Prevalence, Risk Factors and Vaccine Response against Hepatitis B in People Aged 50 Years or Older.

Universal immunization against hepatitis B has contributed to reducing incidence of the disease, but older individuals remain susceptible to acquiring the hepatitis B virus worldwide. Thus, this study aimed to investigate the epidemiology of HBV infection in individuals aged 50 years and over in central Brazil and to evaluate the immunogenicity of the monovalent vaccine against hepatitis B in this age group using two vaccine regimens. METHOD: Initially, a cross-sectional and analytical study was carried out to investigate the epidemiology of hepatitis B. Then, individuals without proof of vaccination for hepatitis B were recruited for a phase IV randomized and controlled clinical trial using two vaccine regimens: Intervention Regimen (IR) (three doses of 40 µg at months 0, 1 and 6) vs. Comparison Regimen (CR) (three doses of 20 µg at months 0, 1 and 6). RESULTS: The overall prevalence of exposure to HBV was 16.6% (95% CI: 14.0%-9.5%). In the clinical trial, statistical differences in protective titers were observed (p = 0.007; IR 96% vs. CR 86%) and the geometric mean of anti-HBs titers was higher in individuals who received the IR (518.2 mIU/mL vs. 260.2 mIU/mL). In addition, the proportion of high responders was higher among those who received the IR (65.3%). CONCLUSION: reinforced doses should be used in individuals aged 50 years or older to overcome the lower efficacy of the vaccine against hepatitis B.

Timeliness and risk factors associated with delay for pneumococcal conjugate 10-valent routine immunization in Brazilian children.

BACKGROUND: Vaccination coverage is the usual metrics to evaluate the immunization programs performance. For the 10-valent pneumococcal conjugate (PCV10) vaccine, measuring the delay of vaccination is also important, particularly as younger children are at increased risk of disease. Routinely collected administrative data was used to assess the timeliness of PCV10 vaccination, and the factors associated with delay to receive the first and second doses, and the completion of the PCV10 3+1 schedule. METHODS: A population-based retrospective cohort study was conducted with children born in 2012 in Central Brazil. Children who received the PCV10 first dose in public health services were followed-up until 23months of age. Timeliness of receiving each PCV10 dose at any given age was defined as receiving the dose within 28days grace period from the recommended age by the National Immunization Program. Log-binomial regression models were used to examine risk factors for delays of the first dose and the completion PCV10 3+1 schedule. RESULTS: In total, 14,282 children were included in the cohort of study. Delayed vaccination occurred in 9.4%, 23.8%, 36.8% and 39.9% children for the first, second, third and the booster doses, respectively. A total of 1912 children (12.8% of the cohort) were not adequately vaccinated at the 6months of life; 1,071 (7%) received the second dose after 6months of age, 784 (5.4%) did not receive the second dose, and 57 (0.4%) received the first dose after six months of life. CONCLUSION: A considerable delay was found in PCV10 third and booster doses. Almost 2 thousand children had not received the recommended PCV10 doses at 6months of age. Timeliness of vaccination is an issue in Brazil although high vaccination coverages.

Epidemiology of the viral hepatitis B and C in female prisoners of Metropolitan Regional Prison Complex in the State of Goiás, Central Brazil.

INTRODUCTION: Little information regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian female prisoners exists. This study investigated the prevalence and risk factors associated with HBV and HCV infections and identified viral genotypes among female prisoners in Goiás, Central Brazil. METHODS: Women incarcerated in the largest prison in the State of Goiás were invited to participate in the study. All female prisoners were interviewed and tested for the detection of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), against hepatitis B core antigen (anti-HBc), and antibody against HCV (anti-HCV) by ELISA. HBsAg and anti-HCV positive samples were tested for HBV DNA and HCV RNA and genotyped, respectively. RESULTS: Participants (n = 148; 98.6%) completed the study with an overall HBV prevalence of 18.9%. Age >30 years, a low education level, sex with a sexually transmitted diseases carrier, and a male sexual partner serving in the same penitentiary were associated with HBV infections. Only 24% of the women were anti-HBs positive suggesting previous HBV vaccination. Nine female prisoners (6.1%) were anti-HCV positive. Age >40 years, injecting drug use and length of incarceration were statistically associated with anti-HCV antibodies. Five samples were HCV RNA positive and classified as genotypes 1 (subtypes 1a; n = 3 and 1b; n = 1) and 3 (subtype 3a; n = 1). The HBsAg-reactive sample was HBV DNA positive and genotype A. CONCLUSIONS: These findings highlight the necessity of public policies to control hepatitis B and C infections and emphasize the importance of hepatitis B vaccination in prison environments.

