| dc.identifier | VITRAL, C. L.; SOUTO, F. J. D.; GASPAR, A. M. C. Changing epidemiology of hepatitis A in Brazil: reassessing immunization policy. Journal of Viral Hepatitis, v. 15, Suppl. 2, p. 22-25, 2008. | |
| dc.description | Recent studies have shown that the prevalence
of antibody to hepatitis A virus (HAV) is decreasing in
several Latin American countries. Brazil is a very large
and heterogeneous country, showing striking regional
differences. With regard to sanitary facilities, 81.7% of the
districts in the south-eastern region have sewage systems,
compared with only 5.8% in the northern region. Results
of sero-epidemiological studies and reported hepatitis A
outbreaks indicate a change in the epidemiological pattern
of hepatitis A in the country. Individuals, especially those
under the age of 10, are mostly unprotected from HAV
infection, regardless of their socioeconomic status. During
2000–2005, approximately 14 000–21 000 cases of hepatitis
A were reported annually in Brazil, a rate of 7.5–11
cases per 100 000 population. Nationwide, hepatitis A
mortality rates declined progressively from 1980 to 2002.
As fatal cases constitute a small, but predictable, portion
of all acute hepatitis A cases, which are in turn part of
the total number of HAV infections, these data suggest
that there has been a decline in HAV circulation in all
Brazilian regions over the last two decades. Taken together
these facts point out that the epidemiological pattern of
hepatitis A is changing in Brazil. Besides improvements in
sanitary conditions in the poorest Brazilian regions, the
introduction of hepatitis A vaccination of young children
could be a strategy for controlling HAV infection in the
country. | |
