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Introduction: Hepatitis B virus (HBV) is a major public health problem affecting 400 million people worldwide, and is a common cause of chronic liver failure (cirrhosis) and hepatocellular carcinoma. Sixty-eight percent of infected people are from the African and Pacific regions. Vertical transmission from mother to newborn baby is one of the mechanisms by which chronic hepatitis virus infection spreads, besides infections from contaminated needles and syringes and sexual contact. Hepatitis B chronic infection is endemic in many poor countries, especially in Africa. Method: A cross-sectional study was conducted between July and August 2021. Pregnant women attending the antenatal care (ANC) in Bor State referral hospital, South Sudan, were interviewed to collect information on their socio-demographic characteristics and risk factors for hepatitis B infection. The objective was to determine the seroprevalence of hepatitis B chronic infection through blood testing. Prevalence ratios for certain risk factors were calculated. Results: Two hundred pregnant women were enrolled. The Prevalence Rate for chronic infection with hepatitis B virus, diagnosed using the rapid immune-chromatographic assay for Hepatitis B surface antigen (HBsAg), was 8.5%. (95% CI; 4.7% - 12.3%). None of the suspected risk factors studied were found to be significantly associated with testing positive for HBV, except for a history of previous jaundice. Conclusion: The prevalence of HBV chronic infection among pregnant women in Bor, Jonglei State, is high hence there is a need for established public health interventions that can lead to a reduction of HBV vertical transmission. Treatment of pregnant women with HBV chronic infection using anti-viral medications during pregnancy might curb the vertical transmission rates.
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Hepatitis B virus , Risk Factors , Chromatography, Affinity , Pregnant Women , Hepatitis B Surface Antigens , Hepatitis B Vaccines , Hepatitis B, ChronicABSTRACT
Chlamydia trachomatis (CT) is the most common curable sexually transmitted non-viral infection, which can cause urethritis, prostatitis, orchitis and epididymitis among males. Toxoplasma gondii, a protozoan causes toxoplasmosis among humans. These infections may lead to decreased fertility. Hence, this study was aimed to estimate the seropositivity of CT and T. gondii infection among the male partners of infertile couples in Odisha, India. In this facility-based cross-sectional study, first void urine, seminal fluid and blood sample were collected from 153 males attending infertility clinics including 74 healthy controls. Urine and seminal fluid were tested through polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay was used to detect immunoglobulin (Ig) G, IgA and IgM anti-Chlamydia and IgM anti-Toxoplasma antibodies through serum. The prevalence of CT was 1.26 per cent (95% CI: 0.03-6.85) as estimated from semen samples using PCR. We detected anti-Chlamydia antibodies IgM-four per cent [95% confidence interval (CI): 0.83-11.24]; IgA-28.16 per cent (95% CI: 18.13-40.09) and IgG-12.5 per cent (95% CI: 5.87-22.4) among participants. Anti-Toxoplasma antibodies IgM were observed in 27.63 per cent (95% CI: 17.98-39.08) of participants. None of the control samples were found positive. Overall seropositivity of CT and Toxoplasma infections is comparable, which suggests that greater attention is required for screening these infections at clinics, especially among infertile couples.
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Introduction: Spondyloarthropathies are a heterogeneousgroup of inflammatory interrelated diseases involvingperipheral joints and spine. All forms of spondyloarthropathiesare known to have a strong association with HLA-B27 gene invarious studies done. There was a paucity of literature aboutclinical and demographic characteristics of the HLA-B27positive arthritis patients in Rajasthan. So this study wasplanned to know the seropositivity of HLA-B27 amongseronegative spondyloarthritis patients and to find outassociation between socio-demographic and clinicalcharacteristics and HLA-B27 seroprevalence.Materials and Methods: A cross sectional observational studywas carried out from May 2017 to April 2018 in Department ofPathology, SMS Medical College, Jaipur (Rajasthan). A total of100 cases of spondyloarthritis disease were enrolled in thestudy to find out seroprevalence of HLA-B27 and todifferentiate the clinical and demographic characteristics inHLA-B27 positive and negative patients.Results: In the present study 29% seroprevalence of HLA-B27was observed. Seropositivity of HLA-B27 was significantlyassociated with age (P-value < 0.05) while sex, religion, caste,family history, raised ESR, Positive C-reactive protein, RAfactor etc. were showed no significant association (P-value >0.05).Conclusion: This study confirms the previously reportedassociation in ankylosing spondylitis patients between HLAB27 and earlier disease onset with male preponderance &family aggregation.
