Human alphaherpesvirus 2 (HSV-2) among female sex workers from Brazil: cross-sectional study using respondent-driven sampling.

OBJECTIVE: Female sex workers (FSWs) are vulnerable to human alphaherpesvirus 2 (HSV-2) infection due to their high numbers of sexual partners. The objective of this study was to evaluate the seroprevalence and risk behaviours associated with HSV-2. METHODS: A cross-sectional study was conducted in Mato Grosso do Sul, Brazil. A total of 376 FSWs were recruited by respondent-driven sampling (RDS) methodology and answered an epidemiological questionnaire. Blood samples were collected to test for HSV-2 antibodies using commercial ELISA and for HSV-2 DNA using real-time PCR. RESULTS: The seropositivity was 47.3% (178/376) for HSV-2 IgG and 10.1% (38/376) for HSV-2 IgM. HSV-2 viraemia was detected in two infected FSWs with primary infections. In bivariate and multivariate analyses, the OR for HSV-2 IgG increased with age (OR=2.53-7.90, OR=2.66-6.37) and the number of sexual partners (OR=2.30-3.25). On the other hand, daily alcohol consumption (OR=0.10) and the use of condoms during the last intercourse (OR=0.47) were protective factors against HSV-2 acquisition. CONCLUSION: Despite the impact of FSWs in public health policies with the dissemination of sexually transmitted infections, there have been few studies performed regarding the prevalence of HSV-2 in Brazil, making it difficult to implement any control or preventative measures. The results produced here using an RDS methodology demonstrated a high prevalence, risk behaviours and primary infection among the FSWs. These results reinforce the need to implement control and preventative measures for HSV-2 infection in this population.

Syphilis infection, sexual practices and bisexual behaviour among men who have sex with men and transgender women: a cross-sectional study.

OBJECTIVES: Men who have sex with men (MSM) and transgender women (TW) are highly vulnerable groups to sexually transmitted infections (STIs). This study aims to assess the prevalence of syphilis infection, sexual behaviour and identify factors associated with syphilis in MSM and TW in Campo Grande, Central Brazil. METHODS: Between 2009 and 2011, 430 MSM/TW participants were interviewed and tested for syphilis. Univariable and multivariable regression analyses were done to assess associations with syphilis infection. RESULTS: A total of 430 MSM/TW (278 MSM and 152 TW) were included in the study. The overall prevalence of lifetime syphilis and active syphilis was 34.7% (26.3% among MSM; 50.0% among TW) and 17.5% (12.3% among MSM; 27.0% among TW), respectively (p<0.001). In multivariable regression analysis, being 20-24 years and ≥30 years, having engaged in a variety of sexual practices and with a history of genital/anal ulcer in the last 12 months were associated with lifetime syphilis infection in the MSM group. Among TW participants, being ≥30 years of age, having more than 10 male sexual partners in last week and being infected with HIV were associated with lifetime syphilis. Factors associated with active syphilis among MSM were massage parlour/sauna recruitment and alcohol consumption at least once a week. Having sex with female partners in the past 12 months was predictive for active syphilis among TW. CONCLUSIONS: The prevalence of syphilis infection and risk sexual behaviour were high in the two samples, especially among TW. High levels of bisexual behaviours and low rates of consistent condom use indicate potential HIV/STIs transmission into the heterosexual population. This finding indicates the need and urgency for implementing more effective integrated programmes targeting MSM/TW for the prevention of syphilis and other STIs.

Differences in risky sexual behaviors and HIV prevalence between men who have sex with men and transgender women in the Midwest Brazil.

Men who have sex with men (MSM) and transgender women (TW) are disproportionally affected by HIV infection. This cross-sectional study evaluated the HIV-1/2 prevalence, risk factors and HIV molecular features of MSM and TW from Midwest Brazil. Four hundred and thirty participants (278 MSM and 152 TW) from Mato Grosso do Sul, Brazil, were interviewed and tested for HIV-1/2 infection between November 2011 and September 2013. Participants who were assigned male at birth, older than 18 years old and self-declared as MSM or TW were recruited from LGBT+ associations, as well as public (parks, square, streets, etc) and private [nightclubs, saunas, brothels, etc] places. The prevalence of HIV-1 was 14.4% (9.0% among MSM and 24% among TW; p<0.001). The factor independently associated with HIV-1 infection among MSM was being 30 years-old or older. Among TW, having suffered sexual coercion, lifetime syphilis infection and hepatitis C virus exposure were associated with HIV-1 infection. Phylogenetic analyses classified 65% sequences as subtype B and 35% as possible recombinants. All but one recombinant sample were from TW individuals. High HIV-1 prevalences were observed in both groups, highlighting the urgent need to devise specific HIV interventions targeting these key populations. Notably, TWs are more vulnerable to HIV infection, which was associated with sexual violence and co-infection with other STIs. With regard to MSM, being 30 years old or older was significanty associated to HIV, reinforcing the idea that MSM are less exposed [or exposed later] to STIs than TWs, although MSM are clearly more vulnerable than the general population.

