence and prevalence, including the identification of epidemiological changes observed in countries that established pediatric HAV vaccination programs. EXPERT OPINION We identified 59 relevant articles, including 34 peer-reviewed seroprevalence studies (12 recent studies from Brazil), three incidence studies, and six vaccine impact studies (three from Argentina). Based on the estimated age at midpoint of population immunity in each country, most have a high-intermediate, intermediate, or low-intermediate level of HAV endemicity, suggesting that national childhood immunization may be an appropriate disease prevention strategy. However, recent data were lacking for most countries. Improved data quality and continued epidemiological surveillance are required for this region.
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Affiliation(s)
| | - Tessa M van Elten
- Pallas Health Research and Consultancy B.V ., Rotterdam, The Netherlands
| | - Eveline M Bunge
- Pallas Health Research and Consultancy B.V ., Rotterdam, The Netherlands
| | | | | | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University , Fairfax, VA, USA
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De Oliveira TM, Vieira NSG, Sepp TDS, Souto FJD. Recent trends in hepatitis A incidence in Brazil. J Med Virol 2020; 92:1343-1349. [DOI: 10.1002/jmv.25694] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/31/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Talita M. De Oliveira
- Facimed Medicine CourseCollege of Biomedical Sciences of CacoalCacoal Rondônia Brazil
| | - Nádia S. G. Vieira
- Facimed Medicine CourseCollege of Biomedical Sciences of CacoalCacoal Rondônia Brazil
| | - Thaís D. S. Sepp
- Facimed Medicine CourseCollege of Biomedical Sciences of CacoalCacoal Rondônia Brazil
| | - Francisco J. D. Souto
- Facimed Medicine CourseCollege of Biomedical Sciences of CacoalCacoal Rondônia Brazil
- Internal Medicine DepartmentFederal University of Mato GrossoCuiabá Mato Grosso Brazil
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Souto FJD, de Brito WI, Fontes CJF. Impact of the single-dose universal mass vaccination strategy against hepatitis A in Brazil. Vaccine 2019; 37:771-775. [DOI: 10.1016/j.vaccine.2018.12.054] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/22/2018] [Accepted: 12/28/2018] [Indexed: 11/15/2022]
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de Almeida Ribeiro CR, Amado LA, Tourinho RS, Pinto Lima LR, Melgaço JG, de Almeida AJ, Bastos LS, Lewis-Ximenez LL, de Paula VS. Accuracy of rapid test for diagnosis of hepatitis A with different infection rate settings and with predictive modeling. Future Microbiol 2019; 14:247-258. [PMID: 30663895 DOI: 10.2217/fmb-2018-0211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM We evaluated the accuracy of a commercial rapid immunochromatographic test (rapid test [RT]) for hepatitis A (HA) diagnosis and epidemiological studies. MATERIALS & METHODS The accuracy of a RT was evaluated in laboratory and in field conditions. Predictive modeling estimated the test performance in a hypothetical population. RESULTS The RT showed sensitivities of 66-86%, and specificities of 21-100%, depending on the antibody isotype (IgM or IgG) analyzed and prevalence of infection. CONCLUSION The RT is a good alternative for diagnostic in HA outbreaks. The predictive model indicates that it should not be used alone for HA diagnosis in low prevalence populations. These data can be used in the future to strengthen decision-making during the implementation of rapid diagnostic methods in health services.
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Affiliation(s)
| | - Luciane A Amado
- Laboratory of Development Technological in Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Renata S Tourinho
- Laboratory of Development Technological in Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Lyana R Pinto Lima
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Juliana G Melgaço
- Laboratory of Development Technological in Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Adilson J de Almeida
- Department of General Medicine, Gaffrée & Guinle University Hospital, Federal University of the State of Rio de Janeiro School of Medicine & Surgery, Rio de Janeiro, Brazil
| | - Leonardo S Bastos
- Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Lia L Lewis-Ximenez
- Ambulatory Clinic of Viral Hepatitis/Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vanessa S de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Initial evaluation of universal immunization with a single dose against hepatitis A virus in Central Brazil. Braz J Infect Dis 2018; 22:166-170. [PMID: 29684320 PMCID: PMC9425659 DOI: 10.1016/j.bjid.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 01/19/2023] Open
Abstract
Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.
