Lessons from the COVID-19 pandemic: the unequal burden of COVID-19 on vulnerable populations in the Brazilian Central-West.

This study aimed to estimate the prevalence and identify social factors and preventive strategies associated with the coronavirus disease 2019 (COVID-19) in socio and economically vulnerable people (recyclable waste pikers, immigrants/refugees, and homeless people) in Goiânia, Goiás State, Central-Western Brazil. A cross-sectional study was conducted from July 2020 to October 2020. COVID-19 positivity was defined as a positive total anti-SARS-COV-2 antibody test and/or RNA test for SARS-COV-2. Univariable and multiple regression analyses were performed to identify the variables associated with COVID-19. Of the 594 participants, 47.3% were recyclable waste pickers, 29.6% were immigrants/refugees, and 23.1% were homeless people. The positivity for SARS-CoV-2 RNA was 14.1%, whereas for anti-SARS-CoV-2 a total of 30.8% were positive, and 39.4% were positive for at least one COVID-19 marker. Among the 541 individuals, being immigrants/refugees, not wearing a surgical mask, and having three or more people sleeping in the same room were associated with SARS-CoV-2 infection, while using TV news as the main source of information about the pandemic was a protective predictor of COVID-19. This study revealed ethnic and socioeconomic inequalities in the prevalence of COVID-19 among impoverished people in Brazil. Additionally, a high prevalence of COVID-19 was detected in all three groups. Developing new strategies to combat and prevent communicable diseases affecting this population is essential for mitigating future and ongoing pandemics.

Hepatitis A and E among immigrants and refugees in Central Brazil.

OBJECTIVE: To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS: Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS: All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5-90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION: The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

Lessons from the COVID-19 pandemic: the unequal burden of COVID-19 on vulnerable populations in the Brazilian Central-West / Lições sobre a pandemia da COVID-19: a carga desigual da COVID-19 sobre as populações vulneráveis da região central do Brasil / Lecciones de la pandemia del COVID-19: la carga desigual del COVID-19 sobre las poblaciones vulnerables en la región central de Brasil

Abstract: This study aimed to estimate the prevalence and identify social factors and preventive strategies associated with the coronavirus disease 2019 (COVID-19) in socio and economically vulnerable people (recyclable waste pikers, immigrants/refugees, and homeless people) in Goiânia, Goiás State, Central-Western Brazil. A cross-sectional study was conducted from July 2020 to October 2020. COVID-19 positivity was defined as a positive total anti-SARS-COV-2 antibody test and/or RNA test for SARS-COV-2. Univariable and multiple regression analyses were performed to identify the variables associated with COVID-19. Of the 594 participants, 47.3% were recyclable waste pickers, 29.6% were immigrants/refugees, and 23.1% were homeless people. The positivity for SARS-CoV-2 RNA was 14.1%, whereas for anti-SARS-CoV-2 a total of 30.8% were positive, and 39.4% were positive for at least one COVID-19 marker. Among the 541 individuals, being immigrants/refugees, not wearing a surgical mask, and having three or more people sleeping in the same room were associated with SARS-CoV-2 infection, while using TV news as the main source of information about the pandemic was a protective predictor of COVID-19. This study revealed ethnic and socioeconomic inequalities in the prevalence of COVID-19 among impoverished people in Brazil. Additionally, a high prevalence of COVID-19 was detected in all three groups. Developing new strategies to combat and prevent communicable diseases affecting this population is essential for mitigating future and ongoing pandemics.

Resumo: Este estudo teve como objetivo estimar a prevalência da COVID-19 e identificar fatores sociais e estratégias preventivas associadas a essa doença em pessoas em situação de vulnerabilidade socioeconômica (catadores de lixo, imigrantes/refugiados e moradores de rua) em Goiânia, Estado de Goiás, na região central do Brasil. Trata-se de um estudo transversal realizado de julho a outubro de 2020. Foram considerados positivos para a covid-19 indivíduos que apresentaram um teste de anticorpos anti-SARS-COV-2 e/ou teste de RNA para SARS-COV-2 com resultado positivo. Foram realizadas análises de regressão univariável e múltipla para identificar as variáveis associadas à COVID-19. Dos 594 participantes, 47,3% eram catadores de lixo reciclável, 29,6% eram imigrantes/refugiados e 23,1% eram moradores de rua. A positividade foi de 14,1% para o RNA do SARS-CoV-2, 30,8% para o total de anti-SARS-CoV-2 e 39,4% para pelo menos um marcador da COVID-19. Entre os 541 indivíduos, ser imigrante/refugiado, não usar máscara cirúrgica e ter três ou mais pessoas dormindo no mesmo quarto foram fatores associados à infecção por SARS-CoV-2, enquanto confiar em informações sobre a pandemia, principalmente aquelas transmitidas por noticiários de TV, foi um indicador de proteção contra a COVID-19. Este estudo revelou desigualdades étnicas e socioeconômicas na prevalência da COVID-19 entre pessoas de baixa renda no Brasil. Além disso, uma alta prevalência de COVID-19 foi detectada nos três grupos. O desenvolvimento de novas estratégias para combater e prevenir doenças transmissíveis que afetam essa população é essencial para mitigar pandemias futuras e atuais.

Resumen: Este estudio tuvo como objetivo estimar la prevalencia del COVID-19 e identificar los factores sociales y las estrategias preventivas asociadas a esta enfermedad en personas en situación de vulnerabilidad socioeconómica (recolectores de basura, inmigrantes/refugiados y personas sin hogar) en Goiânia, Estado de Goiás, en la región central de Brasil. Se trata de un estudio transversal realizado de julio a octubre de 2020. Las personas que tuvieron una prueba de anticuerpos anti-SARS-CoV-2 positiva y/o una prueba de ARN para SARS-CoV-2 se consideraron positivas para el COVID-19. Se realizaron análisis de regresión univariante y múltiple para identificar las variables asociadas al COVID-19. De los 594 participantes, el 47,3% eran recicladores; el 29,6% inmigrantes/refugiados; y el 23,1% eran personas sin hogar. La positividad fue del 14,1% para el ARN del SARS-CoV-2; del 30,8% para el total de anti-SARS-CoV-2; y del 39,4% para al menos un marcador del COVID-19. De los 541 participantes, ser inmigrante/refugiado, no usar mascarilla quirúrgica y tener tres o más personas que comparten la misma habitación fueron los factores asociados con la infección por SARS-CoV-2, mientras que confiar en la información sobre la pandemia, especialmente transmitidas por los noticiarios, fue un indicador de protección contra esta enfermedad. Este estudio reveló las desigualdades étnicas y socioeconómicas en la prevalencia del COVID-19 entre las personas de bajos ingresos en Brasil. Además, se detectó una alta prevalencia del COVID-19 en los tres grupos. El desarrollo de nuevas estrategias para combatir y prevenir las enfermedades transmisibles que afectan a esta población es fundamental para mitigar las pandemias futuras y actuales.

Hepatitis A and E among immigrants and refugees in Central Brazil

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5-90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.