Hepatitis A virus infection in Brazilian correctional facilities.

Hepatitis A virus (HAV) infection is transmitted by the fecal-oral route, through interpersonal contact and ingestion of contaminated food or water. Prisoners are at higher risk of acquiring HAV infection mainly due to the environment of closed penal institutions and socioeconomic conditions. This study aims to determine the seroprevalence of anti-HAV and its associated risk factors among inmates from twelve prisons in Central Brazil. A cross-sectional study was conducted between March 2013 and March 2014. A total of 580 prisoners participated in the study. The participant's samples were tested for Total and IgM anti-HAV antibodies by electrochemiluminescence immunoassay (ECLIA). Risk factors associated with anti-HAV seropositivity were also analyzed. The prevalence rate of HAV exposure was 88.1% (95% CI: 85.5-90.7). No sample had a positive reaction to IgM anti-HAV. Increasing age, low level of education, and being imprisoned in Corumbá city were independently associated with HAV exposure among prisoners. To prevent the burden of the disease, vaccination strategies should be considered for susceptible prisoners in Central Brazil.

HAV infection in Brazilian men who have sex with men: The importance of surveillance to avoid outbreaks.

BACKGROUND: Hepatitis A is a fecal-oral infection caused by hepatitis A virus (HAV). Men who have sex with men (MSM) and transgender women (TW) have been reported as target groups for HAV infection. This study aimed to determine the seroprevalence, risk factors, and circulating strains associated with HAV infection among MSM and TW in Central Brazil. METHODS: A cross-sectional study was conducted from November 2011 to September 2013. Serum samples were collected from 425 individuals for anti-HAV antibody testing and HAV molecular characterization. Of them, 149 (35.1%) participants were self-identified as transgender women. Statistical analysis was performed to evaluate the risk factors of HAV seropositivity. RESULTS: The seroprevalence of HAV exposure was 69.7% (95% Confidence Interval: 65.3-74.0%). Serological evidence of HAV was significantly higher in participants who self-identified as transgender women (83.2%) than MSM (62.3%). Increasing age, non-white race, and lower monthly household income were independently associated with HAV exposure among MSM. Only lower monthly household income was independently associated with HAV exposure among TW. One anti-HAV IgM positive sample, from a transgender woman (0.2%), was detected and classified as subgenotype IA. CONCLUSIONS: High HAV prevalence was observed, markedly among TW. Considering the risky sexual behaviors this population is exposed to, HAV vaccination and prevention programs targeting this population should be considered to prevent outbreaks and the burden of the disease.

Human T cell lymphotropic virus type 1 infection among men who have sex with men in Central Brazil.

Human T cell lymphotropic virus type 1 (HTLV-1) was the first retrovirus discovered in humans and is endemic in several parts of the world. Because of risk behaviors, mainly sexual, men who have sex with men (MSM) are at high risk of acquiring HTLV-1 infection. A cross-sectional study was performed to estimate the prevalence of HTLV-1 infection, to characterize genetically HTLV-1 sequences and to identify risk behaviors associated with this infection among MSM in Central Brazil. A total of 430 MSM were enrolled in this study and three were shown to be HTLV-1 infected, prevalence of 0.7% (95% confidence interval: 0.4-0.9). Phylogenetic analysis showed that all HTLV-1 positive samples belonged to Cosmopolitan subtype Transcontinental subgroup A. Although the prevalence rate of HTLV-1 infection found in this study was similar to that observed among Brazilian blood donors, additional HTLV-1 preventive interventions need to be further implemented because this population is engaged in high-risk sexual behavior.

High-risk behaviors for hepatitis B and C infections among female sex workers.

INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.

Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil.