Epidemiology of the viral hepatitis B and C in female prisoners of Metropolitan Regional Prison Complex in the State of Goiás, Central Brazil

INTRODUCTION: Little information regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian female prisoners exists. This study investigated the prevalence and risk factors associated with HBV and HCV infections and identified viral genotypes among female prisoners in Goiás, Central Brazil. METHODS: Women incarcerated in the largest prison in the State of Goiás were invited to participate in the study. All female prisoners were interviewed and tested for the detection of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), against hepatitis B core antigen (anti-HBc), and antibody against HCV (anti-HCV) by ELISA. HBsAg and anti-HCV positive samples were tested for HBV DNA and HCV RNA and genotyped, respectively. RESULTS: Participants (n=148; 98.6%) completed the study with an overall HBV prevalence of 18.9%. Age >30 years, a low education level, sex with a sexually transmitted diseases carrier, and a male sexual partner serving in the same penitentiary were associated with HBV infections. Only 24% of the women were anti-HBs positive suggesting previous HBV vaccination. Nine female prisoners (6.1%) were anti-HCV positive. Age >40 years, injecting drug use and length of incarceration were statistically associated with anti-HCV antibodies. Five samples were HCV RNA positive and classified as genotypes 1 (subtypes 1a; n=3 and 1b; n=1) and 3 (subtype 3a; n=1). The HBsAg-reactive sample was HBV DNA positive and genotype A. CONCLUSIONS: These findings highlight the necessity of public policies to control hepatitis B and C infections and emphasize the importance of hepatitis B vaccination in prison environments.

Alterações celulares em exame colpocitológico de reeducandas do complexo prisional da região metropolitana de Goiânia / Cellular changes in vaginal smears of inmates of the prison complex in the metropolitan area of Goiânia

Introdução: a colpocitologia oncótica tem se mostrado um método de triagem eficaz na prevenção de câncer de colo uterino e de suas lesões precursoras.Objetivo: identificar as alterações celulares presentes nos resultados da colpocitologia oncótica realizada em reeducandas. Métodos: estudo de cortetransversal e analítico, realizado com reeducandas do Complexo Prisional da Região Metropolitana de Goiânia, Goiás. Resultados: participaram da entrevista 148 mulheres, e 104 realizaram o exame colpocitológico. A população constituiu-se por mulheres que possuíam no máximo 30 anos de idade(57,6%), eram naturais de Goiás (66,3%), solteiras (45,2%), com baixa escolaridade e baixa renda. Quanto à adequabilidade da amostra, 94,2% foram consideradas satisfatórias. O exame colpocitológico identificou 10,2% de alterações celulares classificadas em: ASC-US (4,1%), ASG-US (2,0%), LSIL(1,0%) e HSIL (3,1%). Conclusão: os resultados deste estudo mostram a necessidade de adoção de políticas de saúde voltadas para este grupo.

Introduction: the Pap smear has proven an effective method of screening in preventing cervical cancer and premalignant lesions. Objective: identify the cellular changes present in the results of Pap smear performed on inmates. Methods: cross-sectional study and analytical study carried out with thein mates of the Metropolitan Prison Complex in Goiania, Goias. Results: 148 women participated in the interview and 104 underwent the Pap test. Thepopulation consisted of women who had at least 30 years of age (57.6%) were born in Goias (66.3%), single (45.2%), low education and low in come. Asto the adequacy of the sample, 94.2% were considered satisfactory. The smear test identified 10.2% of cell changes classified as ASC-US (4.1%), ASG-US(2.0%), LSIL (1.0%) and HSIL (3.1%). Conclusion: the results of this study show the need for adoption of health policies aimed at this group.

[Risk behaviors for sexually transmitted diseases among truck drivers in Brazil]. / Comportamentos de risco para doenças sexualmente transmissíveis em caminhoneiros no Brasil.

