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. 2018 Nov 3;18(1):546.
doi: 10.1186/s12879-018-3439-4.

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil

Déborah Ferreira Noronha de Castro Rocha  1 , Luana Rocha da Cunha Rosa  1 , Carla de Almeida Silva  1 , Brunna Rodrigues de Oliveira  2 , Thaynara Lorrane Silva Martins  1 , Regina Maria Bringel Martins  2 , Marcos André de Matos  1 , Megmar Aparecida Dos Santos Carneiro  2 , Juliana Pontes Soares  3 , Ana Cristina de Oliveira E Silva  3 , Márcia Maria de Souza  1 , Robert L Cook  4 , Karlla Antonieta Amorim Caetano  1 , Sheila Araujo Teles  5
Affiliations

Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil

Déborah Ferreira Noronha de Castro Rocha et al. BMC Infect Dis. .

Abstract

Background: In recent decades the epidemic of asymptomatic sexually transmitted infections has extended deep into Brazil, including small towns and rural areas. The purpose of this study was to investigate the epidemiology of HIV, syphilis, and hepatitis B (HBV) and hepatitis C viruses (HCV), and to evaluate immunization coverage against hepatitis B in a group of rural workers in Brazil.

Methods: In 2016, a cross-sectional study was conducted with 937 manual sugarcane cutters of the Midwest and Northeast Regions of Brazil. All individuals were interviewed and screened for HIV, syphilis, HBV and HCV. Correlating factors with lifetime HBV infection were investigated using logistic regression. Positive Predictive Values, Negative Predictive Values, sensitivity and specificity were also calculated relative to vaccination against Hepatitis B, comparing anti-HBs titers to vaccination reports.

Results: Most reported previous hospitalization (55%), occupational injuries (54%), sharing of personal items (45.8%), alcohol consumption (77.2%), multiple sexual partners in previous 12 months (39.8%), and no condom use during sexual intercourse in last 12 months (46.5%). Only 0.2% reported using injection drugs. Anti-HIV-1 was detected in three individuals (0.3%). Serological markers of lifetime syphilis (treponemal test) were detected in 2.5% (95% CI: 1.6-3.6) of participants, and active syphilis (treponemal test and VDRL) present in 1.2%. No samples were positive for anti-HCV. The prevalence of lifetime HBV infection (current or past infection) was 15.9%, and 0.7% (95% CI 0.4 to 1.5) were HBsAg-positive. Previous hospitalization (OR 1.53, CI 1.05-2.24, p < 0.01) and multiple sexual partners in the last 12 months (OR 1.80, CI 1.25-2.60, p < 0.01) were predictors for lifetime HBV infection. Although 46.7% (95% CI 43.4-49.9) of individuals reported having been vaccinated against hepatitis B, only 20.6% (95% CI 18.1-23.3) showed serological evidence of previous hepatitis B vaccination (positive for anti-HBs alone).

Conclusions: The high prevalence of syphilis and HBV compared to the general population and the high frequency of risk behaviors show the potential for sexual and parenteral dissemination of these agents in this rural population. In addition, the low frequency of hepatitis B vaccinated individuals suggests a need for improved vaccination services.

Keywords: Poverty areas; Rural population; Sexually transmitted diseases; Viral hepatitis vaccines.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Research Ethics Committees of Brazil in Goiás and Paraíba, according to resolution CNS No. 466/12, under protocols 042796/2015 and 1,507,737/2016, respectively. All individuals who agreed to participate in the study provided written informed consent, through a signature or thumbprint.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Geographical location of the sampling sites in the states of Goiás (GO) and Paraíba (PB), Central-West and Northeast regions, respectively
See this image and copyright information in PMC

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