Distribuição temporal da morbimortalidade por hepatite B no estado do Ceará, de 2009 a 2018

Abstract

Hepatitis B is a silent disease, with a high clinical latency, with high prevalence worldwide. Approximately one third of the world's population has been infected with the Hepatitis B Virus (HBV), with estimates of 257 million people having its chronic form. The present study aims to analyze the temporal distribution of morbidity and mortality from hepatitis B in the State of Ceará, from 2009 to 2018. This is an ecological study, with a temporal trend, based on secondary data from the Notifiable Diseases Information System and of the Mortality Information System. The study was divided into two stages. In the first, a descriptive study of the sociodemographic and epidemiological characteristics of hepatitis B cases and deaths was carried out. Incidence and mortality coefficients per 100,000 inhabitants were also calculated. In the second stage, a temporal trend analysis of incidence and mortality was performed, using Poisson regression applied from Joinpoint. In total, 1,683 cases of hepatitis B were confirmed, of which 65.2% were male, 48.8% were aged between 20-39 years, 75.5% were brown and 21.6% had studied for 12 years or more. There were 72 deaths, 73.6% male, 37.5% between 40-59 years old, 70.8% brown and 20.4% with 1 to 3 years of studies completed. The Health Region (HR) of Fortaleza concentrated 87.1% of cases and 66.7% of deaths. In general, there was no clear trend in the incidence and mortality of hepatitis B, but there was a tendency for an increase in incidence in the 60-79 age group and a reduction in the 0-10 and 20-39 age group. There was a trend towards increased case detection in HR Sertão Central and in the Decentralized Health Areas of Ceará (DHA) Canindé, Crateús, Juazeiro do Norte and Quixadá. On the other hand, there was a trend towards a reduction in cases in the DHA Acaraú, Brejo Santo, Camocim, Canindé, Caucaia, Iguatu, Juazeiro do Norte and Tauá. There was also a trend towards a reduction in mortality in RS Norte and in the DHA Aracati, Camocim, Canindé, Crateús, Icó and Tianguá, in addition to an increase in the DHA Canindé, Icó and Tianguá. Hepatitis B remains at high morbidity and mortality parameters in Ceará, with no defined time trend on average, but with a heterogeneous pattern in the analyzed period. These findings reiterate its relevance as a public health problem and the need to strengthen integrated surveillance and health care actions in the Unified Health System.