OBJECTIVE: To evaluate the frequency of sexually transmitted diseases (STD) and associated risk factors based on self-reporting by long-haul truck drivers in Brazil. METHOD: From October 2005-October 2006, 641 long-haul truck drivers that travel federal highway BR-153, traversing the country from south to north, were interviewed. A structured interview was used to collect sociodemographic data. The truck drivers also completed a self-administered questionnaire on risk behaviors and STD history. The data were adjusted and analyzed using logistic regression. RESULTS: Of 641 drivers interviewed, 620 (96.7%) provided answers on STD history. Of these, 35.6% (95% confidence interval (CI) = 31.9-39.6) reported past or current STD. Being 30 years of age or older was statistically associated with having a history of STD. In addition, truck drivers who reported using amphetamines (odds ratio (OR) = 1.7; 95%CI = 1.1-2.6), having been incarcerated (OR = 2.2; 95%CI = 1.2-4.2), and sexual relations with sex professionals (OR = 1.9; 95%CI = 1.3-2.8) had increased odds for having a history of STD. CONCLUSION: These results confirm that Brazilian truck drivers are highly vulnerable to STD and show the importance of prevention programs targeting this specific group, one that is constantly on the move and may efficiently disseminate STD.

Comportamentos de risco para doenças sexualmente transmissíveis em caminhoneiros no Brasil / Risk behaviors for sexually transmitted diseases among truck drivers in Brazil

OBJETIVO: Avaliar a freqüência de doenças sexualmente transmissíveis (DST) e os fatores de risco a elas associados conforme auto-relato em caminhoneiros de rota longa no Brasil. MÉTODO: De outubro de 2005 a outubro de 2006, foram entrevistados 641 caminhoneiros de rota longa que circulam na BR-153, uma rodovia federal que atravessa o Brasil de sul a norte. Um roteiro estruturado foi usado para a coleta de dados sociodemográficos. Os caminhoneiros responderam ainda a um questionário auto-aplicável sobre comportamentos de risco e antecedentes de DST. Os dados foram ajustados e analisados por regressão logística. RESULTADOS: Dos 641 entrevistados, 620 (96,7 por cento) responderam sobre antecedentes de DST. Desses, 35,6 por cento (IC95 por cento: 31,9 a 39,6) referiram história presente ou passada de DST. A idade superior a 30 anos foi estatisticamente associada ao relato de DST. Ainda, os caminhoneiros que relataram o uso de anfetaminas ("rebite") (razão de chances, OR: 1,7; IC95 por cento: 1,1 a 2,6), antecedentes prisionais (OR: 2,2; IC95 por cento: 1,2 a 4,2) e relacionamento sexual com profissionais do sexo (OR: 1,9; IC95 por cento: 1,3 a 2,8) apresentaram maior chance de relato de DST. CONCLUSÃO: Os resultados deste estudo ratificam a elevada vulnerabilidade dos caminhoneiros brasileiros às DST e evidenciam a importância de programas específicos de prevenção de doenças e promoção da saúde para esse grupo-alvo, que vive em constante deslocamento, sendo eficaz em disseminar as DST.

OBJECTIVE: To evaluate the frequency of sexually transmitted diseases (STD) and associated risk factors based on self-reporting by long-haul truck drivers in Brazil. METHOD: From October 2005-October 2006, 641 long-haul truck drivers that travel federal highway BR-153, traversing the country from south to north, were interviewed. A structured interview was used to collect sociodemographic data. The truck drivers also completed a self-administered questionnaire on risk behaviors and STD history. The data were adjusted and analyzed using logistic regression. RESULTS: Of 641 drivers interviewed, 620 (96.7 percent) provided answers on STD history. Of these, 35.6 percent (95 percent confidence interval (CI) = 31.9-39.6) reported past or current STD. Being 30 years of age or older was statistically associated with having a history of STD. In addition, truck drivers who reported using amphetamines (odds ratio (OR) = 1.7; 95 percentCI = 1.1-2.6), having been incarcerated (OR = 2.2; 95 percentCI = 1.2-4.2), and sexual relations with sex professionals (OR = 1.9; 95 percentCI = 1.3-2.8) had increased odds for having a history of STD. CONCLUSION: These results confirm that Brazilian truck drivers are highly vulnerable to STD and show the importance of prevention programs targeting this specific group, one that is constantly on the move and may efficiently disseminate STD.