Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital

Overview

Journal Pathogens

Date 2021 Sep 28

PMID 34578114

Citations 1

Authors

Nariman Kareem

Khaled Al-Salahat

Faris G Bakri

Yaser Rayyan

Azmi Mahafzah

Malik Sallam

Affiliations

Soon will be listed here.

Abstract

The study of hepatitis A virus (HAV) epidemiology and sero-prevalence has important public health implications. Changes in the epidemiology of hepatitis A can result in a larger pool of susceptible persons in countries with improved sanitation and hygienic conditions if vaccination is not provided. The aim of this study was to investigate the prevalence of HAV immunoglobulin G (IgG) in Jordan. In addition, we aimed to identify the potential differences in HAV sero-prevalence based on age, among other variables. We recruited the study participants at Jordan University Hospital in Amman, Jordan, during October 2020-June 2021. Assessment of participants' socio-demographic variables was done using a paper-based questionnaire. Testing for HAV IgG was based on a competitive enzyme linked immunosorbent assay (ELISA). The study population comprised 360 individuals with a median age of 18 years. The overall sero-prevalence of HAV in our study sample was 38.3%. Divided by age, the sero-prevalence of HAV was 8.2%, 12.3%, and 20.8% among individuals aged 10 years or less, 15 years or less, and 30 years or less, respectively. The estimated age at mid-population immunity was between 21 and 30 years. Besides age, individuals residing outside the Central region of Jordan had a significantly higher HAV sero-prevalence. Additionally, the use of filtered municipal water was associated with a lower sero-prevalence of HAV compared with the use of unfiltered municipal water among individuals aged 15 years or less. The results of this study suggest an intermediate to low endemicity of HAV in Jordan. An epidemiologic shift of HAV sero-prevalence with a declining rate of positivity for HAV IgG was noticed in this study. This highlights the importance of the recently introduced HAV vaccination in Jordan. Future research to evaluate the public health benefits of HAV vaccination in Jordan is recommended.

Citing Articles

Hepatitis A virus infection and seroprevalence, Istanbul, Turkey, 2020-2023.

Karabey M, Alacam S, Karabulut N, Uysal H, Gunduz A, Aydina O Ann Saudi Med. 2024; 44(6):386-393.

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References

Gossner C, Severi E, Danielsson N, Hutin Y, Coulombier D . Changing hepatitis A epidemiology in the European Union: new challenges and opportunities. Euro Surveill. 2015; 20(16). DOI: 10.2807/1560-7917.es2015.20.16.21101. View

Itani T, Jacobsen K, Nguyen T, Wiktor S . A new method for imputing country-level estimates of hepatitis A virus endemicity levels in the Eastern Mediterranean region. Vaccine. 2014; 32(46):6067-74. DOI: 10.1016/j.vaccine.2014.09.006. View

Khoury S, Graczyk T, Burnham G, Jurdi M, Goldman L . Drinking water system treatment and contamination in Shatila Refugee Camp in Beirut, Lebanon. East Mediterr Health J. 2016; 22(8):568-578. DOI: 10.26719/2016.22.8.568. View

Di Cola G, Fantilli A, Pisano M, Re V . Foodborne transmission of hepatitis A and hepatitis E viruses: A literature review. Int J Food Microbiol. 2020; 338:108986. DOI: 10.1016/j.ijfoodmicro.2020.108986. View

Yassin K, Awad R, Tebi A, Queder A, Laaser U . The epidemiology of hepatitis A infection in Palestine: a universal vaccination programme is not yet needed. Epidemiol Infect. 2001; 127(2):335-9. PMC: 2869753. DOI: 10.1017/s0950268801005970. View

Hayajneh W, Daniels V, James C, Kanibir M, Pilsbury M, Marks M . Public health impact and cost effectiveness of routine childhood vaccination for hepatitis a in Jordan: a dynamic model approach. BMC Infect Dis. 2018; 18(1):119. PMC: 5842652. DOI: 10.1186/s12879-018-3034-8. View

Hayajneh W, Balbeesi A, Faouri S . Hepatitis A virus age-specific sero-prevalence and risk factors among Jordanian children. J Med Virol. 2015; 87(4):569-74. DOI: 10.1002/jmv.24137. View

Al-Rousan T, Schwabkey Z, Jirmanus L, Nelson B . Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers. East Mediterr Health J. 2018; 24(3):243-253. DOI: 10.26719/2018.24.3.243. View

Couturier E, Roque-Afonso A, Letort M, Dussaix E, Vaillant V, de Valk H . Cluster of cases of hepatitis A with a travel history to Egypt, September-November 2008, France. Euro Surveill. 2009; 14(3). View

10.

Toukan A, Sharaiha Z, Hmoud M, Dahbour S, Yacoub S, Margolis H . The seroepidemiology of hepatitis A virus infection in Jordan. Trop Gastroenterol. 1988; 9(2):76-9. View

11.

Manka P, Verheyen J, Gerken G, Canbay A . Liver Failure due to Acute Viral Hepatitis (A-E). Visc Med. 2016; 32(2):80-5. PMC: 4926881. DOI: 10.1159/000444915. View

12.

Franco E, Meleleo C, Serino L, Sorbara D, Zaratti L . Hepatitis A: Epidemiology and prevention in developing countries. World J Hepatol. 2012; 4(3):68-73. PMC: 3321492. DOI: 10.4254/wjh.v4.i3.68. View

13.

Gassowski M, Michaelis K, Wenzel J, Faber M, Figoni J, Mouna L . Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018. Euro Surveill. 2018; 23(27). PMC: 6152161. DOI: 10.2807/1560-7917.ES.2018.23.27.1800329. View

14.

Antaki N, Kebbewar M . Hepatitis A seroprevalence rate in Syria. Trop Doct. 2000; 30(2):99-101. DOI: 10.1177/004947550003000215. View

15.

Salama I, Samy S, Shaaban F, Hassanin A, Abou Ismail L . Seroprevalence of hepatitis A among children of different socioeconomic status in Cairo. East Mediterr Health J. 2008; 13(6):1256-64. DOI: 10.26719/2007.13.6.1256. View

16.

Habib R, Ziadee M, Abi Younes E, El Asmar K, Jawad M . The association between living conditions and health among Syrian refugee children in informal tented settlements in Lebanon. J Public Health (Oxf). 2019; 42(3):e323-e333. DOI: 10.1093/pubmed/fdz108. View

17.

Nelson N, Murphy T . Hepatitis A: The Changing Epidemiology of Hepatitis A. Clin Liver Dis (Hoboken). 2015; 2(6):227-230. PMC: 4641046. DOI: 10.1002/cld.230. View

18.

Mohd Hanafiah K, Jacobsen K, Wiersma S . Challenges to mapping the health risk of hepatitis A virus infection. Int J Health Geogr. 2011; 10:57. PMC: 3210090. DOI: 10.1186/1476-072X-10-57. View

19.

Jacobsen K, Koopman J . The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns. Int J Epidemiol. 2005; 34(3):600-9. DOI: 10.1093/ije/dyi062. View

20.

Frank C, Walter J, Muehlen M, Jansen A, van Treeck U, Hauri A . Large outbreak of hepatitis A in tourists staying at a hotel in Hurghada, Egypt, 2004--orange juice implicated. Euro Surveill. 2006; 10(6):E050609.2. DOI: 10.2807/esw.10.23.02720-en. View