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Van Effelterre T, Guignard A, Marano C, Rojas R, Jacobsen KH. Modeling the hepatitis A epidemiological transition in Brazil and Mexico. Hum Vaccin Immunother 2017; 13:1942-1951. [PMID: 28481680 PMCID: PMC5557237 DOI: 10.1080/21645515.2017.1323158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/05/2017] [Accepted: 04/21/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Many low- to middle-income countries have completed or are in the process of transitioning from high or intermediate to low endemicity for hepatitis A virus (HAV). Because the risk of severe hepatitis A disease increases with age at infection, decreased incidence that leaves older children and adults susceptible to HAV infection may actually increase the population-level burden of disease from HAV. Mathematical models can be helpful for projecting future epidemiological profiles for HAV. METHODS An age-specific deterministic, dynamic compartmental transmission model with stratification by setting (rural versus urban) was calibrated with country-specific data on demography, urbanization, and seroprevalence of anti-HAV antibodies. HAV transmission was modeled as a function of setting-specific access to safe water. The model was then used to project various HAV-related epidemiological outcomes in Brazil and in Mexico from 1950 to 2050. RESULTS The projected epidemiological outcomes were qualitatively similar in the 2 countries. The age at the midpoint of population immunity (AMPI) increased considerably and the mean age of symptomatic HAV cases shifted from childhood to early adulthood. The projected overall incidence rate of HAV infections decreased by about two thirds as safe water access improved. However, the incidence rate of symptomatic HAV infections remained roughly the same over the projection period. The incidence rates of HAV infections (all and symptomatic alone) were projected to become similar in rural and urban settings in the next decades. CONCLUSION This model featuring population age structure, urbanization and access to safe water as key contributors to the epidemiological transition for HAV was previously validated with data from Thailand and fits equally well with data from Latin American countries. Assuming no introduction of a vaccination program over the projection period, both Brazil and Mexico were projected to experience a continued decrease in HAV incidence rates without any substantial decrease in the incidence rates of symptomatic HAV infections.
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Affiliation(s)
| | | | | | - Rosalba Rojas
- Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pùblica, Morelos, México
| | - Kathryn H. Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
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da Silva Junior HC, da Silva ED, Lewis-Ximenez de Souza Rodrigues LL, Medeiros MA. Recombinant VP1 protein as a potential marker for the diagnosis of acute hepatitis A virus infection. J Virol Methods 2017; 245:1-4. [DOI: 10.1016/j.jviromet.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 01/02/2017] [Accepted: 03/07/2017] [Indexed: 12/21/2022]
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Kury CM, Pinto MA, Silva JPD, Cruz OG, Vitral CL. Hepatitis A seroprevalence in public school children in Campos dos Goytacazes, Rio de Janeiro State, Brazil, prior to the introduction of the hepatitis A universal childhood vaccination. CAD SAUDE PUBLICA 2016; 32:e00175614. [PMID: 27982290 DOI: 10.1590/0102-311x00175614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 02/23/2016] [Indexed: 01/14/2023] Open
Abstract
This cross-sectional study was carried out between August 2011 and July 2012 in the city of Campos dos Goytacazes in Rio de Janeiro State, Brazil. Dried blood spot samples were collected on filter paper from 919 individuals between the ages of 1 and 19 and were tested for antibodies against the hepatitis A virus (anti-HAV). The total prevalence was 20.7%, while 94.7% of children under the age of 5 were found to be susceptible to HAV infection. The prevalence of anti-HAV increased with age, reaching 33.3% among individuals aged between 15 and 19, thereby indicating that this municipality has a low level of endemicity for hepatitis A. Age, non-white skin color, accustomed to swimming in the river and more than five people living at home were the factors that were associated with an increase in the chance of a positive anti-HAV result. Mother's education level (secondary or tertiary) was considered a protective factor for HAV infection. The data obtained showed that a large proportion of the children from Campos dos Goytacazes were at risk of HAV infection, which should be minimized with the introduction of the vaccination program against hepatitis A that was launched in the municipality in 2011.
