High prevalence of hepatitis A in indigenous population in north Brazil.

OBJECTIVES: Little is known about hepatitis A virus (HAV) prevalence in indigenous communities. This study aims to evaluate the prevalence of HAV in indigenous community compared to urban population located at Western Amazon in Brazil. RESULTS: A total of 872 serum samples were obtained from 491 indigenous and 381 non indigenous individuals aging 0 to 90 years. Samples were tested for total and IgM anti-HAV and positive IgM samples were tested for HAV RNA. The overall prevalence of total anti-HAV was 87%, increased according age showing 100% of prevalence in those aging more than 30 years (p < 0.0001) and it was similar among indigenous and urban population. Total anti-HAV prevalence varied between tribes (p < 0.0001) and urban sites (p = 0.0014) and spatial distribution showed high prevalence in homes that received up to 100 dollars. IgM anti-HAV prevalence was 1.7% with predominance in males, those aging more than 41 years. No HAV RNA was detected. In conclusion, high overall anti-HAV prevalence was found in indigenous communities in North Brazil demonstrating the importance of universal vaccination in this group.

Clinical and neuropsychological assessment of attention and ADHD comorbidity in a sample of children and adolescents with idiopathic epilepsy.

UNLABELLED: Children with epilepsy present significant problems concerning attention and comorbidity with attention deficit hyperactivity disorder (ADHD). OBJECTIVE: To determine the prevalence of attention complaints, ADHD diagnosis and attention profile in a sample of children and adolescents with idiopathic epilepsy. METHOD: 36 children and adolescents with idiopathic epilepsy and 37 genre and age matched healthy controls underwent several procedures to diagnose their neuropsychological profile and comorbidity with ADHD. RESULTS: The prevalence of ADHD was higher in patients with epilepsy [χ2= 4.1, p = 0.043, 6 (16.7%) vs 1 (2.7%)], with worse results in attention related WISC items and factors in patients with epilepsy comparing to the controls, but not between patients with and without ADHD. Clinical characteristics did not influence those results. CONCLUSION: This study found a greater prevalence of problems wih attention in pediatric patients with idiopathic epilepsy, but not a distinct profile between those with or without ADHD.

Clinical and neuropsychological assessment of attention and ADHD comorbidity in a sample of children and adolescents with idiopathic epilepsy / Avaliação clínica e neuropsicológica da atenção e comorbidade com TDAH em crianças e adolescentes com epilepsia idiopática

Children with epilepsy present significant problems concerning attention and comorbidity with attention deficit hyperactivity disorder (ADHD). Objective To determine the prevalence of attention complaints, ADHD diagnosis and attention profile in a sample of children and adolescents with idiopathic epilepsy. Method 36 children and adolescents with idiopathic epilepsy and 37 genre and age matched healthy controls underwent several procedures to diagnose their neuropsychological profile and comorbidity with ADHD. Results The prevalence of ADHD was higher in patients with epilepsy [χ2= 4.1, p = 0.043, 6 (16.7%) vs 1 (2.7%)], with worse results in attention related WISC items and factors in patients with epilepsy comparing to the controls, but not between patients with and without ADHD. Clinical characteristics did not influence those results. Conclusion This study found a greater prevalence of problems wih attention in pediatric patients with idiopathic epilepsy, but not a distinct profile between those with or without ADHD. .

Crianças com epilepsia podem apresentar problemas de atenção e comorbidade com transtorno de atenção e hiperatividade (TDAH). Objetivo Determinar a prevalência de queixas de atenção, diagnóstico de TDAH e perfil atentivo em uma amostra de crianças e adolescentes com epilepsia idiopática. Método 36 crianças e adolescentes com epilepsia idiopática e 37 controles saudáveis foram submetidos a vários procedimentos para diagnosticar perfil neuropsicológico e comorbidade com TDAH. Resultados A prevalência de TDAH foi maior em pacientes com epilepsia [χ2 = 4,1, p = 0,043, 6 ( 16,7%) vs 1 (2,7%)] , que também apresentaram piores resultados em itens e fatores dependentes de atenção do WISC. Não foram observadas diferenças entre pacientes com e sem TDAH. As características clínicas não influenciaram resultados. Conclusão Este estudo encontrou uma maior prevalência de problemas com atenção em pacientes pediátricos com epilepsia idiopática , mas não um perfil distinto entre aqueles com ou sem TDAH. .

