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1.
Epidemiol Health ; 41: e2019038, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31715685

RESUMO

The 2019 hepatitis A outbreak has become increasingly prevalent among adults in Korea and is the largest outbreak since that in 2009-2010. The incidence in the current outbreak is highest among adults aged 35-44 years, corresponding to the peak incidence among those aged 25-34 years 10 years ago. This may indicate a cohort effect in the corresponding age group. Causes of these repeated outbreaks of hepatitis A in Korea are low level of immunity among adults, Korean food culture that consumes raw seafood such as salted clam and inadequate public health system. Among countermeasures, along with general infectious disease control measures including control of the infectious agent, infection spread, and host, urgent actions are needed to review the vaccination policy and establish an adequate public health system.


Assuntos
Surtos de Doenças , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Adulto , Surtos de Doenças/prevenção & controle , Política de Saúde , Vacinas contra Hepatite A/administração & dosagem , Humanos , Saúde Pública , República da Coreia/epidemiologia , Fatores de Risco
2.
Top Antivir Med ; 27(3): 101-110, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31634861

RESUMO

Among individuals with HIV infection, liver disease remains an important cause of morbidity and mortality, even with the availability of agents that cure hepatitis C infection and suppress hepatitis B replication. The causes of liver disease are multifaceted and continue to evolve as the population ages and new etiologies arise. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis and hepatitis viruses such as A, D, and E have emerged even as hepatitis C has receded. Newer antiretroviral agents may increase risk of weight gain and subsequent fatty infiltration, and prior use of nucleotide-based therapies may continue to impact liver health. Several barriers including economics, social stigma, and psychiatric disease impact identification of liver disease, as well as management and treatment interventions. Hepatocellular carcinoma is emerging as a more common and late-diagnosed complication in those with HIV infection and liver disease.


Assuntos
Infecções por HIV/complicações , Hepatite Viral Humana/complicações , Hepatopatias/etiologia , Fígado/virologia , Antirreumáticos/uso terapêutico , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/etiologia , Fígado Gorduroso/complicações , Fígado Gorduroso/epidemiologia , Fígado Gorduroso Alcoólico/complicações , Fígado Gorduroso Alcoólico/epidemiologia , Infecções por HIV/epidemiologia , Hepatite A/complicações , Hepatite A/epidemiologia , Hepatite B/complicações , Hepatite B/epidemiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite D/complicações , Hepatite D/epidemiologia , Hepatite E/complicações , Hepatite E/epidemiologia , Vírus de Hepatite , Hepatite Viral Humana/epidemiologia , Humanos , Fígado/lesões , Hepatopatia Gordurosa não Alcoólica
3.
Int J Health Care Qual Assur ; 32(8): 1175-1199, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31566514

RESUMO

PURPOSE: Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a "developed" area: the USA, and a less economically developed country (LEDC), generally known as a "developing" area: the state of Rio de Janeiro, Brazil. DESIGN/METHODOLOGY/APPROACH: This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected. FINDINGS: The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination. ORIGINALITY/VALUE: This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study's approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.


Assuntos
Análise Custo-Benefício , Países em Desenvolvimento , Hepatite A/prevenção & controle , Vacinação/economia , Vacinação/tendências , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Hepatite A/epidemiologia , Humanos , Lactente , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Adulto Jovem
4.
Infect Dis Poverty ; 8(1): 80, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31578150