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Background: Blood Transfusion plays a vital role in patient management and is lifesaving in many instances. It plays a pivotal role as a specialized modality of treatment and saves millions of lives worldwide each year and reduces morbidity. It is well known to be associated with a large number of complications, some of them trivial while others are life threatening, demanding for meticulous pre transfusion testing and screening. The priority objective of BTS is to ensure safe, adequate accessible efficient blood supply at all times. The magnitude of TTI varies from country to country and depends directly on the TTI load of society and also effective screening of donors at blood bank. Materials and methods: A retrospective study was conducted in our hospital blood bank from 2014- 1016, to study the sero- prevalence and trends in TTI, including HIV, HBV, HCV, VDRL, and malaria. The total number of voluntary and replacement donors increased steadily in 3 years. Results: The sero- prevalence of HBV, HCV and HIV decreased steadily over 3 years, whereas incidence of syphilis increased steadily. HBV was noted to be more in voluntary donors than in replacement donors. Blood unit utilization index was calculated and ranged from 90.9% in 2014 to 88.9% in 2015 and 91.6% in 2016. Most common cause for discard of the blood units was TTI followed by expiry of products. Conclusion: Strict selection of blood donors is mandatory and is recommended to ensure safe blood supply. Voluntary blood donations need to be increased to decrease the incidence of TTI.
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Introduction: Hepatitis B and C virus (HBV and HCV) infections are considered an occupational risk for dental professionals and other health care workers. It is a risk that includes the possibility of dental personnel getting HBV or HCV infection from an infected patient and the potential transmission of HBV to susceptible patients from infected dental personnel. There is dearth of consensus prevalence data on HBV & HCV infections among patients attending dental clinics in Kashmir Valley, and no prevalence study is available. The aim of this study to detect the presence of HBsAg and HCV antigen, and the relation of it‘s presence with other factors such as gender, age, social status, history of surgical operation and blood transfusion among patients attending dental clinics in Kashmir Valley. Materials and methods: Serum from 2000 patients who attended Government Dental College and Hospital, Srinagar was screened for detection HBV surface Ag and HCV Ag using the Rapid Card Diagnostic Test (SD Bioline rapid immunochromatographic test for antibody IgG). All rapid test positive samples were further tested at SMHS Hospital, Kaksarai, Srinagar by a third-generation Enzyme linked immune sorbent assay (ELISA). Data was analyzed by SPSS (Statistical Package of Social Science) software program version 16 and the prevalence and percentage of all variables were calculated. Chi-square test was applied to see difference by gender. Results: The overall sero-prevalence of HBV and HCV among dental patients was 4.4% and 4.3 % respectively. There was no statistical significant difference in prevalence of HCV and HBV in male and females. A high sero-positivity was prevalent in the age group of 51-60 years (12% for HBV and HCV respectively). Most of positive results were observed from District Anantnag especially villages Suhail Latoo, Mohammad Shafi, Humaira Nazir. Sero-prevalence of Hepatitis B and C virus among patients attending Dental clinics in Kashmir Valley. IAIM, 2017; 4(2): 53-59. Page 54 of Kokernag (77.3 % of total no. of serologically HBV positive cases and 82.6% of total no. of serologically HCV positive cases). There was a significantly high prevalence of dental procedures among cases as compared to controls (p < 0.001) for both HBV and HCV results. Conclusion: The sero frequency of hepatitis B and C is high among Kashmiri patients especially from rural population of South Kashmir attending Government Dental College and Hospital, Srinagar, dental malpractice being major source of cross infection.
