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Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions
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 inte...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028178/ https://www.ncbi.nlm.nih.gov/pubmed/24845598 http://dx.doi.org/10.1371/journal.pone.0094622 |
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author | Ximenes, Ricardo Arraes de Alencar Martelli, Celina Maria Turchi Amaku, Marcos Sartori, Ana Marli C. de Soárez, Patricia Coelho Novaes, Hillegonda Maria Dutilh Pereira, Leila Maria Moreira Beltrão Moreira, Regina Célia Figueiredo, Gerusa Maria de Azevedo, Raymundo Soares |
author_facet | Ximenes, Ricardo Arraes de Alencar Martelli, Celina Maria Turchi Amaku, Marcos Sartori, Ana Marli C. de Soárez, Patricia Coelho Novaes, Hillegonda Maria Dutilh Pereira, Leila Maria Moreira Beltrão Moreira, Regina Célia Figueiredo, Gerusa Maria de Azevedo, Raymundo Soares |
author_sort | Ximenes, Ricardo Arraes de Alencar |
collection | PubMed |
description | 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 (∼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 (∼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. |
format | Online Article Text |
id | pubmed-4028178 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-40281782014-05-21 Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions Ximenes, Ricardo Arraes de Alencar Martelli, Celina Maria Turchi Amaku, Marcos Sartori, Ana Marli C. de Soárez, Patricia Coelho Novaes, Hillegonda Maria Dutilh Pereira, Leila Maria Moreira Beltrão Moreira, Regina Célia Figueiredo, Gerusa Maria de Azevedo, Raymundo Soares PLoS One Research Article 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 (∼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 (∼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. Public Library of Science 2014-05-20 /pmc/articles/PMC4028178/ /pubmed/24845598 http://dx.doi.org/10.1371/journal.pone.0094622 Text en © 2014 Ximenes et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Ximenes, Ricardo Arraes de Alencar Martelli, Celina Maria Turchi Amaku, Marcos Sartori, Ana Marli C. de Soárez, Patricia Coelho Novaes, Hillegonda Maria Dutilh Pereira, Leila Maria Moreira Beltrão Moreira, Regina Célia Figueiredo, Gerusa Maria de Azevedo, Raymundo Soares Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title | Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title_full | Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title_fullStr | Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title_full_unstemmed | Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title_short | Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions |
title_sort | modelling the force of infection for hepatitis a in an urban population-based survey: a comparison of transmission patterns in brazilian macro-regions |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028178/ https://www.ncbi.nlm.nih.gov/pubmed/24845598 http://dx.doi.org/10.1371/journal.pone.0094622 |
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