Multilevel analysis of hepatitis A infection in children and adolescents: a household survey in the Northeast and Central-west regions of Brazil

摘要: Background The objectives were to estimate the prevalence of hepatitis A among children and adolescents from Northeast Midwest regions Federal District Brazil identify individual-, household- area-levels factors associated with infection. Methods This population-based survey was conducted in 2004–2005 covered individuals aged between 5 19 years. stratified multistage cluster sampling technique probability proportional size used select 1937 years living capital State capitals 12 states study regions. sample according age (5–9 10- 19-years-old) within each region. Individual- household-level data collected by interview at home individual. Variables related area retrieved census tract data. outcome total antibodies virus detected using commercial EIA. distribution susceptible population estimated a simple catalytic model. associations HAV infection independent variables assessed odds ratio corrected for random design effect weight. Multilevel analysis performed GLLAMM Stata 9.2. Results 5–9 10–19 age-group 41.5 57.4%, respectively Northeast, 32.3 56.0%, 33.8 65.1% District. trend increase all sites. By 5, 31.5% had already been infected region compared 20.0% other years, seropositivity ∼70% areas. curves populations differed one another. modeling showed that relating different levels education sites. Conclusion sites classified as areas intermediate endemicity infection. Differences trends settings. multilevel model allowed quantification contextual predictors urban