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探讨阿根廷布宜诺斯艾利斯省坦迪尔市人群中戊型肝炎病毒血清流行率及其相关危险因素。

Exploring hepatitis E virus seroprevalence and associated risk factors among the human population in Tandil, Buenos Aires, Argentina.

机构信息

Centro de Investigación Veterinaria de Tandil (UNCPBA-CICPBA-CONICET), Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Tandil, Argentina.

Laboratorio de Biología de las Infecciones, Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, Tucumán, Argentina.

出版信息

Front Public Health. 2023 Oct 5;11:1257754. doi: 10.3389/fpubh.2023.1257754. eCollection 2023.

Abstract

BACKGROUND

Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide and is emerging as a disease in Argentina. It is primarily transmitted through contaminated water and food, following the fecal-oral route. Furthermore, is a zoonotic disease with swine as the primary reservoir. Prevalence of HEV infection in humans in several regions of Argentina remains unknown.

OBJECTIVES

(i) Determine the seroprevalence of HEV among the human population in Tandil, Buenos Aires, Argentina; (ii) Evaluate its association with demographic, socioeconomic and other risk exposures variables, and (iii) Describe and analyze spatial patterns related to HEV infection.

METHODS

From August 2020 to July 2021, serum samples were collected from 969 individuals aged 1-80 years. Seroprevalence and 95% Confidence Interval was determined. To assess the factors associated with the presence of anti-HEV antibodies, associations between the variables and seropositivity were evaluated through bivariate and multivariate analysis. Spatial scanning for clusters of positivity was carried out. Factors associated with these clusters were also assessed.

RESULTS

Anti-HEV antibodies were detected in 4.64% (IC 95% 3.27-6.02) of samples. Dark urine was associated with seropositivity ( = 0.02). Seropositivity was linked with the presence of natural water courses near their households ( = 0.02); the age ( = 0.04); and previous travel to Europe ( = 0.04). A spatial cluster of low rates of HEV seropositivity was detected, with greater distance of the households to water courses associated to the cluster, and male sex inversely associated to it.

DISCUSSION AND CONCLUSION

This study is the first study to investigate the prevalence of HEV in the population from Tandil, Buenos Aires, Argentina. Considering HEV infection in the differential diagnosis in individuals presenting acute hepatitis is highlighted. The incorporation of HEV testing into blood screening policies should be mandatory. Factors related to the infection and spatial patterns of high and low risk were determined, and should be considered when implementing specific preventive measures.

摘要

背景

戊型肝炎病毒(HEV)感染是全球范围内急性临床肝炎的常见病因,在阿根廷也逐渐成为一种疾病。它主要通过粪-口途径经污染的水和食物传播。此外,HEV 是一种人畜共患病,猪是主要的储存宿主。阿根廷多个地区的人类 HEV 感染流行率尚不清楚。

目的

(i)确定阿根廷坦迪尔市(Tandil)人群的 HEV 血清流行率;(ii)评估其与人口统计学、社会经济和其他风险暴露变量的相关性;(iii)描述和分析与 HEV 感染相关的空间模式。

方法

2020 年 8 月至 2021 年 7 月,采集了 969 名 1-80 岁个体的血清样本。确定了血清流行率及其 95%置信区间。为了评估与抗-HEV 抗体存在相关的因素,通过双变量和多变量分析评估了变量与血清阳性之间的相关性。对阳性的空间扫描聚类进行了分析,并评估了与这些聚类相关的因素。

结果

在 4.64%(95%CI 3.27-6.02)的样本中检测到了抗-HEV 抗体。尿液颜色深与血清阳性相关( = 0.02)。血清阳性与家中附近存在天然水道( = 0.02)、年龄( = 0.04)和既往前往欧洲旅行( = 0.04)相关。检测到 HEV 血清阳性率低的空间聚类,家庭与水道的距离越大,与聚类相关,而男性与聚类呈负相关。

讨论与结论

本研究首次调查了阿根廷坦迪尔市人群的 HEV 流行率。强调了在出现急性肝炎的个体中进行 HEV 感染鉴别诊断的重要性。有必要将 HEV 检测纳入血液筛查政策。确定了与感染相关的因素和高风险与低风险的空间模式,在实施具体预防措施时应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91e1/10585172/fdf0c48c88b5/fpubh-11-1257754-g001.jpg

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