Estimating the post‐neonatal prevalence of sickle cell disease in a Brazilian Population

Objective To estimate the prevalence of individuals with sickle cell disease (SCD) in Aracaju, Brazil, using the capture–recapture (CRC) method. SCD is a significant public health problem with long‐term life‐threatening complications. There are no reliable estimates of the number of individuals with this condition in Aracaju, north‐east Brazil. The CRC method has been used to quantify other ubiquitous populations. Method Three independent lists of individuals with homozygous (HbSS) SCD were constructed from patients attending the main specialist ambulatory service, all patients with SCD admitted to three government hospitals and a clinic providing specialist immunisation services to patients with SCD. Individuals were matched to ascertain whether they appeared in one, two or three lists, and population size was estimated using the log‐linear model. Results The lists identified 374 individuals. Two hundred and one appeared in one, 99 in two and 74 in three lists with an estimated number 400 (95% CI 387–418) HbSS SCD individuals; 51.6% patients with SCD were men and age ranged from 1–62 years (median 14). Conclusion The CRC method resulted in a smaller population estimate than expected. The causes of this discrepancy may include list dependence, high mortality with a survival cohort effect and the method of identifying the more severe cases. The CRC method has potential to estimate the size of this population and could supplement neonatal screening to further characterise the SCD population in this region.     

Estimating the number of street children and adolescents in two cities of Brazil using capture-recapture

Aim: To use the capture–recapture method to estimate the number of street children and adolescents in Maceió and Arapiraca, north‐east Brazil, and describe the characteristics of the two populations. Methods: The number of children and adolescents on the street in Maceió and Arapiraca was estimated using the multi‐list capture–recapture method. Two street surveys and an official list from the social services department were compared. The characteristics of the children were recorded during the street surveys using a questionnaire. Results: The estimated number of street children and adolescents was 5225 in Maceió and 1191 in Arapiraca. According to the official records, the population registered was 565 and 157, respectively. Most individuals were male (71.4% and 71.8%, respectively). They still maintain contact with their families (85.5% in Maceió and 89.6% in Arapiraca) and attend school regularly (43.4% and 49.7%). Drug use was admitted by 46.9% of the individuals in Maceió and by 26.9% in Arapiraca. In both cities, glue inhalation, associated or not with other drugs, was most frequently cited. Conclusions: Children and adolescents on the streets are a common and underestimated occurrence in Maceió and Arapiraca. They have similar characteristics to street children from other countries and other cities in Brazil. The method of capture–recapture seems to be suited to study populations such as street children.     

Circulation of hepatitis B virus genotype-E among outpatients in tertiary hospitals in the Niger-Delta region of Nigeria

IntroductionHepatitis B virus (HBV) infection continues to be a significant public health challenge globally, with higher disease burden in developing countries. HBV genotypes are associated with different geographical regions and clinical outcomes. Limited information exists on epidemiology of HBV in the Niger-Delta region (South-South) of Nigeria. Consequently, this study was designed to characterise hepatitis B virus infection among outpatients in selected tertiary hospitals in the region.MethodologyBetween June and August 2017, consenting nine hundred asymptomatic out-patients were enrolled and initially screened for HBV infection using one step Hepatitis B surface antigen (HBsAg) strip and subsequently re-tested using HBsAg and Hepatitis B core total antibody (anti-HBc) specific Enzyme-Linked Immunosorbent Assay (ELISA). Blood serum with detectable HBsAg were subsequently subjected to DNA extraction, S-gene amplification using a nested polymerase chain reaction (PCR) protocol, gel electrophoresis, sequencing and phylogenetic analysis.ResultsSeroprevalence of HBsAg was 4.6% (95% CI 2.5–7.1) and anti-HBc was 10.1% (95% confidence interval (CI) 6.1–15.3). Of the 41 HBsAg positive samples subjected to DNA extraction and HBV S-gene specific PCR, only 6 (14.6%) yielded the expected ∼408bp band. Phylogenetic analysis based on HBV pre-S/S sequences identified all six typable samples as genotype E, subtype ayw4 of the West African clade.ConclusionResults of the study confirm the presence and circulation of HBV genotype-E in the Niger-Delta region of Nigeria, thus corroborating the inclusion of the country in the Genotype E crescent. The authors advocate value-added HBV intervention in the region and the country at large.     

Pre-diabetes and it’s predictors in Abia State,Eastern Nigeria

International Journal of Diabetes in Developing Countries - The prevalence of diabetes mellitus (DM) is rising in sub-Saharan Africa, including Nigeria. A previous study in Abia State, Nigeria,...     

Impact of rotavirus vaccination on diarrhoea mortality and hospital admissions in Brazil

Objective To analyse the data reported by the national surveillance system of Brazil, including data on diarrhoea mortality and hospital admissions before and after rotavirus vaccine introduction, and evaluate the impact of its widespread use under operational conditions. Method Retrospective analysis of routinely collected data was reported by several surveillance systems of Brazil, comprising an 8‐year period of all diarrhoea‐related hospitalisations and deaths in children <5 years old (2002–2009). Linear regressions were used to compare trends of diarrhoea hospitalisations and deaths before and after vaccine introduction (2002–2005 vs. 2006–2009). Results There was a long‐term reduction in hospitalisations that preceded the introduction of the vaccine. This reduction was more marked in <1‐year‐old than in 1– to 4‐year‐old children. All‐cause diarrhoea hospitalisations decreased further after vaccine introduction and the decrease was larger in <1‐year‐old (?35.6%) than in 1– to 4‐year‐old children (?12.3%). The number of deaths was decreasing before vaccine introduction, and the decrease also accelerated after vaccine introduction, with deaths halving in <1‐year‐old and decreasing by 32.9% in 1‐ to 4‐year‐old children. The linear relationships between hospitalisations and deaths were statistically different before and after vaccine introduction. Conclusions The data demonstrate a decreasing trend in all‐cause diarrhoea‐related hospitalisations and deaths in children <5 years of age. These reductions were steeper between 2006 and 2009, highlighting the potential beneficial effect of the rotavirus vaccine associated with all‐cause diarrhoeal disease.