The aim of this multicenter, cross sectional study was to assess the prevalence, incidence and associated risk factors among incarcerated populations from twelve Brazilian prisons. The total of 3,368 individuals from twelve prisons was randomly recruited between March 2013 and March 2014. Participants were interviewed, and provided blood samples which were tested for antibodies to Hepatitis C (HCV ab). One year after the first investigation, a cohort study was conducted with 1,656 inmates who participated the cross sectional study. Positive samples were tested for the presence of HCV RNA. Out of 3,368 inmates, 520 (15.4%) were females, and 2,848 (84.6%) were males. The overall prevalence of HCV was 2.4% (95% CI: 1.9 to 2.9), with 0.6% (95% CI: 0.4 to 0.8) in females, and 2.7% (95% CI: 2.1 to 3.3) in males (p<0.01). HCV RNA was detected in 51/80 (63.7%) samples. Among men prisoners, multivariate analysis of associated factors showed independent associations between HCV exposure and increasing age, inject drug use, length of incarceration, smoking hashish, sharing needle and syringe and HIV positivity. During the cohort study, 7/1,656 new cases of HCV infection were detected, and the incidence rate was 0.4/100 person-year. Once high frequency rates of specific HCV risk behaviors and new HCV infections have been identified inside prisons, effective interventions strategies such as screening, clinical evaluation and treatment to reduce the spread of HCV infection are essential.

Infecção por Giardia duodenalis entre crianças em idade escolar no sul do Mato Grosso / Infection by Giardia duodenalis among school-age children in the south of Mato Grosso / Infección por Giardia duodenalis entre niños en edad escolar en el sur del Mato Grosso

Justificativa e Objetivos: A giardíase representa um problema de saúde pública com possibilidade de ocasionar agravos no desenvolvimento físico e mental, particularmente em crianças. Assim, destaca-se a relevância em efetuar a avaliação parasitológica desse público e seus determinantes. Desse modo, essa pesquisa teve como objetivo avaliar a prevalência e fatores associados à infecção por Giardia duodenalis em crianças matriculadas entre o 1º e 3º ano do ensino fundamental em duas unidades de ensino de um município no sul de Mato Grosso. Métodos: Após o consentimento dos pais e crianças, foram entregues o questionário socioepidemiológico e o coletor universal, contendo solução conservante para a coleta única de amostra fecal, que foi analisada pela técnica de sedimentação espontânea. Resultados: Foram incluídos 60 participantes com média de idade de 7,05 anos e predominância do sexo masculino (53,3%). A prevalência global de enteroparasitas foi de 36,7%, dos quais 54,5% estavam infectados por G. duodenalis. Foi encontrada associação significativa entre a ocorrência dessa infecção e o fato de a criança pertencer à família que declarou não possuir renda financeira (p=0,04). Conclusão: A infecção por G. duodenalis em crianças em idade escolar persiste e está associada à ausência de renda financeira familiar. Tais achados evidenciam a necessidade de melhoria das condições de vida, ações de educação em saúde e tratamento medicamentoso dessa população.(AU)

Background and Objectives: Giardiasis represents a health public problem that may damage the physical and mental development, particularly of children. Therefore, the importance of performing the parasitological evaluation of this population and its determinants is highlighted. Thus, this study aimed to evaluate the prevalence and factors associated with Giardia duodenalis infection in children enrolled between the 1st and 3rd grades of primary education in two educational units in the south of Mato Grosso. Methods: After the consent of parents and children, the socioepidemiological questionnaire and the universal collector containing a preservative solution for the single fecal sample collection were handed out, which were analyzed by the spontaneous sedimentation technique. Results: Sixty participants with mean age of 7.05 years and male predominance (53.3%) were included. The overall prevalence of enteroparasites was 36.7%, of which 54.5% was infected by G. duodenalis. A significant association was found between the occurrence of this infection and the fact that the child belonged to the family that declared not having financial income (p = 0.04). Conclusion: G. duodenalis infection in school-age children persists and is associated with the absence of family financial income. These findings highlight the need to improve this population's living conditions, health education practices, and drug treatment access.(AU)