RESUMO

BACKGROUND: Hepatitis A (HepA) vaccination and economic transitions can change the epidemiology of HepA. China's Gross Domestic Product (GDP) per capita was known to be inversely associated with the incidence of HepA, but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking. We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China. METHODS: We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season. We categorized the country into three regions, the sequential years into five era, compared the incidence, quartile age, seasonal intensity and coverage of HepA of the three regions. Linear regression was performed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence. RESULTS: The annual mean incidences of HepA in the eastern, central, and western regions decreased from 63.52/100 000, 50.57/100 000 and 46.39/100 000 in 1990-1992 to 1.18/100 000, 1.05/100 000 and 3.14/100 000 in 2012-2017, respectively. Decreases in incidence were seen in all age groups in the three regions; the incidence was highest (9.3/100 000) in the youngest age group (0-4 years) of the western region, while in the central region, the age group with the highest incidence changed from 0 to 9 years to adults ≥60 years old. In 2017, the median age of HepA cases was 43 years (Q1-Q3: 33-55), 47 years (Q1-Q3: 32-60) and 33 years (Q1-Q3: 9-52) in the eastern, central, and western provinces, respectively. Seasonal peaks became smaller or were nearly elimination nationwide, but seasonality persisted in some provinces. After the Expanded Program on Immunization (EPI) included HepA vaccine into the routine schedule in 2007, HepA coverage increased to > 80% in the three regions and was negatively association with the HepA incidence. CONCLUSION: The incidence of HepA decreased markedly between 1990 and 2017. A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system, but inequity in incidence still existed in lower socio-economic developed region.


Assuntos
Vacinas contra Hepatite A/administração & dosagem , Hepatite A/epidemiologia , Programas de Imunização/estatística & dados numéricos , Fatores Socioeconômicos , Vacinação/estatística & dados numéricos , China/epidemiologia , Geografia , Hepatite A/virologia , Incidência , Estudos Longitudinais , Estações do Ano , Fatores de Tempo
5.
J Korean Med Sci ; 34(36): e230, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31538417

RESUMO

Until 1995, the incidence of symptomatic acute hepatitis A was minimal and there were no cases of national outbreak in Korea. However, there was a nationwide outbreak of hepatitis A that peaked in 2009. In 2019, a total of 10,083 cases of acute hepatitis A were reported for seven months of the year according to the Korea Center for Disease Control and Prevention. This may be attributed to the proportion of susceptible subjects in the Korean population, as about 10 years have passed since herd immunity was induced by the epidemic occurring during the late 2000s. Recent studies have shown that the rate of seropositivity for anti-hepatitis A virus antibodies (anti-HAV) is the lowest in adults in their 20s and has not changed much over the past 10 years, and seropositivity of anti-HAV in adults in their 30s has continued to decline from 69.6% in 2005 to 32.4% in 2014. Most young adults who have not yet experienced hepatitis A and are not vaccinated are vulnerable to hepatitis A infection. This year's epidemic of hepatitis A is a predictable outcome for vulnerable populations. Therefore, effective acute hepatitis A control and prevention strategies are needed, particularly for those in their 20s and 30s.


Assuntos
Hepatite A/prevenção & controle , Doença Aguda , Efeitos Psicossociais da Doença , Hepatite A/diagnóstico , Hepatite A/epidemiologia , Anticorpos Anti-Hepatite A/sangue , Humanos , Prevalência , República da Coreia/epidemiologia
6.
Public Health Rep ; 134(6): 651-659, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31539482

RESUMO

OBJECTIVES: Despite recommendations for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) for all adults at increased risk of infection, several US states have reported increases in HAV and HBV infections among persons who inject drugs. We investigated hepatitis A and hepatitis B vaccination coverage among a sample of persons who reported injecting drugs and had evidence of hepatitis C virus (HCV) infection. METHODS: We searched the Wisconsin Immunization Registry for the vaccination records of persons who underwent HCV testing at syringe services programs from January 1 through August 31, 2018, and were reported to the Wisconsin Division of Public Health as having positive HCV antibody test results and a history of injection drug use. We calculated the percentage of persons who were vaccinated according to national recommendations. RESULTS: Of 215 persons reported, 204 (94.9%) had a client record in the Wisconsin Immunization Registry. Of these 204 persons, 66 (32.4%) had received ≥1 dose of hepatitis A vaccine, 46 (22.5%) had received 2 doses of hepatitis A vaccine, and 115 (56.4%) had received 3 doses of hepatitis B vaccine. Hepatitis B vaccine coverage decreased with increasing age, from 88.0% (22 of 25) among adults aged 20-24 to 30.3% (10 of 33) among adults aged 35-39. CONCLUSIONS: These findings suggest that most persons who inject drugs in Wisconsin are susceptible to HAV infection and that most persons aged ≥35 who inject drugs are susceptible to HBV infection. In addition to routine vaccination of children, targeted hepatitis vaccination programs should focus on adults who inject drugs to help prevent future infections.