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Affiliation(s)
- Charbell Miguel Kury
- Secretaria Municipal de Saúde, Campos dos Goytacazes, Brasil.,Faculdade de Medicina de Campos, Campos dos Goytacazes, Brasil.,Instituto Biomédico, Universidade Federal Fluminense, Niterói, Brasil
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Pinheiro RS, Araújo LAD, Caetano KAA, Matos MAD, Carneiro MADS, Teles SA. INTERMEDIATE ENDEMICITY OF HEPATITIS A VIRUS INFECTION IN RURAL SETTLEMENT PROJECTS OF SOUTHWEST GOIÁS, BRAZIL. ARQUIVOS DE GASTROENTEROLOGIA 2016; 52:200-3. [PMID: 26486287 DOI: 10.1590/s0004-28032015000300009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/01/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rural populations present an elevated risk of exposure to hepatitis A virus. OBJECTIVE The objective of this study was to estimate the prevalence and risk factors associated with hepatitis A virus infection among residents of rural settlement projects of southwest Goiás, Central Brazil. METHODS A total of 466 residents were interviewed and tested for the detection of anti- hepatitis A virus antibodies by ELISA. RESULTS The global prevalence of anti- hepatitis A virus was 82.2%. In individuals aged 5-9 years and 10-19 years, the prevalence was 15% and 58.8%, respectively. Persons in the 10-19 age group, with a history of life in encampments, with more than five people per residence consuming well water, were predictors for exposure to hepatitis A virus. CONCLUSION Our results suggest that the hepatitis A virus endemicity in rural settlements in southwest Goiás similar to that found in the urban population of the Midwest Region, confirming the implementation of universal hepatitis A vaccination in children.
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Mirzaei J, Ziaee M, Farsad SA, Fereydooni M, Anani Sarab G, Rezvani Khorashad MR. Vaccination Against Hepatitis A for Hemophilic Patients: Is It Necessary? HEPATITIS MONTHLY 2016; 16:e37447. [PMID: 27257430 PMCID: PMC4888500 DOI: 10.5812/hepatmon.37447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hemophilic patients require long-life intravenous infusion of factor concentrates to treat bleedings. This could increase the risk of transmission of blood-borne infections like hepatitis C. OBJECTIVES The current study was aimed at investigating the immunity status against hepatitis A in hemophilic patients in south Khorasan and evaluating the necessity of hepatitis A vaccination for this population. PATIENTS AND METHODS A cross-sectional descriptive study was conducted between 2014 and 2015 on all hemophilic patients of south Khorasan province, Iran (n = 108) for anti-HAV total, anti- HCV, HBs-Ag, anti-HIV, and anti-HTLV-I /II. Note that no one had already received a hepatitis A vaccine. RESULTS As our results show, 77.8% of the participants (59% under 20 and 88.4% above 20 years old) were seropositive for anti-HAV total; 20.4% and 2.8% (three patients) of the cases were anti-HCV positive and anti-HTLV-1 positive, respectively, while none of the subjects were HBS-Ag or HIV-Ab positive. Seventeen of the patients (15.75%) showed a co-infection of HAV with HCV, and five HCV-infected patients (22.73%) had no immunity against hepatitis A. There was a significant relationship between age, rural life, and anti-HAV positive state in our patients (P < 0.001). No significant relationship between positive anti-HAV status and sex (P = 0.16), severity of hemophilia (P = 0.23), and infection with HIV, HCV, HTLV-1, and hepatitis B (P > 0.05) was detected. CONCLUSIONS More than 40% of the hemophilic patients under 20 years of age in the present study had no immunity against hepatitis A, and 23% of hepatitis C patients had not had a hepatitis A co-infection yet. Since hepatitis A can show a fulminant course in hepatitis C patients, vaccination against hepatitis A seems necessary in hemophilic patients in the region.
