Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil.

BACKGROUND: In recent decades the epidemic of asymptomatic sexually transmitted infections has extended deep into Brazil, including small towns and rural areas. The purpose of this study was to investigate the epidemiology of HIV, syphilis, and hepatitis B (HBV) and hepatitis C viruses (HCV), and to evaluate immunization coverage against hepatitis B in a group of rural workers in Brazil. METHODS: In 2016, a cross-sectional study was conducted with 937 manual sugarcane cutters of the Midwest and Northeast Regions of Brazil. All individuals were interviewed and screened for HIV, syphilis, HBV and HCV. Correlating factors with lifetime HBV infection were investigated using logistic regression. Positive Predictive Values, Negative Predictive Values, sensitivity and specificity were also calculated relative to vaccination against Hepatitis B, comparing anti-HBs titers to vaccination reports. RESULTS: Most reported previous hospitalization (55%), occupational injuries (54%), sharing of personal items (45.8%), alcohol consumption (77.2%), multiple sexual partners in previous 12 months (39.8%), and no condom use during sexual intercourse in last 12 months (46.5%). Only 0.2% reported using injection drugs. Anti-HIV-1 was detected in three individuals (0.3%). Serological markers of lifetime syphilis (treponemal test) were detected in 2.5% (95% CI: 1.6-3.6) of participants, and active syphilis (treponemal test and VDRL) present in 1.2%. No samples were positive for anti-HCV. The prevalence of lifetime HBV infection (current or past infection) was 15.9%, and 0.7% (95% CI 0.4 to 1.5) were HBsAg-positive. Previous hospitalization (OR 1.53, CI 1.05-2.24, p < 0.01) and multiple sexual partners in the last 12 months (OR 1.80, CI 1.25-2.60, p < 0.01) were predictors for lifetime HBV infection. Although 46.7% (95% CI 43.4-49.9) of individuals reported having been vaccinated against hepatitis B, only 20.6% (95% CI 18.1-23.3) showed serological evidence of previous hepatitis B vaccination (positive for anti-HBs alone). CONCLUSIONS: The high prevalence of syphilis and HBV compared to the general population and the high frequency of risk behaviors show the potential for sexual and parenteral dissemination of these agents in this rural population. In addition, the low frequency of hepatitis B vaccinated individuals suggests a need for improved vaccination services.

Factores asociados a la calidad de vida relacionada con la salud bucal en preescolares de una comunidad andina / Factors associated with oral health related-quality of life in preschoolers from an Andean community

Objective : To analyze the oral health status and its relationship with the quality of life of Andean children of the community of Paucarbamba in Huancavelica, Peru. Material and Methods : The observational, cross-sectional, and correlational study was conducted on a sample of 120 children aged 3-5 years. Early childhood caries was considered using the dmft index. In addition, presence and type of malocclusion were assessed. The oral health-related quality of life was measured by The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire. Univariate and bivariate analysis were performed. Linear regression and Spearman correlation were conducted to identify the factors that most explained the ECOHIS score. Results : Multiple linear regression by least squares method did not consider gender, age, malocclusion, and simplified oral hygiene index as significant. This analysis only included dmft index as significant (p<0.05) to explicate the ECOHIS score. The estimated regression model was ECOHIS score = 11.67 + 0.79*dmft, in which the score increased by 0,79 for each unit obtained of the dmft index, and the dmft in a R2 = 30% (p<0.001) explained the variability of the ECOHIS score achieved. Conclusions : There is a negative impact of dental caries on the quality of life of preschool children and their families in an Andean community in Paucarbamba, Peru.

Objetivo : Analizar el estado de salud bucal y su relación con la calidad de vida de los preescolares de una comunidad andina y vulnerable del Perú. Material y Métodos : El estudio observacional, correlacional y transversal se realizó en una muestra de 120 niños de 3 a 5 años. La caries de la primera infancia se determinó mediante el índice ceod. También se consideró la presencia y el tipo de maloclusión. El cuestionario Early Childhood Oral Health Impact Scale (ECOHIS) midió la calidad de vida relacionada con la salud bucal. Los factores y variables orales se analizaron de manera univariada y bivariada. Se realizó un análisis de correlación de Spearman y regresión lineal para identificar los factores y en qué medida explicaban la puntuación del cuestionario. Resultados : El análisis de regresión lineal múltiple por el método de mínimos cuadrados solo incluyó como significativa (p <0,05) la contribución de ceod para explicar la puntuación del cuestionario, dejando de lado variables como el sexo, la edad, la maloclusión y el índice de higiene bucal simplificado. El modelo de regresión estimado fue Puntuación del Cuestionario = 11,67 + 0,79*ceod, donde la puntuación del cuestionario aumentó en 0,79 por cada unidad ganada de ceod, y la variabilidad de las puntuaciones obtenidas se explica por el ceod en un R2 = 30% (p<0,001). Conclusiones : Existe un impacto de la caries dental en la calidad de vida de los preescolares de uma comunidade andina del Perú y sus familias.