Assuntos
Hepatite A/epidemiologia , Hepatite B/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Feminino , Vacinas contra Hepatite A/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/imunologia , Wisconsin/epidemiologia
7.
MMWR Morb Mortal Wkly Rep ; 68(35): 766-770, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31487277

RESUMO

Hepatitis A virus (HAV) is an RNA virus primarily transmitted via the fecal-oral route and, in rare cases, causes liver failure and death in infected persons. Although drinking water-associated hepatitis A outbreaks in the United States are rarely reported (1), HAV was the most commonly reported etiology for outbreaks associated with untreated ground water during 1971-2008 (2), and HAV can remain infectious in water for months (3). This report analyzes drinking water-associated hepatitis A outbreaks reported to the Waterborne Disease and Outbreak Surveillance System (WBDOSS) during 1971-2017. During that period, 32 outbreaks resulting in 857 cases were reported, all before 2010. Untreated ground water was associated with 23 (72%) outbreaks, resulting in 585 (68.3%) reported cases. Reported outbreaks significantly decreased after introduction of Advisory Committee on Immunization Practices (ACIP) hepatitis A vaccination recommendations* and U.S. Environmental Protection Agency's (USEPA) public ground water system regulations.† Individual water systems, which are not required to meet national drinking water standards,§ were the only contaminated drinking water systems to cause the last four reported hepatitis A outbreaks during 1995-2009. No waterborne outbreaks were reported during 2009-2017. Water testing and treatment are important considerations to protect persons who use these unregulated systems from HAV infection.


Assuntos
Surtos de Doenças/prevenção & controle , Água Potável/virologia , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Prática de Saúde Pública , Regulamentação Governamental , Vacinas contra Hepatite A/administração & dosagem , Humanos , Avaliação de Programas e Projetos de Saúde , Estados Unidos/epidemiologia , United States Environmental Protection Agency , Abastecimento de Água/legislação & jurisprudência
8.
Food Environ Virol ; 11(4): 393-399, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31420848

RESUMO

Enteroviruses (EVs) and Hepatitis A Viruses (HAVs) are human pathogens with a wide spectrum of clinical manifestations. The monitoring of sewage samples enables to monitor the EVs and HAVs in circulation among the general population and recognize possible outbreaks. This study focused on the molecular characterization and phylogenetic analysis of the EVs and HAVs identified in 33 sewage samples collected every 15 days at the influent of a wastewater treatment plant located in Northern Italy from March to October 2016. According to the results of the molecular characterization, the most frequently identified viruses were Echovirus 6 (E-6), E-11 and HAV-IA. The phylogenetic analyses indicated the rapid genetic evolution of E-6 and E-1; noteworthy, most E-11 strains clustered with a strain isolated from a clinical sample collected in the same geographical area over the same period by our laboratory. Most of the HAV strains detected clustered with epidemic HAV-IA strains identified during the European hepatitis A outbreak that occurred in 2016-2017 affecting men who have sex with men (MSM). The detection of environmental HAV strains before and at the beginning of its spread amongst humans demonstrated that this outbreak could have been predicted by monitoring sewage samples. Moreover, conducting a genetic comparison between the HAV and EV strains identified in sewage and clinical samples may improve knowledge of viral epidemiology. EV and HAV molecular environmental surveillance may prove useful for identifying viral circulation and for issuing early warning alerts on possible outbreaks among the human population.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/genética , Vírus da Hepatite A/genética , Hepatite A/virologia , Filogenia , Esgotos/virologia , Enterovirus/classificação , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Hepatite A/epidemiologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/isolamento & purificação , Humanos , Itália/epidemiologia
9.
BMC Infect Dis ; 19(1): 651, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331281

