Martínez-Gallego Jaime, Castro-Arroyave Diana, Quintero Juan Carlos, De la Hoz Fernando, Montoya Melissa, Palacio Isabela, Navas María Cristina, Rojas Carlos
Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Grupo de Estudio en Pedagogía, Infancia y Desarrollo Humano - GEPIDH, Facultad de Educación, Universidad de Antioquia, Medellín, Colombia.
Biomedica. 2024 May 30;44(2):144-154. doi: 10.7705/biomedica.7243.
Introduction. Colombia is home to 2 million indigenous people who live in conditions of poverty and with health deficiencies, making them vulnerable to contracting hepatitis B (HBV). Amazonas has a high virus prevalence, and there are barriers to accessing vaccination; thus, part of the population is susceptible to infection. Objective. To identify factors associated with HBV in Colombian indigenous people. Materials and Methods. A case-control study of people over 18 years from four departments of Colombia. Cases were identified through the national hepatitis B notification registry (2015-2022). Controls were selected and matched to cases (2:1) by age, sex, ethnicity, and department. Sociodemographic characteristics, factors associated with contact with body fluids, cultural practices, and vaccination history were identified by means of a survey. The ethics committee of the Universidad de Antioquia approved the project. Results. Seventy five cases and 150 controls from 13 ethnic groups were surveyed. Amazonas contributed 49% of participants, 83% were women, and the median age of cases was 30 years (IQ range: 27-37). The associated factors were a family history of hepatitis B [adjusted OR: 2.61 (95% CI: 1.09-6.27)] and, in women, the number of pregnancies [adjusted OR: 1.61 (95% CI 1.02- 2.54)]. The vaccination history showed a protective effect, but the association was not significant. Conclusion. Aspects associated with family life and unprotected sexual relations seem to be responsible for the potential transmission of the virus. It was not possible to identify associated cultural practices. Innovative and differential strategies are required for indigenous people to achieve a reduction of HBV.
引言。哥伦比亚有200万原住民,他们生活贫困,健康状况不佳,易感染乙型肝炎(HBV)。亚马孙地区病毒流行率很高,且存在疫苗接种障碍;因此,部分人群易受感染。目的。确定哥伦比亚原住民中与HBV相关的因素。材料与方法。对来自哥伦比亚四个省份18岁以上人群进行病例对照研究。通过国家乙型肝炎通报登记系统(2015 - 2022年)确定病例。对照按年龄、性别、种族和省份与病例进行匹配(2:1)。通过调查确定社会人口学特征、与体液接触相关的因素、文化习俗和疫苗接种史。安蒂奥基亚大学伦理委员会批准了该项目。结果。对来自13个族群的75例病例和150例对照进行了调查。亚马孙地区的参与者占49%,83%为女性,病例的中位年龄为30岁(四分位距范围:27 - 37岁)。相关因素为乙型肝炎家族史[调整后比值比:2.61(95%置信区间:1.09 - 6.27)],在女性中,怀孕次数[调整后比值比:1.61(95%置信区间1.02 - 2.54)]。疫苗接种史显示有保护作用,但关联不显著。结论。与家庭生活和无保护性行为相关的方面似乎是病毒潜在传播的原因。无法确定相关的文化习俗。需要采取创新和差异化策略来减少原住民中的HBV感染。