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Background: Hepatitis E Virus (HEV) infection occurs predominantly by the faeco oral route. Cases of transmission through blood transfusion have also been reported. Currently, blood donors in India are not screened for HEV. So the present study has been undertaken to know the sero-prevalence of HEV and to determine the status of endemicity of this infection. The aim of this study is to determine the sero-prevalence of hepatitis E virus (HEV) among blood donors in a tertiary care teaching hospital. Method: 551 blood donors’ samples analysed for presence of Anti HEV IgG using 3rd generation HEV ELISA kit. The serum samples were also tested for detection of HIV, HBsAg, HCV infections, Syphilis and Malaria. Results: The study included 551 donors, of which 99% (546) were males. The sero-positivity for anti-HEV IgG antibodies was 10.7%, the maximum sero-positivity being in the age group 51-65. All the donors were non- reactive for HIV, HCV, HBsAg infections, Syphilis and Malaria. Conclusion: High Prevalence of IgG antibodies (10.7%) shows that HEV is endemic in our region. However, more studies with confirmatory assays need to be done before making it a mandatory screening test for blood donors.
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Background: Vertical transmission of hepatitis B virus infection during pregnancy and delivery remains the major route of transmission in low resource areas. The objectives of this study were to determine the sero-prevalence of hepatitis B infection (HBsAg) and the potential risk factors among pregnant women admitted for delivery. Materials and Methods: This cross-sectional study of 300 women admitted for delivery was conducted at University of Calabar Teaching Hospital, Calabar, Nigeria. A pretested questionnaire was used for the collection of socio-demographic data and possible risk factors. Blood sample was collected from each consented woman and the plasma tested for the presence of HBsAg using rapid ELISA test Kits in the laboratory of the hospital. All the data were analyzed using microsoft SPSS version 17 statistical program. Results: Out of the 300 women studied, positive HBsAg was detected in 14 women, giving a seroprevalence rate of 4.7%. The age of the women studied varied from 16 to 43 years with mean age of 27.9±4.6 years and mean parity of 1.1±1.5. Hepatitis B viral infection was significantly higher among pregnant women who did not attend any antenatal care (unbooked women) than pregnant women who attended antenatal care (booked women). There were statistically significant relationships between HBV infection and 2 or more sexual partners and previous history of induced abortion. Previous histories of blood transfusion, previous surgeries/dental manipulations, tribal marks/tattoos, previous contact with somebody with hepatitis B infection were not statistically significant. The data are related to 14 (4.7%) of HBV infected women in the study. Conclusion: An intermediate prevalence of hepatitis B virus infection was identified which justifies the need for routine screening in pregnancy especially among unbooked women in order to identify and treat the infection.
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Aims: This study was carried out to ascertain the prevalence of hepatitis B virus infection and its relationship to gender and age among apparently healthy students of a tertiary institution in Northeastern Nigeria. Study Design: Sero-prevalence of HBsAg in relation to gender and age. Place and Duration of Study: Federal Polytechnic Mubi, North-eastern Nigeria, between August 2013 and September, 2014. Methodology: In this study, 200 apparently healthy students of a tertiary institution in North eastern Nigeria were screened randomly to determine the prevalence of Hepatitis B surface antigen (HBsAg). To achieve this, 200 blood samples were screened in a step wise order using One Step Strip Style HBsAg test. The blood was allowed to retract and then centrifuged at 2500 rpm for 10 minutes. The test device was dipped into the serum sample for 3 sec and read after 10 min. Results: The result showed an overall HBsAg seroprevalence of 31.5%. The seroprevalence of HBsAg among males (43%) was higher than that of females (27%) but with no statistical significant difference (p=0.462). The age-specific distribution of HBsAg among subjects in this study showed higher HBsAg prevalence rate among the age group 35 & above (50%), closely followed by the age group 30-34 (48%) with no statistical significant difference between all the age groups (p=0.353). Conclusion: The result of this study confirmed the high endemicity of HBsAg among apparently healthy individuals in North-eastern Nigeria which is alarming. It is therefore recommended that as a matter of urgency Nigerian government should extend HBV vaccination programme to the adult folks and not just limited to the national childhood immunization programme.