RESUMO

BACKGROUND: Hepatitis A, caused by the hepatitis A virus (HAV), is a vaccine preventable disease. In Low and Middle-Income Countries (LMICs), poor hygiene and sanitation conditions are the main risk factors contributing to HAV infection. There have been, however, notable improvements in hygiene and sanitation conditions in many LMICs. As a result, there are studies showing a possible transition of some LMICs from high to intermediate HAV endemicity. The World Health Organization (WHO) recommends that countries should routinely collect, analyse and review local factors (including disease burden) to guide the development of hepatitis A vaccination programs. Up-to-date information on hepatitis A burden is, therefore, critical in aiding the development of country-specific recommendations on hepatitis A vaccination. METHODS: We conducted a systematic review to present an up-to-date, comprehensive synthesis of hepatitis A epidemiological data in Africa. RESULTS: The main results of this review include: 1) the reported HAV seroprevalence data suggests that Africa, as a whole, should not be considered as a high HAV endemic region; 2) the IgM anti-HAV seroprevalence data showed similar risk of acute hepatitis A infection among all age-groups; 3) South Africa could be experiencing a possible transition from high to intermediate HAV endemicity. The results of this review should be interpreted with caution as the reported data represents research work with significant sociocultural, economic and environmental diversity from 13 out of 54 African countries. CONCLUSIONS: Our findings show that priority should be given to collecting HAV seroprevalence data and re-assessing the current hepatitis A control strategies in Africa to prevent future disease outbreaks.


Assuntos
Hepatite A/epidemiologia , África/epidemiologia , Surtos de Doenças , Hepatite A/mortalidade , Anticorpos Anti-Hepatite A/sangue , Hospitalização/estatística & dados numéricos , Humanos , Imunoglobulina M/sangue , Pobreza , Fatores de Risco , Saneamento , Estudos Soroepidemiológicos , África do Sul/epidemiologia
10.
J Assoc Physicians India ; 67(4): 38-40, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309794

RESUMO

Introduction: Eschar is one of the most important clinical sign which helps in early diagnosis, and consequently initiation of specific treatment and prevention of complications in scrub typhus. Aims: To study the prevalence and distribution of eschar in scrub typhus and comparison of clinical manifestations and complications among patients with or without eschar. Methodology: A retrospective hospital based study in patients aged ≥ 18 years admitted to a tertiary care centre in north-eastern India. Scrub typhus was diagnosed based on clinical features supported by serological tests (Immunochromatographic card test, IgM ELISA and Weil Felix test). Chi square test was used for comparing variables. A 'p value' <0.05 was considered as statistically significant. Results: A total of 129 patients of scrub typhus were included in the present study. Male to female ratio is 1.93:1 with the commonest age group being 18-30 years followed by 30-40 years. Eschar was found in 24.8% patients with 9.3% having multiple eschars and the rest had single eschar. Eschar was most commonly found in the inguinal region (28.57%) followed by trunk (25.75%) and lower limbs (22.85%). Presence of multi-organ dysfunction (p=0.008), hepatitis (p=0.005) and lymphadenopathy (p<0.01) were significantly higher in those patients who had eschar. Conclusion: The common sites of distribution of eschar are the inguinal region, lower limbs and trunk and multiorgan dysfunction is more commonly associated with eschars.


Assuntos
Tifo por Ácaros/epidemiologia , Adolescente , Feminino , Hepatite A/epidemiologia , Humanos , Índia/epidemiologia , Masculino , Estudos Retrospectivos , Testes Sorológicos
11.
Emerg Infect Dis ; 25(8): 1594-1596, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310213

RESUMO

We implemented subgenomic and whole-genome sequencing to support the investigation of a large hepatitis A virus outbreak among persons experiencing homelessness, users of illicit drugs, or both in California, USA, during 2017-2018. Genotyping data helped confirm case-patients, track chains of transmission, and monitor the effectiveness of public health control measures.


