Epidemiologia da Infecção pelo Vírus da Hepatite B em Assentamento Rural em Mato Grosso do Sul, Brasil Central
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2013-12-09
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Universidade Federal de Goiás
Resumo
Hepatitis B virus (HBV) infection has been responsible for the largest number of
chronic hepatitis illness throughout the world as well as its sequelae: cirrhosis and
hepatocellular carcinoma. In Brazil, a low endemic country for hepatitis B, the most of
the information on this infection has been limited to urban populations. Data about
hepatitis B epidemiology in rural settlement are rare. Thus, the aim of this study was
to investigate the epidemiological profile of hepatitis B virus infection in individuals
living in a rural settlement (Itamarati I) from Mato Grosso do Sul, Brazil. Initially a
cross-sectional study was carried out. Then HBV susceptible individuals were
vaccinated against HBV and their vaccine response were evaluated. Participants
were recruited following a random selection of their families. All family member aged
≥ 2 years who agreed to take part into the study was recruited by signing an
Informed Consent Form. Then, 10-ml-blood sample was taken for detecting HBV
markers: HBsAg, anti-HBs and total anti-HBc by using commercial kits. HBsAg
positive samples were retested for HBeAg and anti-Hbe markers. Hepatitis B
vaccine was offered to all individuals who were identified as susceptible to infection,
and quantitative detection of anti-HBs was measured after the third vaccine dose.
Statistical Package for the Social Sciences – SPSS for Window 15.0 was used for
processing and analyzing data. The present project was approved by the Ethics
Committee from Universidade Federal de Mato Grosso do Sul – UFMS. Of all
participants, 54.4% were female. The majority (59.7%) were up to 40 years old,
62.7% were married and 78.3% self-declared white. Serological markers of HBV
infection were identified in 110 settlers, resulting in an overall prevalence of 24.1%
(95% CI: 20.4 to 28.2). Twelve subjects (2.6%) were HBsAg-positive. In 139 (30.5%)
individuals were detected only anti-HBs, suggesting previous vaccination. Multiple
regression analysis showed that age, social movements and sharing personal
hygiene objects were independently associated to HBV. HBV DNA was found in four
samples, being classified as genotypes D (3/4) and A (1/4). From those 207
individuals identified as susceptible to HBV infection, 84 received the first vaccine
dose, but only 44 complied with the full vaccine regimen. In 28 of them (63.6%)
vaccine response was evaluated, and 57.1% showed protective anti-HBs titers. The
results of the present study show a high prevalence of hepatitis B in the settlers
studied, compared to the urban population in the Midwest Region, and difficulties for
vaccination against hepatitis B in this population. These findings ratify the need of the
relationship between agricultural and health services and leaders of social
movements of settlers for the creation and implementation of health strategies
specific to this slice of rural Brazil.
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RODRIGUES, Fabiana Perez. Epidemiologia da Infecção pelo Vírus da Hepatite B em Assentamento Rural em Mato Grosso do Sul, Brasil Central. 2013. 98 f. Tese (Doutorado em Enfermagem), Universidade Federal de Goiás, Goiânia, 2013.