Justificación y Objetivos: La giardiasis representa un problema de salud pública con posibilidad de ocasionar agravios en el desarrollo físico y mental, particularmente en niños. Así se pone en relieve la importancia en efectuar la evaluación parasitológica de ese público y sus determinantes. De este modo, esta investigación tuvo como objetivo evaluar la prevalencia y los factores asociados a la infección por Giardia duodenalis en niños matriculados entre el 1º y el 3º año de la enseñanza básica en dos unidades de enseñanza en un distrito en el sur de Mato Grosso (Brasil). Métodos: Después del consentimiento de los padres y de los niños, se les entregó el cuestionario socioepidemiológico y el colector universal conteniendo solución conservante para extraer una única muestra fecal, que fue analizada por el técnica de sedimentación espontánea. Resultados: Se incluyeron 60 participantes con media de edad de 7,05 años y predominancia del sexo masculino (53,3%). La prevalencia global de enteroparasitas fue del 36,7%, de los cuales el 54,5% estaban infectados por G. duodenalis. Se encontró una asociación significativa entre la ocurrencia de esta infección y el hecho del niño pertenecer a la familia que declaró no tener ingresos financieros (p = 0,04). Conclusión: La infección por G. duodenalis en niños en edad escolar persiste y estuvo esencialmente asociada a la ausencia de renta financiera familiar. Estos resultados evidencian la necesidad de mejorar las condiciones de vida, de contar con acciones de educación en salud y tratamiento medicamentoso para esa población.(AU)

Human T cell lymphotropic virus type 1 infection among men who have sex with men in Central Brazil

ABSTRACT Human T cell lymphotropic virus type 1 (HTLV-1) was the first retrovirus discovered in humans and is endemic in several parts of the world. Because of risk behaviors, mainly sexual, men who have sex with men (MSM) are at high risk of acquiring HTLV-1 infection. A cross-sectional study was performed to estimate the prevalence of HTLV-1 infection, to characterize genetically HTLV-1 sequences and to identify risk behaviors associated with this infection among MSM in Central Brazil. A total of 430 MSM were enrolled in this study and three were shown to be HTLV-1 infected, prevalence of 0.7% (95% confidence interval: 0.4-0.9). Phylogenetic analysis showed that all HTLV-1 positive samples belonged to Cosmopolitan subtype Transcontinental subgroup A. Although the prevalence rate of HTLV-1 infection found in this study was similar to that observed among Brazilian blood donors, additional HTLV-1 preventive interventions need to be further implemented because this population is engaged in high-risk sexual behavior.

High-risk behaviors for hepatitis B and C infections among female sex workers

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.

Prevalência de enteroparasitos em crianças de uma unidade de educação infantil municipal de Rondonópolis ­ MT / Prevalence of enteroparasites in children of a municipal infant education unit of Rondonópolis - MT

Objetivos: Este estudo teve como um de seus objetivos avaliar a presença de enteroparasitos em crianças que frequentavam um Centro de Educação Municipal Infantil (CMEI) de Rondonópolis - MT. Métodos: Foram realizadas as coletas das amostras fecais no período de março a maio de 2016 e, posteriormente, analisadas pelo método de Hoffman, Pons e Janer (HPJ) no laboratório de Ciências Básicas da Universidade Federal de Mato Grosso, Campus Universitário de Rondonópolis, finalizando com um questionário sócio demográfico de fatores de risco para a infecção. Resultados: Entre as 57 crianças pesquisadas, detectou-se positividade para enteroparasitoses em 10 (17,54%) delas, o parasita mais prevalente foi a Giardia lamblia (70%). Em relação ao sexo, a maior positividade das amostras se deu entre crianças do sexo masculino. Conclusão: Os achados dessa pesquisa demonstram que, embora o Ministério da Saúde venha aplicando medidas de controle dos enteroparasitos como o Programa Saúde na Escola, mais medidas deverão ser tomadas, principalmente pelos profissionais de saúde da Atenção Primária. Uma medida simples e eficaz é a educação em saúde executada de forma específica para a conscientização dessas crianças e de seus responsáveis sobre cuidados e higienização para uma melhor qualidade de vida. (AU)

Objectives: This study had as one of its objectives the evaluation of the presence of enteroparasites in children attending a Municipal Infant Education Center (CMEI) in Rondonópolis - MT. Methods: Feces samples were collected from March to May of 2016 and later analyzed by the method of Hoffman, Pons and Janer (HPJ) in the laboratory of Basic Sciences of the Federal University of Mato Grosso, Campus Universitário de Rondonópolis, ending with a Sociodemographic questionnaire and risk factors for infection. Results: Among the 57 children surveyed, 10 (17.54%) of them were positive for enteroparasitoses, the most prevalent parasite was Giardia lamblia (70%). In relation to sex, the greatest positivity occurred among male children. Conclusion: The findings of this research demonstrate that although the Ministry of Health has been implementing measures to control enteroparasites, such as the School Health Program. More actions should be taken, mainly by primary health care professionals. A simple and effective measure is health education to raise awareness of these children and their caregivers about care and hygiene for a better quality of life. (AU)