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Aims: This study aimed at establishing the prevalence of some viral Transfusion Transmissible Infectious (TTI) agents among blood donors in the Kintampo North municipality of Ghana. Study Design: A retrospective cross-sectional hospital based study. Place and Duration of Study: The study was conducted at the Laboratory unit of the Kintampo Municipal Hospital between May and August, 2013. Methodology: Archived results (from January 2010 to December 2012) on blood donation from the hospital’s laboratory were reviewed manually. Data comprising age, sex and results on HBsAg, anti-HCV and anti-HIV tests of blood donors were reviewed. The data were analyzed using Microsoft excel 2007 statistical package. Results: A total of 3402 people were screened for blood donation. Out of this number 3139 (92.3%) were males while 263 (7.7%) were females. The combined sero-prevalence of HBsAg, anti-HCV and anti-HIV was 19.5% (643/3139) and 11.4% (30/263) for males and females respectively. Hepatitis B surface antigen year-on-year prevalence was 9.6%. Anti-HCV and anti-HIV recorded year-on-year prevalences of 4.4% and 4.9% respectively. Donors younger than 20 years recorded the highest prevalence of HBsAg [15.9% (34/214)] followed by those in age group ≥20<30 [10.3% (170/1652)]. The highest prevalence rates of 6.1% and 5.0% for anti-HIV and anti-HCV were observed in age groups ≥50 and ≥30<40 years respectively. The commonest co-infection occurrence was HBV-HCV [45.5% (10/22)]. Conclusion: The prevalence of the viral TTI agents studied among blood donors in the Kintampo municipality is relatively high. Co-infection with HBV and HCV was also high.
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Background: Infection with the Hepatitis B Virus (HBV) is a global health problem. Epidemiological studies worldwide show wide variations in the prevalence patterns of the Hepatitis B infections. Early detection can contribute substantially to the timely diagnosis of the patients with acute illnesses and to an early treatment and hence, it can limit the transmission of the infection. Aim: To provide a baseline data on the prevalence of Hepatitis B among the patients who were attending Chennai Medical College Hospital and Research Centre, Trichy, Tamilnadu, over a period of 4 years (2010-2013). Methods: This was a retrospective study which was carried out among 19,513 patients who were attending the rural tertiary care teaching hospital, Trichy, over a period of 4 years (January 2010 – December 2013). The sera were screened for the presence of Hepatitis B surface antigen (HBsAg) by HEPACARD. Those found positive on screening test were confirmed by Enzyme linked Immuno-sorbent Assay (ELISA) test. Results: Out of 19,513 sera which were studied, 315 (1.61%) were sero-positive cases. Among the positive cases (315), the seroprevalence in males and females were 73% (230) and 27% (85) respectively and the frequency of HBV among age groups 0-20, 21-40, 41-60, >60 was 5.07% (16), 45.07% (142), 35.9% (113),11425% (36) respectively. Among the positive cases, a majority were in the age group of 21 to 40 years, with a male preponderance (p<0.05). Conclusion: The overall prevalence for this HBsAg marker among the patients who attended the rural tertiary teaching hospital in this study was comparatively similar to that which was reported by other studies from India.
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Aujeszky's disease caused by Aujeszky's disease virus (ADV) is one of the most important diseases in the pig industry. In this study, we conducted a seroepidemiological survey of ADV in wild boars and raccoon dogs in South Korea. In total, 217 wild boar sera collected between March and August 2013, and 96 raccoon dogs between 2011 and 2012 were screened for the presence of antibodies against ADV. The sero-positive rates in wild boars and raccoon dogs tested for ADV were found to be 3.55% (8/225) and 0% (0/96), respectively. The presence of virus neutralization antibody titer against ADV means that small number of wild boars was infected with ADV and AD may be circulated continuously in Korean wild boar populations, and that wild boars may act as a potential reservoir of ADV. Therefore, to achieve the declaration of AD free, effective preventive measures to block transmission of AD should be taken to the wild boars.