Assuntos
Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Hepatite A/virologia , Tipagem Molecular , California/epidemiologia , Surtos de Doenças , Genótipo , Hepatite A/história , Hepatite A/transmissão , Vírus da Hepatite A/imunologia , Vírus da Hepatite A/isolamento & purificação , História do Século XXI , Humanos , Vigilância em Saúde Pública , Proteínas Virais/genética , Sequenciamento Completo do Genoma
12.
Emerg Infect Dis ; 25(8): 1501-1510, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310226

RESUMO

Immigrants traveling to their birth countries to visit friends or relatives are disproportionately affected by travel-related infections, in part because most preventive travel health services are not publicly funded. To help identify cost-effective policies to reduce this disparity, we measured the medical costs (in 2015 Canadian dollars) of 3 reportable travel-related infectious diseases (hepatitis A, malaria, and enteric fever) that accrued during a 3-year period (2012-2014) in an ethnoculturally diverse region of Canada (Peel, Ontario) by linking reportable disease surveillance and health administrative data. In total, 318 case-patients were included, each matched with 2 controls. Most spending accrued in inpatient settings. Direct healthcare spending totaled $2,058,196; the mean attributable cost per case was $6,098 (95% CI $5,328-$6,868) but varied by disease (range $4,558-$7,852). Costs were greatest for enteric fever. Policies that address financial barriers to preventive health services for high-risk groups should be evaluated.


Assuntos
Custos de Cuidados de Saúde , Hepatite A/epidemiologia , Malária/epidemiologia , Doença Relacionada a Viagens , Febre Tifoide/epidemiologia , Estudos de Casos e Controles , Feminino , Hepatite A/história , História do Século XXI , Humanos , Malária/história , Masculino , Ontário/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Vigilância em Saúde Pública , Febre Tifoide/história
13.
PLoS One ; 14(6): e0216033, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31242191

RESUMO

INTRODUCTION: South Africa is considered highly endemic for hepatitis A virus (HAV) although few seroprevalence studies have been conducted over the past two decades. The World Health Organization recommends integrating HAV vaccination into national childhood immunization schedules where there is transition from high to intermediate endemicity. As a means of gauging age-specific rates of infection, we report HAV seroprevalence rates among specimens tested for HAV serology within South Africa's public health sector from 2005-2015. MATERIALS AND METHODS: Hepatitis A serology results (Anti-HAV IgM, IgG and total antibody) from 2005-2015 were extracted from South Africa's National Health Laboratory Service's Corporate Data Warehouse (NHLS CDW), the central data repository of all laboratory test-sets within the public health sector. Results were extracted according to test-set, result, date of testing, health facility, name, surname, age, and sex. Anti-HAV IgG results were merged with total antibody results to reflect anti-HAV seroprevalence. Testing volume, positivity rates and age-specific anti-HAV seroprevalence rates by year and geographic distribution are described. RESULTS AND DISCUSSION: A total of 501 083 HAV IgM results were retrieved, of which 16 423 (3.3%) were positive, 484 259 (96.6%) negative and 401 (0.1%) equivocal; and 34 710 HAV total antibody/IgG tests of which 30 675 (88.4%) were positive, 4 020 (11.6%) negative and 15 equivocal. Whereas IgM positivity was highest among the 1-4 year age group (33.5%) and lowest among patients >45 years (<0.5%), total antibody positivity ranged from its lowest level of 52.7% in the 1-4 year age group increasing to levels of >90% only after 25 years of age. CONCLUSION: Anti-HAV total antibody testing within the South African public health sector demonstrates seroprevalence rates reach levels >90% only in adulthood, suggesting South Africa could be in transition from high to intermediate endemicity. Prospective studies with geographically representative sampling are required to confirm these findings and evaluate provincial and urban/rural heterogeneity.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , África do Sul/epidemiologia , Adulto Jovem
14.
Sci Total Environ ; 686: 158-170, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31176815

