RESUMO
BACKGROUND: The epidemiology of inflammatory bowel diseases (IBD) varies between different regions of Brazil. This cross-sectional study examined the epidemiological characteristics of IBD in the Southern Brazilian state of Paraná. METHODS: We included patients with IBD (n=6.748) selected across 11,468,818 population of Paraná. All patients had a known diagnosis of either Crohn's disease (CD) or ulcerative colitis (UC) and had started treatment through the Government Program of the Brazilian Unified Health System (2010-2019). The primary outcomes were changes in the incidence and prevalence rates of IBD. RESULTS: The study population consisted of 4.931 (73.1%) patients with UC and 1.817 (26.9%) patients with CD. In participants aged 11-30 years, CD was more common, while in participants aged 40-80 years, UC predominated. UC was more common in female compared to male patients, with a similar incidence between the sexes evident for CD. In 2010, the incidence of IBD was 2.00/100,00 population; this increased to 13.77/100,000 population by 2019. The highest concentration of IBD patients was found in the eastern macro-region of Paraná, which includes the 2nd Health Regional of Curitiba, where the capital of the state is located. CONCLUSION: This is the first study to describe the epidemiological characteristics of IBD in the state of Paraná and showed an increase in its incidence and prevalence. We also identified that IBD was concentrated in the eastern macro-region of this Brazilian state.
Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Brasil/epidemiologia , Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Doenças Inflamatórias Intestinais/epidemiologia , Masculino , PrevalênciaRESUMO
ABSTRACT Background: The epidemiology of inflammatory bowel diseases (IBD) varies between different regions of Brazil. This cross-sectional study examined the epidemiological characteristics of IBD in the Southern Brazilian state of Paraná. Methods: We included patients with IBD (n=6.748) selected across 11,468,818 population of Paraná. All patients had a known diagnosis of either Crohn's disease (CD) or ulcerative colitis (UC) and had started treatment through the Government Program of the Brazilian Unified Health System (2010-2019). The primary outcomes were changes in the incidence and prevalence rates of IBD. Results: The study population consisted of 4.931 (73.1%) patients with UC and 1.817 (26.9%) patients with CD. In participants aged 11-30 years, CD was more common, while in participants aged 40-80 years, UC predominated. UC was more common in female compared to male patients, with a similar incidence between the sexes evident for CD. In 2010, the incidence of IBD was 2.00/100,00 population; this increased to 13.77/100,000 population by 2019. The highest concentration of IBD patients was found in the eastern macro-region of Paraná, which includes the 2nd Health Regional of Curitiba, where the capital of the state is located. Conclusion: This is the first study to describe the epidemiological characteristics of IBD in the state of Paraná and showed an increase in its incidence and prevalence. We also identified that IBD was concentrated in the eastern macro-region of this Brazilian state.
RESUMO Contexto: A epidemiologia das doenças inflamatórias intestinais (DII) varia em diferentes regiões do Brasil. Este estudo transversal avaliou as características epidemiológicas da DII no estado do Paraná no sul do Brasil. Métodos: Foram incluídos pacientes com DII (n=6,748) selecionados de 11.468.818 habitantes no estado do Paraná. Todos os pacientes eram portadores de doença de Crohn (DC) ou retocolite ulcerativa (RCU) e iniciaram seu tratamento por meio do Sistema Público de Dispensação de Medicamentos da Secretaria de Saúde do Estado do Paraná (2010-2019). Os desfechos primários foram as alterações na incidência e prevalência de DII. Resultados: A população de estudo foi constituída de 4.931 pacientes (73,1%) portadores de RCU e 1.817 (26,9%) de DC. Nos pacientes com 11 a 30 anos a DC foi mais comum, enquanto naqueles com 40-80 anos a RCU predominou. Retocolite ulcerativa foi mais frequente no sexo feminino, com frequência semelhante entre os sexos para DC. A incidência de DII passou de 2,00/100.000 habitantes em 2010 para 13,77/100.000 habitantes em 2019. A maior incidência da DII foi observada na macrorregional leste, que inclui a 2ª Regional Curitiba, onde a capital do estado está localizada. Conclusão: Este é o primeiro estudo com a descrição das características epidemiológicas do Paraná e mostrou aumento na incidência e prevalência da DII no estado. Foi também identificada maior concentração da DII na macrorregional leste deste estado brasileiro.
RESUMO
Leprosy is a disease, which is accompanied by cellular immunity defects, which may increase the susceptibility of patients in developing co-infections. The association of leprosy with hepatitis C virus (HCV) infection, human immunodeficiency virus types 1 and 2 (HIV 1+2) infection and human T-lymphotropic virus types I and II (HTLV I+II) infection have previously been described in different populations. In this study, the prevalence of these infections was determined in 199 Southern Brazilian leprosy patients and in 681 matched controls. Antibodies to HCV were positive in 3.52% of the patients (7/199) and in 0.15% of the controls (1/681; odds ratio (OR)=24.79; 95% CI=3.03-202.74; p=0.0002). An increased risk of HCV infection was observed in institutionalized patients (OR=14.95; 95% CI=1.76-127.03; p=0.004) and in the lepromatous form of the disease (OR=7.67; 95% CI=0.43-136.62; p=ns). Anti-HIV 1+2 antibodies were positive in only one out-patient (1/199; 0.50%) and in none of the controls (0/681; OR=3.43; 95% CI=0.21-55.16; p>0.05). No leprosy patient was positive for anti-HTLV I+II antibodies. These results demonstrate an increased prevalence of HCV infection in leprosy patients from South Brazil and that both institutionalization and lepromatous form of the disease confer higher risk to HCV infection. These data emphasizes the importance of monitoring hepatitis C and leprosy interactions and the need of special care to institutionalized and lepromatous patients in preventing HCV co-infection.
Assuntos
Hepatite C/complicações , Hepatite C/epidemiologia , Hanseníase/complicações , Hanseníase/epidemiologia , Isolamento de Pacientes , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HTLV-I/complicações , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-II/complicações , Infecções por HTLV-II/epidemiologia , Hepacivirus/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
Leprosy is a disease, which is accompanied by cellular immunity defects, which may increase the susceptibility of patients in developing co-infections. The association of leprosy with hepatitis C virus (HCV) infection, human immunodeficiency virus types 1 and 2 (HIV 1+2) infection and human T-lymphotropic virus types I and II (HTLV I+II) infection have previously been described in different populations. In this study, the prevalence of these infections was determined in 199 Southern Brazilian leprosy patients and in 681 matched controls. Antibodies to HCV were positive in 3.52% of the patients (7/199) and in 0.15% of the controls (1/681; odds ratio (OR)=24.79; 95% CI=3.03-202.74; p=0.0002). An increased risk of HCV infection was observed in institutionalized patients (OR=14.95; 95% CI=1.76-127.03; p=0.004) and in the lepromatous form of the disease (OR=7.67; 95% CI=0.43-136.62; p=ns). Anti-HIV 1+2 antibodies were positive in only one out-patient (1/199; 0.50%) and in none of the controls (0/681; OR=3.43; 95% CI=0.21-55.16; p>0.05). No leprosy patient was positive for anti-HTLV I+II antibodies. These results demonstrate an increased prevalence of HCV infection in leprosy patients from South Brazil and that both institutionalization and lepromatous form of the disease confer higher risk to HCV infection. These data emphasizes the importance of monitoring hepatitis C and leprosy interactions and the need of special care to institutionalized and lepromatous patients in preventing HCV co-infection.