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Antibodies , Herpesvirus 1, Suid , Korea , Pseudorabies , Raccoon Dogs , Sus scrofaABSTRACT
Um inquérito de soroprevalência de doença de Chagas foi realizado em amostra representativa da população com idade até cinco anos de toda a área rural brasileira, exceto o Estado do Rio de Janeiro. Foram estudadas 104.954 crianças, que tiveram amostras de sangue coletadas em papel de filtro e submetidas a testes de screening pelas técnicas de imunofluorescência indireta (IFI) e ELISA em um único laboratório. Todas as amostras com resultados positivos ou indeterminados, juntamente com 10 por cento daquelas com resultados negativos, foram enviadas para um laboratório de referência e aí submetidas a novos testes por IFI e ELISA, além de western blot TESA (Trypomastigote Excreted Secreted Antigen). Para as crianças com resultado final positivo foi agendada uma re-visita para coleta de sangue venoso do próprio participante e das suas mães e familiares. Da avaliação do conjunto de testes resultaram 104 (0,1 por cento) resultados positivos, dos quais apenas 32 (0,03 por cento) foram confirmadas como infectadas. Destas, 20 (0,02 por cento) com positividade materna concomitante (sugerindo transmissão congênita), 11 (0,01 por cento) com positividade apenas na criança (indicativo de provável transmissão vetorial), e uma criança positiva cuja mãe havia falecido. Em 41 situações ocorreu confirmação apenas nas mães, sugerindo transferência passiva de anticorpos maternos; em 18 a positividade não se confirmou nem nas crianças nem nas suas mães; e em 13 não foi possível a localização de ambas. As 11 crianças que adquiriram a infecção por provável via vetorial distribuíram-se predominantemente na região nordeste (Piauí, Ceará, Rio Grande do Norte, Paraíba e Alagoas), acrescidas de um caso no Amazonas e um no Paraná. Dos 20 casos com provável transmissão congênita sobressaiu-se o Rio Grande do Sul, com 60 por cento deles, representando este o primeiro relato de diferenças regionais na transmissão congênita da doença de Chagas no Brasil, possivelmente relacionada à existência de Trypanosoma cruzi grupo IId e IIe, atualmente classificados como TcV e TcVI. Os resultados deste inquérito apontam para a virtual inexistência de transmissão de doença de Chagas por via vetorial no Brasil em anos recentes, resultante da combinação dos programas regulares e sistemáticos de combate á moléstia e de mudanças de natureza socioeconômica observadas no país ao longo das últimas décadas. Por outro lado, reforçam a necessidade de manutenção de um programa de controle que garanta a consolidação deste grande avanço.
A survey for seroprevalence of Chagas disease was held in a representative sample of Brazilian individuals up to 5 years of age in all the rural areas of Brazil, with the single exception of Rio de Janeiro State. Blood on filter paper was collected from 104,954 children and screened in a single laboratory with two serological tests: indirect immunofluorescence and enzyme linked immunoassay. All samples with positive or indetermined results, as well as 10 percent of all the negative samples were submitted to a quality control reference laboratory, which performed both tests a second time, as well as the western blot assay of TESA (Trypomastigote Excreted Secreted Antigen). All children with confirmed final positive result (n = 104, prevalence = 0.1 percent) had a follow-up visit and were submitted to a second blood collection, this time a whole blood sample. In addition, blood samples from the respective mothers and familiar members were collected. The infection was confirmed in only 32 (0.03 percent) of those children. From them, 20 (0.025 percent) had maternal positive results, suggesting congenital transmission; 11 (0.01 percent) had non-infected mothers, indicating a possible vectorial transmission; and in one whose mother had died the transmission mechanism could not be elucidated. In further 41 visited children the infection was confirmed only in their mothers, suggesting passive transference of maternal antibodies; in other 18, both child and mother were negative; and in 13 cases both were not localized. The 11 children that acquired the infection presumably through the vector were distributed mainly in the Northeast region of Brazil (States of Piauí, Ceará, Rio Grande do Norte, Paraíba and Alagoas), in addition to one case in Amazonas (North region) and another in Parana (South region). Remarkably, 60 percent of the 20 cases of probably congenital transmission were from a single State, Rio Grande do Sul, with the remaining cases distributed in other states. This is the first report demonstrating regional geographical differences in the vertical transmission of Chagas disease in Brazil, which probably reflects the predominant Trypanosoma cruzi group IId and IIe (now TcV and TcVI) found in this state. Overall, these results show that the regular and systematic control programs against the transmission of Chagas disease, together with socioeconomic changes observed in Brazil in the last decades, interrupted the vectorial transmission in Brazil, resumed in the few cases found in this national survey. Furthermore they reinforce the need for maintenance of control programs for the consolidation of this major advance in public health.