RESUMO

Fecal pollution source tracking (FST) studies the origin of fecal contamination and promotes action to eliminate it to improve human health and environmental sustainability. This work presents the temporal and spatial relations of human mitochondrial DNA (HmtDNA), fecal coliforms (FC) and live microbial biomass (ATP) in seawater during a hepatitis A outbreak among a human coastal population. The study area is approximately 100 km along the coastline of the Biobío Region in the southeastern Pacific (Humboldt Current System, Chile). Total data from the swash zone from summer 2015 to autumn 2016 show there were significant positive log-log correlations between FC and HmtDNA (R = 0.32) and ATP (R = 0.31). These correlations were highest during the austral spring of 2015 (R = 0.53 and 0.58 respectively), when HmtDNA also correlated significantly with ATP (R = 0.86). Maximum average values of the parameters measured in this season showed a temporal-spatial concordance with the peak in the number of hepatitis A cases among the nearby coastal population. FC correlated significantly with HmtDNA (R = 0.98) in the water column of the coastal zone close to Concepción Bay during the austral summer of 2016 and in the swash zone of the bay (R = 0.68) throughout the study period. Hepatitis A virus (HAV) has also been detected in organisms and seawater in Concepción Bay, which is consistent with the high incidence of hepatitis A among the coastal population. The concordance between human fecal pollution in the study area and a seasonal hepatitis A outbreak strongly suggests that HmtDNA and its relation with FC and ATP in the coastal zone of marine environments can be used as a proxy to evaluate the risk of outbreaks of thalassogenic diseases.


Assuntos
Monitoramento Ambiental/métodos , Hepatite A/epidemiologia , Poluição da Água/análise , Doenças Transmitidas pela Água/epidemiologia , Chile/epidemiologia , DNA Mitocondrial/análise , Surtos de Doenças , Fezes , Humanos , Água do Mar/química , Microbiologia da Água , Poluição da Água/estatística & dados numéricos
15.
PLoS One ; 14(6): e0217176, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163046

RESUMO

To assess the current hepatitis A virus (HAV) endemicity in the Autonomous Province of Vojvodina, Serbia, we examined the seroprevalence and susceptibility profiles of the general population. A serum bank of 3466 residual samples, collected in 2015-16 as per the specifications of the European Sero-Epidemiology Network 2 project (ESEN2), was tested for anti-HAV antibodies with an enzyme immunoassay. Relationships between anti-HAV positivity and demographic features of respondents were examined by univariable and multivariable analyses. Present-day HAV seroprevalence was compared with that obtained in 1978-79. Surveillance data for hepatitis A recorded between 2008 and 2017 were also analyzed. Age was the only demographic variable found to be independently associated with a HAV seropositive status. Seropositivity (17% overall vs. 79% in 1978-79) increased with age to a maximum of 90% in the elderly ≥60 years. Only 5% of subjects <30 years were seropositive, unlike the 44% of seropositives ≥30 years. The estimated age at midpoint of population immunity (AMPI) increased markedly from 14 years in the late 70s to 55 years in 2015-16. Meanwhile, disease incidence decreased noticeably in recent years (from 11 in 2008 to 2 per 100,000 population in 2017). In the ongoing pre-vaccine era, natural infection provides immunity for merely a third (31%) and two thirds (57%) of people in their 40s and 50s, respectively. Hence, the majority of people ≤40 years (94%) and middle-aged adults 40-49 years (69%) are susceptible to HAV. Older susceptible individuals, particularly those ≥50 years (24%), are prone to severe symptoms. Taken together, these changes reflect the epidemiological transition of Vojvodina and Serbia from high to very low HAV endemicity, thereby supporting the current national policy of immunization of only high-risk groups.