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Affiliation(s)
- Jamal Mirzaei
- Infectious Disease Research Center, AJA University of Medical Sciences, Tehran, IR Iran
| | - Masood Ziaee
- Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
- Corresponding Author: Masood Ziaee, Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran. Tel: +98-5632443243; +98-9151613942, E-mail:
| | - Seyed Ali Farsad
- Infectious Disease Research Center, AJA University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Fereydooni
- Asthma, Allergy and Immunology Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
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Amado Leon LA, de Almeida AJ, de Paula VS, Tourinho RS, Villela DAM, Gaspar AMC, Lewis-Ximenez LL, Pinto MA. Longitudinal Study of Hepatitis A Infection by Saliva Sampling: The Kinetics of HAV Markers in Saliva Revealed the Application of Saliva Tests for Hepatitis A Study. PLoS One 2015; 10:e0145454. [PMID: 26690904 PMCID: PMC4686585 DOI: 10.1371/journal.pone.0145454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/03/2015] [Indexed: 01/31/2023] Open
Abstract
Despite the increasing numbers of studies investigating hepatitis A diagnostic through saliva, the frequency and the pattern of hepatitis A virus (HAV) markers in this fluid still remains unknown. To address this issue, we carried on a longitudinal study to examine the kinetics of HAV markers in saliva, in comparison with serum samples. The present study followed-up ten patients with acute hepatitis A infection during 180 days post diagnosis (dpd). Total anti-HAV was detected in paired serum and saliva samples until the end of the follow-up, showing a peak titer at 90th. However, total anti-HAV level was higher in serum than in saliva samples. This HAV marker showed a probability of 100% to be detected in both serum and saliva during 180 dpd. The IgM anti-HAV could be detected in saliva up to 150 dpd, showing the highest frequency at 30th, when it was detected in all individuals. During the first month of HAV infection, this acute HAV marker showed a detection probability of 100% in paired samples. The detection of IgM anti-HAV in saliva was not dependent on its level in serum, HAV-RNA detection and/or viral load, since no association was found between IgM anti-HAV positivity in saliva and any of these parameter (p>0.05). Most of the patients (80%) were found to contain HAV-RNA in saliva, mainly at early acute phase (30th day). However, it was possible to demonstrate the HAV RNA presence in paired samples for more than 90 days, even after seroconversion. No significant relationship was observed between salivary HAV-RNA positivity and serum viral load, demonstrating that serum viral load is not predictive of HAV-RNA detection in saliva. Similar viral load was seen in paired samples (on average 104 copies/mL). These data demonstrate that the best diagnostic coverage can be achieved by salivary anti-HAV antibodies and HAV-RNA tests during 30-90 dpd. The long detection and high probability of specific-HAV antibodies positivity in saliva samples make the assessment of salivary antibodies a useful tool for diagnosis and epidemiological studies. The high frequency of HAV-RNA in saliva and the probability of detection of about 50%, during the first 30 dpd, demonstrate that saliva is also useful for molecular investigation of hepatitis A cases, mainly during the early course of infection. Therefore, the collection of saliva may provide a simple, cheap and non-invasive means of diagnosis, epidemiological surveys and monitoring of hepatitis A infection purposes.
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Affiliation(s)
- Luciane Almeida Amado Leon
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
- * E-mail:
| | - Adilson José de Almeida
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
| | - Vanessa Salete de Paula
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
| | - Renata Santos Tourinho
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
| | | | - Ana Maria Coimbra Gaspar
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
| | - Lia Laura Lewis-Ximenez
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
| | - Marcelo Alves Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, Brazil
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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.
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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.
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16
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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.
