Name: Beatriz Zago Gomes
Type: MSc dissertation
Publication date: 09/11/2017
Advisor:

Name	Role
Luciana Lofego Gonçalves	Advisor *

Examining board:

Name	Role
Ana Daniela Izoton de Sadovsky	Internal Examiner *
Luciana Lofego Gonçalves	Advisor *
Sandra Fagundes Moreira da Silva	External Examiner *
Valmin Ramos da Silva	External Examiner *

Summary: INTRODUCTION: Infection caused by hepatitis B virus (HBV) is a major public health problem, with a prevalence of 350 million chronic carriers worldwide, and can progress with death from cirrhosis and liver cancer. In 2015, complete 19 years of universal vaccination in Brazil, so children and adolescents under 20 years of age theoretically should not have chronic Hepatitis B. OBJECTIVE: To analyze the notifications in the System of Information of Notifiable Diseases (SINAN) of HBV infection in children under 20 years of age in Brazil and the State of Espírito Santo (ES) between 2010 and 2015, through incidence and prevalence and the description of sex, age, race, source / mechanism of infection, clinical presentation, etiological classification and year of notification. METHODS: An observational, descriptive and cross-sectional epidemiological study was conducted with a sample consisting of SINAN data, referring to reports of HBV infection in children under 20 years of age in Brazil and ES. Reagent HBsAg serology is included as an obligatory item for inclusion in the study.
RESULTS: There were 4,275 cases of Hepatitis B in children under 20 years of age in Brazil in the six years studied, of which 62 were in ES. The estimated prevalence was 6.49 cases / 100,000 inhabitants in the country and 5.14 cases / 100,000 in the State, and in the age range 0- 4 years was 3.61 / 100,000 inhabitants in Brazil and 7.23 cases / 100,000 not ES. The age group with the highest number of notifications in Brazil was 15 to 19 years (68.58%), but the second most frequent was from 0 to 01 year (9.43%). The incidence dropped significantly in 2015, both at the national and state levels. The occurrences predominated in females and white and brown races. The North Region presented the highest number of occurrences, annual incidence and prevalence, with attention to Acre, with a large number of notifications. The Metropolitan Region of ES presented the highest number of notifications in the State, and the most reported municipality of housing was Cariacica. The form of transmission was ignored in almost half of the cases, and the most reported form of transmission in Brazil was the sexual one, followed by the vertical, in contrast to the ES. The most frequent coinfection was with the Hepatitis Delta virus (1.87%) and no co-infection was described in ES. Chronic hepatitis was the most anticipated clinical form, as expected in children. CONCLUSIONS: It was possible to observe that from the implementation of universal vaccination the prevalence and incidence of HBV in children and adolescents presented a marked and progressive decrease, which points to the effectiveness of the vaccine. However, frequency and prevalence were not expected in children under 01 year, mainly in ES, and may correspond to vaccine failure in the last years. Some failures in relation to the notification were evidenced. It is necessary, therefore, training of the health professionals for the correct fulfillment of the forms of notification and reinforcement of policies directed to the prevention of the infection by the HBV.

Keywords: Hepatitis B. Child. Adolescent. Mandatory reporting.