Assuntos
Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Surtos de Doenças , Suscetibilidade a Doenças , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Sérvia/epidemiologia , Estudos Soroepidemiológicos , Adulto Jovem
16.
Am J Trop Med Hyg ; 101(1): 45-50, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162016

RESUMO

Waterborne pathogens, associated with poverty and poor sanitary conditions, are a major cause of morbidity and mortality worldwide. There are limited data on the epidemiology of waterborne pathogens in indigenous populations living in the Amazon region. We did a cross-sectional survey in two indigenous Shuar communities in the Amazon region of Ecuador in which we documented the presence of pathogens representing different sources of environmental contamination of water. We detected protozoa and soil-transmitted helminths by microscopy of fecal samples and the presence of IgG antibodies to hepatitis A and Leptospira spp. in blood samples from individuals older than 2 years and collected data by questionnaire on sociodemographic factors and knowledge of infectious diseases. Seroprevalence for hepatitis A and Leptospira spp. were 98.1% (95% CI: 97.0-99.8) and 50.0% (95% CI: 43.3-56.6), respectively, whereas 62.6% (95% CI: 55.8-69.4) had enteric parasites in stool samples. In participants older than 6 years, eight of 10 had evidence of infection with or exposure to at least one of the pathogens studied. Although prevalence of pathogens varied by age, it did not vary significantly by gender, temporal migration, illiteracy, perceived morbidity, receipt of conditional cash transfers, water boiling practices, poor housing conditions, and anthropometric status. These findings indicate a high level of contamination of drinking water by human pathogens in these indigenous communities and the need for interventions to improve access to and use of clean drinking water in these marginalized communities.


Assuntos
Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Hepatite A/epidemiologia , Leptospirose/epidemiologia , Microbiologia da Água , Água/parasitologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Hepatite A/sangue , Vírus da Hepatite A/imunologia , Humanos , Imunoglobulina G/sangue , Leptospira/imunologia , Leptospirose/sangue , Pessoa de Meia-Idade , Pobreza , Saneamento , Estudos Soroepidemiológicos , Abastecimento de Água , Adulto Jovem
17.
New Microbiol ; 42(3): 181-183, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31157402

RESUMO

From April to October 2017, 27 cases of Hepatitis A (HA), 22 male and 5 female, were reported in Cosenza (South Italy). The median age of cases was 32 years (range 3-49 years). Out of 21 male adults, 14 were identified as men who have sex with men (MSM). Phylogenetic analysis was conducted in 15 cases and revealed two distinct sequences of genotype IA linking to clusters recognised in MSM in other European countries in 2016; genotype IB was recognized in only 2 cases. The report confirms that HA is an emerging issue among MSM. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on local epidemiological patterns to prevent outbreaks among high risk groups and eventual spill-over of the infection into the general population.


Assuntos
Surtos de Doenças , Hepatite A , Minorias Sexuais e de Gênero , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Genótipo , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A Humana/classificação , Vírus da Hepatite A Humana/genética , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Filogenia , Adulto Jovem
18.
Int J Infect Dis ; 86: 12-14, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31238154

RESUMO

OBJECTIVES: To investigate the prevalence of anti-HAV and HEV markers in order to better understand spread of these two viruses among adults in Rwanda. METHODS: Samples from 1045 and 1133 blood donors, healthy adults and liver disease patients were analysed for anti-HAV IgG and HEV markers respectively. RESULTS: Anti-HAV was present in 96.9% (1013/1045), with proportions of immune persons increasing with age. HEV infection markers were detected in 11.9% (135/1133) without differences between the three categories. Seven persons had low levels of HEV RNA including four blood donors but none of the HEV strains could be sequenced. The highest prevalence of HEV markers was in farmers and persons from the Southern (17.3%) and Western regions (18.6%), which have the national highest density of pigs. This may indicate that pigs constitute an important source of HEV infection for humans in Rwanda. CONCLUSION: HAV remains highly endemic in Rwanda, but there may now be a decline of exposure during childhood. HEV is also endemic in Rwanda, but has a moderate spread and may be transmitted by blood transfusion. Based on the geographical and occupational differences in HEV prevalence, a possible zoonotic transmission from pigs should be further explored.


