Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions

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art_XIMENES_Modelling_the_Force_of_Infection_for_Hepatitis_A_2014.PDF (829.97 KB)
Citações na Scopus
30
Tipo de produção
article
Data de publicação
2014
DOI
Scopus
Web of Science
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
XIMENES, Ricardo Arraes de Alencar
MARTELLI, Celina Maria Turchi
AMAKU, Marcos
PEREIRA, Leila Maria Moreira Beltrao
MOREIRA, Regina Celia
Citação
PLOS ONE, v.9, n.5, article ID e94622, 10p, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: This study aimed to identify the transmission pattern of hepatitis A (HA) infection based on a primary dataset from the Brazilian National Hepatitis Survey in a pre-vaccination context. The national survey conducted in urban areas disclosed two epidemiological scenarios with low and intermediate HA endemicity. Methods: A catalytic model of HA transmission was built based on a national seroprevalence survey (2005 to 2009). The seroprevalence data from 7,062 individuals aged 5-69 years from all the Brazilian macro-regions were included. We built up three models: fully homogeneous mixing model, with constant contact pattern; the highly assortative model and the highly assortative model with the additional component accounting for contacts with infected food/water. Curves of prevalence, force of infection (FOI) and the number of new infections with 99% confidence intervals (CIs) were compared between the intermediate (North, Northeast, Midwest and Federal District) and low (South and Southeast) endemicity areas. A contour plot was also constructed. Results: The anti-HAV IgG seroprevalence was 68.8% (95% CI, 64.8%-72.5%) and 33.7% (95% CI, 32.4%-35.1%) for the intermediate and low endemicity areas, respectively, according to the field data analysis. The models showed that a higher force of infection was identified in the 10- to 19-year-old age cohort (similar to 9,000 infected individuals per year per 100,000 susceptible persons) in the intermediate endemicity area, whereas a higher force of infection occurred in the 15-to 29-year-old age cohort (similar to 6,000 infected individuals per year per 100,000 susceptible persons) for the other macro-regions. Conclusion: Our findings support the shift of Brazil toward intermediate and low endemicity levels with the shift of the risk of infection to older age groups. These estimates of HA force of infection stratified by age and endemicity levels are useful information to characterize the pre-vaccination scenario in Brazil.
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URI
https://observatorio.fm.usp.br/handle/OPI/8458
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - FM/MPR
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - IMT
Artigos e Materiais de Revistas Científicas - LIM/01
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