Dinâmica espacial e temporal da ocorrência de hepatite B em gestantes no Brasil

Abstract

Introduction: Hepatitis B is a viral infection (HBV) considered a global public health problem, in which one of the transmission mechanisms is transversal, implying the possibility of transmission to newborns, allowing the persistence of the infection in the chronic form. Objective: To analyze the trend and spatial distribution of hepatitis B in pregnant women in Brazil. Methods: Ecological study based on all reported cases of hepatitis B in pregnant women by the National System of Notifiable Diseases between 2009 and 2018. Spatial analysis was performed using the Moran Global Index for global data and Local Association Indicators Space (Lisa) for the country's 5,570 municipalities. Time trends by state were analyzed using linear regression, considering p<0.05. Results: 15,253 pregnant women with HBV were reported, most of them between 20 and 39 years old (82.22%), brown (40.58%), sexually contaminated (28.16%), diagnosed in the third trimester (37, 55%) and classified as chronic carriers (79.59). Between 2009 and 2018, in the analysis of crude rates, a concentration of cases was observed in the municipalities of the North (Amazonas, Rondônia and Acre), Midwest (Mato Grosso) and South (Paraná and Santa Catarina) regions. Smoothed rates, in all biennia, were lower, but with a greater number of cases in municipalities in the same regions as the gross rate. The Moran Global Index (I) obtained for the period between 2009 and 2018 (I = 0.056) showed a positive spatial association. While, in the Local Indicators of Spatial Association (Lisa) 78 municipalities were observed in the high-high cluster, with a concentration in the South region (51.28%). The low-low cluster totaled 48, most located in the Southeast region (72.91%). When analyzing the trend, it was found that it increased in Maranhão (p=0.004) and Pernambuco (p=0.007) and decreased in Mato Grosso (p=0.012), Paraná (p=0.031) and Santa Catarina (p=0.008). Conclusion: The study showed that there is detection in most Brazilian municipalities, which demands attention from health policies for the prevention of vertical transmission and, therefore, the neonatal complications that may arise.