Assuntos
Vírus da Hepatite A/fisiologia , Hepatite A/epidemiologia , Vírus da Hepatite E/fisiologia , Hepatite E/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Doadores de Sangue/estatística & dados numéricos , Feminino , Hepatite A/sangue , Hepatite A/transmissão , Hepatite A/virologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/isolamento & purificação , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Hepatite E/transmissão , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Ruanda/epidemiologia , Estudos Soroepidemiológicos , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Adulto Jovem , Zoonoses/sangue , Zoonoses/epidemiologia , Zoonoses/virologia
19.
BMC Infect Dis ; 19(1): 443, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113369

RESUMO

BACKGROUND: Hepatitis A Virus (HAV) is one of the most common food and water borne infectious disease prevailing globally. The objective of the study was to determine sero-prevalence of HAV infection in a district of Sri Lanka. METHODS: This was a descriptive cross sectional study conducted on 1403 participants aged 1 year and above selected by multistage stratified (for age group and area of residence) cluster sampling from September 2015 to December, 2016. An interviewer-administered questionnaire was used to collect data and Anti-IgG testing was done to determine sero-positivity. The overall, the age and sex specific sero-prevalence of HAV were calculated with 95% confidence intervals (CI). RESULTS: Of the 1403 participants 1132 were anti HAV IgG positive. Therefore the overall sero-prevalence of HAV infection was 80.7% (95%CI: 78.64-82.76). There were 283 (20.2%) individuals below the age group of 14 years and below and out of them, 204 had anti HAV IgG, therefore sero-prevalence was 72.1% for that age group. The age group 15 years and aboe comprised of 1120 (79.8%) participants and of them 928 had anti HAV IgG, making sero-prevalence 82.9%. The lowest sero-prevalence (66.9%, n = 232) was observed in the age group of 11-20 years followed by 21-30 age group. From age 31 years onwards, the sero-prevalence exceeded 90%, reaching 100% after 71 years. The urban population showed a sero-prevalence of 83% (n = 195) and 80.2% (n = 937) for the rural sector while females had a sero-prevalence of 82.2% (n = 766) and it was 77.7% (n = 366) for males. Thirty-four (3.0%) participants who had sero-positive results (n = 1132) claimed that they have had HAV in the past. CONCLUSIONS: Overall, four fifth of the population was immune to HAV infection in the district of Gampaha.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/sangue , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Anticorpos Anti-Hepatite A/imunologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Sri Lanka/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
20.
S Afr Med J ; 109(5): 314-318, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31131797

RESUMO

BACKGROUND: Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A. OBJECTIVES: To determine the seroprevalence of hepatitis A infection in Western Cape Province (WCP), South Africa. METHODS: We conducted a cross-sectional seroprevalence study in the 1 - 7-year age group in WCP. Our samples (N=482) were blood specimens left over after laboratory testing obtained from referral hospitals between August and October 2015. A Siemens enzyme immunoassay was used to test for total hepatitis A antibodies. We also analysed hepatitis A immunoglobulin G antibody results from the National Health Laboratory Service (NHLS) Disa*Lab database at Groote Schuur Hospital from 2009 to 2014, and included 2009 - 2014 acute hepatitis A (immunoglobulin M-positive) surveillance data from the National Institute for Communicable Diseases to look at trends in notified acute infections over the same period. RESULTS: Our cross-sectional study showed 44.1% seroprevalence in the 1 - 7-year age group. Hepatitis A data from the NHLS database indicated a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The surveillance data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7 - 40-year age group, suggesting that an increasing proportion of the population is susceptible to HAV infection. CONCLUSIONS: These results suggest an urgent need for detailed evidence-based considerations to introduce hepatitis A vaccine into the EPI-SA.


Assuntos
Anticorpos Anti-Hepatite A/análise , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/virologia , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , África do Sul/epidemiologia
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