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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
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17
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Estripeaut D, Contreras R, Tinajeros O, Castrejón MM, Shafi F, Ortega-Barria E, DeAntonio R. Impact of Hepatitis A vaccination with a two-dose schedule in Panama: Results of epidemiological surveillance and time trend analysis. Vaccine 2015; 33:3200-7. [PMID: 25981490 DOI: 10.1016/j.vaccine.2015.04.100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/25/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE In April 2007, Panama introduced Hepatitis A universal vaccination using a two-dose schedule (Havrix(®)junior; GSK Vaccines, Belgium). We assessed the impact of this hepatitis A vaccine three years after it was recommended for universal mass vaccination in Panama. MATERIALS AND METHODS Hepatitis A vaccination impact was assessed using two different approaches. The first approach used retrospective data (incidence and number of cases for all age groups), collected from the passive surveillance of the Epidemiologic Surveillance System of the Ministry of Health of hepatitis A and unspecified hepatitis before (2000-2006) and after (2008-2010) introduction of hepatitis A vaccine. The second approach was a prospective hospital-based active surveillance for hepatitis cases conducted in subjects (0-14 years) during 2009-2011 at three sentinel hospitals in Panama. RESULTS Overall, the annual incidence of hepatitis A and unspecified hepatitis in 2008, 2009 and 2010 were 13.1, 7.9 and 3.7 per 100,000 subjects, lower than the baseline incidence of 51.1 per 100,000 subjects. In comparison to the mean baseline period (2000-2006), there was an 82% mean reduction in the overall hepatitis-related outcomes (hepatitis A and unspecified hepatitis) after vaccine introduction (2008-2010) in all age groups. In the hospital-based surveillance (2009-2011), of the 42 probable viral hepatitis A cases, nine cases were confirmed as acute hepatitis A (8 in 2009, 1 in 2010). Of these confirmed cases, two belonged to the targeted vaccine group (1-4 years) but were not vaccinated. CONCLUSIONS Our study suggests that the introduction of two-dose hepatitis A vaccines in Panama has contributed to the reduction in the incidence of overall hepatitis-related outcomes for all age groups, suggesting herd protection. Additional monitoring is required to document a sustained long-term effect.
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Affiliation(s)
| | - Rodolfo Contreras
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Olga Tinajeros
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT), Panama City, Panama
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18
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Navas Navas MC, Báez Triana PA. Infección por el virus de la hepatitis A: epidemiología y diversidad genética. IATREIA 2015. [DOI: 10.17533/udea.iatreia.v28n2a06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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19
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Hepatitis A and E seroprevalence and associated risk factors: a community-based cross-sectional survey in rural Amazonia. BMC Infect Dis 2014; 14:458. [PMID: 25149658 PMCID: PMC4152586 DOI: 10.1186/1471-2334-14-458] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/18/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatitis A virus (HAV) and hepatitis E virus (HEV) are both transmitted by the faecal-oral route, and represent common causes of acute hepatitis in developing countries. The endemicity of HAV infection has shifted from high to moderate in Brazil. Human cases of HEV infection seem to be rare, although the virus has been detected in swine livestock and effluents of slaughterhouses. This study was to determine the epidemiology of hepatitis A and E in one of the largest agricultural settlements in the Amazon Basin of Brazil. METHODS Serum samples collected from 397 individuals aged between 5 and 90 years during a population-based cross-sectional survey were tested for anti-HAV and anti-HEV antibodies. Associated risk factors and spatial clustering of HAV and HEV seropositivity were also analyzed. RESULTS The overall rate of HAV seropositivity was 82.9% (95% confidence interval (CI), 79.2-86.6%). Multilevel logistic regression analysis identified increasing age (in years; odds ratio (OR), 1.097; 95% CI, 1.050-1.147; P < 0.001) and crowding (OR, 1.603; 95% CI, 1.054-2.440; P = 0.028) as significant risk factors for HAV seropositivity. Anti-HEV IgG was detected in 50/388 settlers (12.9%, 95% CI, 9.5-16.2%). Anti-HEV IgM was detected in 7/43 (16.3%) anti-IgG positive samples, and 4 of them had a confirmed result by immunoblot. Increasing age was the only significant determinant of HEV seropositivity (OR, 1.033; 95% CI, 1.016-1.050; P < 0.001). No significant spatial clustering of HAV and HEV seropositivity was detected in the area. CONCLUSIONS Both HAV and HEV are endemic, with differing rates of infection in children and adults in this rural setting of the Brazilian Amazon. Anti-HEV prevalence was considerably higher than those previously reported in Brazil. The detection of HEV- specific IgM antibodies in four asymptomatic individuals is highly suggestive of the circulation of HEV in this rural population.
