RESUMO
Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.
Assuntos
Vírus da Hepatite B/genética , Hepatite B/etnologia , Hepatite B/epidemiologia , Adulto , Etnicidade , Feminino , Genótipo , Hepatite B/virologia , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/classificação , Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Prevalência , Fatores de Risco , Suriname/epidemiologia , Proteínas Virais/genéticaRESUMO
In the Caribbean, Schistosoma mansoni has been reported from the Dominican Republic, Puerto Rico, Guadiloupe, Martinique, Saint Lucia, St. Kitts, Montserrat and Antigua, but clinical disease has not been reported in recent times in the latter three countries. Recently, however, during routine parasitological examination, the parasite was rediscovered in Montserrat and Antigua. In order to determine the prevalence of infections, surveys were carried out in these two countries in areas where the vector Biomphalaria glabrata was known to be present. In Montserrat 317 samples were obtained and 11 percent were positive for S. mansoni. Only two individuals of 87 examined under 15 years were positive. In Antigua 10 percent of 303 samples were positive. The youngest positive case was 12 years old. In both countries, the majority of the positive were in the 15 - 44 age group. Treatment of positive cases is being undertaken. These surveys highlight (1) the insidious nature of the disease and the need for continuing surveillance in areas where the vector is present and there is danger of introduction and reintroduction of the disease and (2) the value of developing reliable and specific serological tests (AU)