Epidemiologia da infecção pelo vírus da hepatite B em cortadores de cana manual do Brasil: um estudo multicêntrico
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2018-03-05
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Universidade Federal de Goiás
Resumo
Despite the impact of the hepatitis B virus (HBV) worldwide in diverse populations,
investigations have focused on urban groups with few studies targeting the rural population.
In Brazil, manual sugarcane cutters are rural workers exposed to multiple challenging
conditions that increase their vulnerability to HBV. The objective of this study was to
investigate the epidemiology of hepatitis B in manual sugar cane cutters from the States of
Goiás and Paraíba. This is a multicentric analytical cross-sectional study carried out in the
states of Goiás and Paraíba, in the Midwest and Northeast regions of Brazil, respectively. Data
collection took place in 2016, and 937 sugarcane cutters aged 18 or over were recruited. All
subjects were interviewed and tested for the detection of hepatitis B serological markers
(HBsAg, anti-HBs and anti-HBc) by enzyme-linked immunosorbent assay (ELISA). Univariate
and multivariate analyses with logistic regression were used to identify association between
HBV exposure and sociodemographic and behavioral variables. This study was approved by
the Research Ethics Committee of the Federal Universities of Goiás and Paraíba. All
participants (n = 937) were male, mostly young adults (68.9%), with an average age of 35.4
years, and natives of the Northeast Region of the country (85.7%). Of the total, 78.8%
reported monthly income less than BRL$2,000.00 (about USD$540) and almost half (47.4%)
declared four years of education or less. Among the participants, 49.4% started sexual
activity early, aged between 7 and 15 years; 77.2% reported history of alcohol use; 29.6%
reported experience living in shared housing; 39.8% reported two or more sexual partners in
the last year; and 46.5% reported not having used a condom in the same period. In addition,
45.8% shared sharp personal hygiene instruments; 55.0% reported previous hospitalization,
and 53.9% had at least one work related accident. The overall prevalence of HBV exposure
was 15.9% (95% CI: 13.7% - 18.4%). The HBsAg marker was detected in seven individuals,
all of whom presented at least one risk behavior for hepatitis B. Only 20.6% (n = 193, 95%
CI: 23.1% - 23.3%) tested positive for isolated anti-HBs, indicating previous vaccination. It
was observed that reports of two or more sexual partners in the last 12 months and history of
hospital admission (p<0.05) were predictors of HBV exposure, confirming these routes of
parenteral and sexual transmission. These results demonstrate the need for effective hepatitis
B prevention strategies among sugarcane cutters, focusing on timing, supply and
administration of hepatitis B vaccine.
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ROSA, L. R. C. Epidemiologia da infecção pelo vírus da hepatite B em cortadores de cana manual do Brasil: um estudo multicêntrico. 2018. 124 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2018.