title: Socioeconomic inequities and hepatitis A virus infection in Western Brazilian Amazonian children: spatial distribution and associated factors.
abstract: BACKGROUND
  Hepatitis A is still a neglected health problem in the world. The most affected areas are the ones with disadvantaged socioeconomic conditions. In Brazil, seroprevalence studies showed that 64.7 % of the general population has antibodies against HAV (hepatitis A virus), and the Amazon region has the highest seroprevalence in the country.
  
  
  METHODS
  In the present study the seroprevalence of total HAV antibodies in children between 1 and 5 years old residing in the urban area of Assis Brasil, Acre was measured and spatial distribution of several socioeconomic inequities was evaluated.
  
  
  RESULTS
  In the year of 2011, seroprevalence rate was 16.66 %. Factors associated with having a positive serology identified by multivariate analysis were being of indigenous ethnicity [adjusted Odds Ratio (aOR) = 3.27, CI 1.45-7.28], usage of water from the public system (aOR = 8.18, CI 1.07-62.53), living in a house not located in a street (aOR = 3.48, CI 1.54-7.87), and child age over 4 years old (aOR = 2.43, CI 1.23-4.79). The distribution of seropositive children was clustered in the eastern part of the city, where several socioeconomic inequities (lack of flushed toilets, lack of piped water inside the household and susceptibility of the household to flooding during rain, low maternal education, having wood or ground floor at home, and not owning a house, lack of piped water at home, and type of drinking water) also clustered.
  
  
  CONCLUSIONS
  The findings highlight that sanitation and water treatment still need improvement in the Brazilian Amazon, and that socioeconomic development is warranted in order to decrease this and other infectious diseases.
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. sauloaugustomantovani@hotmail.com.
authors.forename: Saulo A S
authors.initials: SA
authors.lastname: Mantovani
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. brenomd_@hotmail.com.
authors.forename: Breno Matos
authors.initials: BM
authors.lastname: Delfino
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. antonio_camargo0@yahoo.com.br.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Martins
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. hosoliart@hotmail.com.
authors.forename: Humberto
authors.initials: H
authors.lastname: Oliart-Guzmán
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. thascy_moraes@hotmail.com.
authors.forename: Thasciany M
authors.initials: TM
authors.lastname: Pereira
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. flccbranco@uol.com.br.
authors.forename: Fernando L C C
authors.initials: FL
authors.lastname: Branco
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. athosbrana@hotmail.com.
authors.forename: Athos Muniz
authors.initials: AM
authors.lastname: Braña
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. alcant_junior@hotmail.com.
authors.forename: José A
authors.initials: JA
authors.lastname: Filgueira-Júnior
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. aps_anna@hotmail.com.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Santos
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. rayanne5alves@gmail.com.
authors.forename: Rayanne A
authors.initials: RA
authors.lastname: Arruda
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. andreia_ufac@yahoo.com.br.
authors.forename: Andréia S
authors.initials: AS
authors.lastname: Guimarães
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. alandersonalves@hotmail.com.
authors.forename: Alanderson A
authors.initials: AA
authors.lastname: Ramalho
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. crisufac@yahoo.com.br.
authors.forename: Cristieli Sergio de Menezes
authors.initials: CS
authors.lastname: Oliveira
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. thiagoacre@gmail.com.
authors.forename: Thiago S
authors.initials: TS
authors.lastname: Araújo
authors.affiliation: Instituto Nacional de Salud, Cápac Yupanqui 1400 - Jesus María, Lima, 11, Peru. navelasco2007@gmail.com.
authors.forename: Nancy
authors.initials: N
authors.lastname: Arróspide
authors.affiliation: Dirección Regional de Salud de Madre de Dios, Av. Ernesto Rivero N° 475, Puerto Maldonado, Peru. cmanriquedle@yahoo.es.
authors.forename: Carlos H M L
authors.initials: CH
authors.lastname: Estrada
authors.affiliation: Scientific Computing Program, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil. claudia.codeco@gmail.com.
authors.forename: Cláudia T
authors.initials: CT
authors.lastname: Codeço
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. msnunes1@yahoo.com.br.
authors.forename: Mônica
authors.initials: M
authors.lastname: da Silva-Nunes
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D035922:Hepatitis A Antibodies / Q000097:blood; D030041:Hepatitis A virus / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D035922:Hepatitis A Antibodies