Análise da soroprevalência da hepatite A em povoados de Tocantinópolis e índios Apinajé em Tocantins – Brasil / Seroprevalence analysis of hepatitis A in Tocantinópolis towns and villages of indians Apinajé from Tocantins - Brazil

A hepatite A é uma doença hepática aguda, causada pelo vírus da hepatite A (HAV), um vírus de RNA da família Picornaviridae com transmissão fecal-oral. Atualmente, o Brasil apresenta um padrão de endemicidade intermediária da doença. Normalmente, a doença possui curso autolimitado e é benigna, porém existem formas graves que podem causar insuficiência hepática aguda em 0,01 porcento dos casos. Além de medidas sanitárias, outro método importante de prevenção é a utilização de vacinas inativadas, esta porém só é utilizada na imunização de grupos de risco. É conhecido o elevado risco de infecção pelo HAV em comunidades nativas no mundo, no entanto, poucos trabalhos abordam este tema em comunidades indígenas do Brasil. O objetivo deste estudo foi avaliar a prevalência de hepatite A em aldeias e povoados pertencentes a reserva Apinajé, Tocantinópolis/TO. Foram analisadas 799 amostras sorológicas para anti-HAV total, sendo 358 indígenas e 441 dos povoados locais, em onze comunidades geograficamente separadas. Para tal, utilizou-se o Kit imunoenzimático comercial da marca Diasorin®. A prevalência total de anti-HAV na população estudada foi de 85,5 porcento . A localidade que apresentou maior prevalência foi a Aldeia Girassol (95,5 porcento). Observou-se o aumento da prevalência de anti-HAV com o envelhecimento da população, sendo menor a prevalência (32,7 porcento ) observada no grupo etário mais jovem (0-2 anos) e maior prevalência (100 porcento ) acima dos 40 anos de idade. Observa-se que, entre os indígenas, 84,87 porcento possuem anti-HAV reagente e nos povoados 85,97 porcento , não havendo diferença ao comparar estas prevalências.

Observamos que 39 porcento das crianças até 12 anos estão sob risco de adquirir a doença, e até os 5 anos este número sobe para 59 porcento , logo, a população média suscetível à hepatite A é baixa por situar-se entre a faixa de 5 à 14 anos. A reserva Apinajé apresenta prevalência intermediária de anti- HAV, tanto nas aldeias quanto nos povoados. Em relação a tendência de soroconversão de hepatite A, nas aldeias isto ocorre com maior frequência durante a transição da fase pré-escolar para escolar, enquanto que nos povoados este risco se dá entre a fase escolar e a adolescência. A prevalência encontrada em crianças e adolescentes reforça a possibilidade da implementação da vacina contra hepatite A no calendário infantil.

Hepatitis A is an acute liver disease caused by hepatitis A virus (HAV), an RNA virusof the Picornaviridae's family of fecal-oral transmission. Currently Brazil has a pattern ofintermediate endemicity of the disease. Usually the disease is self-limited and has a benigncourse, but there are severe forms that can cause acute liver failure in 0.01 percent of cases. Besidesto sanitary actions, another important method of prevention is to use inactivated vaccines, butthis is only used to immunize risk groups in Brazil. In native communities, the risk of HAVinfection is high around the world, however, few works address this issue in indigenouscommunities in Brazil. The objective of this study was to evaluate the prevalence of hepatitisA in villages and towns belonging to Apinajé reservation, Tocantinópolis/TO. For this purpose,799 serum samples were analyzed for anti-HAV total being 358 from indigenous villages and441 from local town in eleven geographically separated communities. It was used thecommercial immunoenzymatic kit DiaSorin® brand. The overall prevalence of anti-HAV inthe population studied was 85.5 percent . The locality with the highest prevalence was the GirassolVillage (95.5 percent ). We observed increased prevalence of anti-HAV with an ascending aging ofpopulation, and the lowest prevalence (32.7 percent ) in the younger age group (0-2 years) and a higherprevalence (100 percent ) over 40 years of age.

It is observed that among the indigenous people84.87 percent have anti-HAV reagent and in the towns 85.97 percent , with no difference when comparingthese prevalences. We observed that 39 percent of children under 12 years are bound to acquire thedisease, and up to 5 years, this prevalence rises to 59 percent , so the average population susceptibleto hepatitis A is low as it is between the ranges of 5 to 14 years old. The reserve Apinajé hasintermediate prevalence of anti-HAV, both in villages and in the town. Regarding the trend ofseroconversion of hepatitis A in the villages that occurs most frequently during the transitionfrom preschool to school phase, while in the villages this risk occurs between middle childhoodand adolescence. The prevalence in children and adolescents strengthens implementation ofhepatitis A vaccine included in the childhood schedule could minimize the risks associated withthe disease.