Sociodemographic and spatiotemporal profiles of hepatitis-A in the state of Pará, Brazil, based on reported notified cases

Abstract

Hepatitis-A virus is a worldwide healthcare problem, mainly affecting countries with poor sanitary and socioeconomic conditions. This communication evaluates the spatiotemporal variability of the disease’s socioepidemiological profile in one of the endemic Brazilian regions (Pará State) prior to (2008-2013) and after (2014-2017) the launch of the national public vaccination programme. Hepatitis-A epidemiological reports concerning Pará State - Brazil - were used for this study including municipalitylevel data of the disease’s reported positive notification cases (PNCs). The analyses involved socioepidemiological profiling and space-time scan statistics. A total of 5500 PNCs were reported in the study period. On average, PNCs decreased over time throughout the state, with strongest drops after 2015. The PNCs were specific for gender, race/ethnic origin and age group. The predominant gender and race/ethnic groups was male and brown, respectively. While children were the most susceptible age group prior to 2015, there was a shift towards older ages (young and adults) in later years. Those found to be the most affected by the disease, as shown by space-time scan statistics, were people in densely populated municipalities with unsatisfactory sanitary conditions and also less well covered by the public vaccination programme. Despite drops in the number of hepatitis-A PNCs, thanks to the national vaccination programme, the disease still persists in Pará State and elsewhere in Brazil. The present study reinforces the need of continuous prevention and control strategies for effective control and erradication of hepatitis-A.