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20
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Evidence of hepatitis A virus person-to-person transmission in household outbreaks. PLoS One 2014; 9:e102925. [PMID: 25050760 PMCID: PMC4106857 DOI: 10.1371/journal.pone.0102925] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/23/2014] [Indexed: 01/11/2023] Open
Abstract
The person-to-person transmission of the hepatitis A virus primarily occurs in enclosed spaces, particularly in the presence of inadequate hygiene conditions and a high proportion of susceptible individuals. Thus, intimate family contact stands out as a risk factor for HAV infection dissemination. The present study aimed to evaluate the occurrence of household HAV transmission. Blood samples were collected from patients with hepatitis A (index cases) and their family members (contacts) that were referred to an ambulatory care clinic specializing in viral hepatitis. A total of 97 samples were collected from 30 families with a confirmed hepatitis A case (index case). Serological and molecular techniques for the diagnosis of hepatitis A were conducted on all samples. HAV infection (anti-HAV IgM + and/or HAV RNA +) was detected in 34.3% (23/67) of the contacts; 34.3% (23/67) of the contacts were immune to HAV, and 31.4% (21/67) were susceptible. In the household contacts, HAV immunity was significantly associated with older age; susceptibility to infection and HAV infection were associated with younger age. Household outbreaks were detected in 16/30 families studied. Co-circulation of subgenotypes IA and IB was found in the household outbreaks, and person-to-person transmission was evidenced in six of the household outbreaks, with 100% homology between the index case and contact strains. The results demonstrated the relevance of HAV household transmission, reaffirming the need for hepatitis A vaccine administration in susceptible contacts and effective infection control procedures to prevent the extension of household outbreaks.
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Soares HDO, Lopes CLR, Freitas NRD, Silva AMDCE, Moura LRD, Martins RMB. High prevalence of hepatitis A antibodies among recyclable waste pickers, Central Brazil. Rev Inst Med Trop Sao Paulo 2013; 55:433-4. [PMID: 24213200 PMCID: PMC4105095 DOI: 10.1590/s0036-46652013000600013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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C MA, J M RT, A CR, M BN, M DG, S L MR. Prevalence of hepatitis A antibodies in Eastern Bolivia: a population-based study. J Med Virol 2013; 85:1692-7. [PMID: 23861034 DOI: 10.1002/jmv.23671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2013] [Indexed: 11/12/2022]
Abstract
The seroprevalence of hepatitis A virus (HAV) is changing from high to intermediate endemicity in several Latin American countries, but the pattern in the Andean Latin American countries is unknown. A seroepidemiological survey (n = 436) of HAV in schoolchildren living in the Cochabamba region of Bolivia was conducted in 2010. A questionnaire was completed by parents to obtain demographic, socio-economic, and housing data, and blood samples were collected. The overall prevalence of HAV IgG was 95.4% (95% CI 93.5-97.4). The prevalence was higher in children aged 5-10 years (97%) and pre-adolescents aged 10-13 years (97.9%). The prevalence was also higher in subjects whose parents had a low level of education (99.4-99.5%), who lived in rural areas (98.7%), lived in municipalities with low urban development (99.1-100%), had water delivered at home from a tanker (99.4%), and spoke Quechua at home (99.5%). The descriptive and bivariate analysis suggested that no change in HAV epidemiology has occurred in Cochabamba.
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Affiliation(s)
- Masuet-Aumatell C
- Preventive Medicine Department, Bellvitge Biomedical Research Institute (IDIBELL), International Health Centre and Travel Medicine Clinic, University Hospital of Bellvitge, Catalonia, Spain.
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