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Animals , Female , Humans , Infant, Newborn , Male , Chagas Disease/epidemiology , Insect Vectors/parasitology , Triatominae/parasitology , Brazil/epidemiology , Chagas Disease/diagnosis , Chagas Disease/prevention & control , Chagas Disease/transmission , Health Surveys , Insect Vectors/classification , Population Surveillance , Prevalence , Rural Population , Seroepidemiologic Studies , Triatominae/classificationABSTRACT
Objective. To assess the prevalence of viral co-infections in HIV infected children. Methods. Children born to HIV seropositive parents and those children who were suspected to be HIV infected based on clinical presentation by the pediatrician were screened for HIV –1 and 2 antibodies as per National Aids Control Organization (NACO) guidelines. Those found to be seropositive for HIV infection were further tested for Hepatitis B&C, Herpes simplex virus and Human cytomegalovirus infection. Results. Among 803 children screened, 101 were found positive for HIVantibodies. Among the five viral markers tested, HCMV IgG was positive in 88 children (87.1%). HCMV IgM was positive in 35 cases (34.6%). HBsAg tested positive in 30 children, while anti-HCV IgM was reactive in 27 cases. IgM anti- HSV antibodies were observed positive in 59 (58.4%) cases. Both hepatitis virus coinfection (HBsAg and anti- HCV IgM antibodies) was observed in 10 HIV positive children, while both Herpesviridae family viruses (HCMV -IgM antibodies and HSV -IgM antibodies) were positive in 30 cases (29.7%). Conclusion. Viral co-infections are significantly higher in HIV positive children, which adds to significant mortality and morbidity and should therefore be screened in all HIV positive children for timely treatment in order to improve the quality of life and better survival of HIV infected children.
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Adolescent , Antibodies, Viral/blood , Biomarkers/blood , Child , Child, Preschool , Cytomegalovirus Infections/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , HIV-1 , HIV-2 , Hepatitis B/epidemiology , Hepatitis B Surface Antigens/blood , Hepatitis C/epidemiology , Herpes Simplex/epidemiology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , India/epidemiology , Infant , Male , Seroepidemiologic StudiesABSTRACT
A cidade do Salvador, capital do Estado da Bahia, apresenta a população com maior prevalência da infecção pelo HTLV-I no Brasil. Todavia, somente um estudo incluiu uma cidade do interior deste Estado, mesmo assim com número amostral pequeno. O objetivo foi o de avaliar a prevalência de anticorpos anti-HTLV-I/II na população de quatro cidades do interior do Estado da Bahia. As amostras de soro proveninentes de 1.539 indivíduos residentes em Catolândia, Ipupiara, Jacobina e Prado foram triadas através do ELISA, e a confirmação dos resultados nas amostras repetidamente positivas foi realizada através do "Western blot". Quarenta e sete (3,1%) amostras foram positivas pelo ELISA, e 44 destas foram submetidas ao Western blot, com 5 resultados positivos (0,3%), 8 (0,5%) indeterminados (todos da cidade de Jacobina) e 31 negativos. A prevalência geral de anticorpos anti-HTLV-I, nas cidades estudadas, foi de 0,3%. Esta prevalência variou de 0,0% (Prado) a 0,7% (Jacobina), porém não houve diferença estatisticamente significante (p > 0,21). Nenhum indivíduo apresentou anticorpos anti-HTLV-II. Em conclusão, a prevalência da infecção pelo HTLV-I no interior do Estado da Bahia foi baixa, contudo, a população da cidade de Jacobina apresentou a maior prevalência. No entanto, outros estudos epidemiológicos, clínicos e virológicos serão necessários para a melhor compreensão da história natural desta infecção em Jacobina.
The city of Salvador, capital of Bahia, presents a population with the highest prevalence of HTLV-I infection in Brazil. Until now, only one study has investigated this infection in other cities of this state, even though by using a small sample. With objective to evaluate the prevalence of HTLV-I/II antibodies in four cities of the state of Bahia. Serum samples from 1,539 individuals who lived in Catolândia, Ipupiara, Jacobina and Prado were screened by ELISA, and repeatedly reactive samples confirmed by Western Blot. Forty-seven (3.1%) samples were positive by ELISA, and 44 of them were tested by Western blot: 5 (0.3%) were positive, 8 (0.5%) were indeterminate (all of them from Jacobina) and 31 were negative. The overall prevalence of HTLV-I antibodies was 0.3%. This prevalence varied from 0.0% (Prado) to 0.7% (Jacobina), but differences were not statistically significant (p > 0.21). None of these individuals presented HTLV-II antibodies. Jacobina showed the highest prevalence of HTLV-I infection among the cities studied, although the overall prevalence was low. In conclusion, further epidemiological, clinical and virological studies will be of paramount importance to obtain a better understanding of the natural history of this infection in Jacobina.