Iniquidades de género e vulnerabilidade às ist/hiv/aids em adolescentes de assentamento urbano: um estudo exploratório / Gender inequalities and vulnerability to sti/hiv/aids in urban settlement adolescents: an exploratory study / Iniquidades de género y vulnerabilidad a las its/vih/sida en adolescentes de asentamiento urbano: un estudio exploratorio

RESUMO Objetivo: Compreender a percepção acerca da vulnerabilidade às IST/HIV/AIDS entre as adolescentes residentes em assentamento urbano de uma capital do Brasil Central. Material e Método: Estudo descritivo e exploratório, com abordagem qualitativo, realizado em assentamento da periferia de uma capital do Brasil Central. De um total de 407 adolescentes da única instituição do assentamento, 107 foram considerados para o estúdio, 20 deles assistiram à consulta hebiátrica até atingir a saturação dos dados, a amostra final foi constituída por 16 adolescentes. Os dados foram obtidos por meio de entrevistas semiestruturadas. A análise de conteúdo foi utilizada para tratar os dados, sob a ótima da Teoria das Representações Sociais. Resultados: Emergiram as seguintes categorias temáticas: sentimento de invulnerabilidade às IST/HIV/AIDS; relação de gênero e vulnerabilidade às IST/HIV/AIDS e sexualidade, rede social e vulnerabilidade às IST/HIV/AIDS. Conclusão: As adolescentes assentadas são marcadas pela subalternidade de gênero, que muitas vezes é negada e naturalizada pelos ideais de legitimação de desigualdade entre os sexos.

ABSTRACT Objective: To understand the perception about the vulnerability to STI/HIV/AIDS among female adolescents living in an urban settlement in a city of Central Brazil. Materials and Methods: Descriptive and exploratory study, with qualitative approach, carried out in an urban settlement on the outskirts of a capital city in central Brazil. From a population of 407 adolescents from the only educational institution in the settlement, 107 were considered for the study. Of these, 20 went for hebiatric consultation and, until data saturation was reached, the final sample consisted of 16 adolescents. Data were obtained through semi-structured interviews. Content analysis was used to treat the data from the perspective of the Theory of Social Representations. Results: The following thematic categories emerged: feeling of invulnerability to STI/HIV/AIDS; gender relationship and vulnerability to STI/HIV/AIDS and sexuality, social network and vulnerability to STI/HIV/AIDS. Conclusion: Adolescent girls from the settlement are marked by gender subordination, which is often denied by them and naturalized by the ideals of legitimizing gender inequality.

RESUMEN Objetivo: Comprender la percepción sobre la vulnerabilidad a las IST/VIH/SIDA entre las adolescentes que viven en un asentamiento urbano en una capital del centro de Brasil. Material y Método: Estudio descriptivo y exploratorio, de abordaje cualitativo, realizado en un asentamiento urbano de la periferia de una capital de Brasil central. De un total de 407 adolescentes de la única institución del asentamiento, 107 fueron considerados para el estudio, de ellos, 20 acudieron a consulta hebiátrica y hasta que se alcanzó la saturación de datos, la muestra final quedó constituida por 16 adolescentes. Los datos se obtuvieron a través de entrevistas semiestructuradas. El análisis de contenido se utilizó para tratar los datos, bajo el óptimo de la Teoría de las representaciones sociales. Resultados: Surgieron las siguientes categorías temáticas: sensación de invulnerabilidad a las IST/VIH/ SIDA; Relación de género y vulnerabilidad a las IST/VIH/SIDA y Sexualidad, red social y vulnerabilidad a las IST/VIH/SIDA. Conclusión: Las adolescentes asentadas están marcadas por la subordinación de género, que a menudo es negada y naturalizada por los ideales de legitimar la desigualdad entre los sexos.