A study of hepatitis A virus seropositivity among children aged between 1 and 5 years of age: Implications for universal immunization

Abstract

Background: Hepatitis A virus (HAV) causes an enterically transmitted viral disease mainly affecting children and endemic in many developing countries, including India. There is an epidemiological shift with an increased incidence of symptomatic cases among children.This study was conducted to assess the seroprevalence of HAV among young children aged below 5 years and the need for universal immunization.Method: This cross-sectional study was conducted at two tertiary care hospitals in Northern India, from Apr 2014 to Jul 2015, among healthy children aged between 1 and 5 years. The sample size was calculated based on the prevalence of HAV seropositivity of 40% among children aged <10 years [16e60%] and alpha error of 5%. Analysis of serum IgG against HAV was performed by enzyme-linked immunosorbent assay method, and results were analyzed.Results: A total of 1084 children aged between 12 and 60 months were enrolled, with maleto-female ratio of 1.86:1. A total of 471 children (43.5%) were found to be positive for IgG against HAV. The seroprevalence of HAV was lower among younger children aged 12e23 months (odds ratio [OR] ¼ 0.73, 95% confidence interval [CI] ¼ 0.52e0.87, p ¼ 0.03), which was statistically significant. Seropositivity of HAV was lower among boys and families consuming safe drinking water and having improved sanitation facilities. Conclusion:The study observed lower seropositivity against HAV among younger children, making them susceptible of contracting the disease. Possible underlying risk factors were younger age, unsafe drinking water, poor sanitation, and low education status of parents. Therefore, vaccination may be recommended as optional vaccine at one year of age, along with improved public health efforts for safe drinking water, hygiene practices, and food safety.

Seroprevalence of hepatitis A virus antibodies among children and adolescents living in Northern Thailand: an implication for hepatitis A immunization

“…In this study, we found that a previous history of hepatitis A vaccination was significantly associated with HAV seropositivity among our participants. This finding was similar to a cross-sectional study in India, a lower-middle-income country, which revealed that hepatitis A vaccination, together with parental education levels, source of water supply, and history of jaundice, were the significantly associated factors of HAV seropositivity among their Indian children aged between 1 and 5 years 26 . We also found that overweight status was significantly correlated with seropositivity of HAV in our participants, particularly among unvaccinated individuals.…”

Incidence of hepatitis A in children with acute icteric hepatitis of district Shopian of Kashmir

“…8 In India, the antibodies to HAV are found in more than 90% of adults; however, limited information is available on anti-HAV among children. 9 Hepatitis A is a vaccine-preventable disease and typically has an abrupt onset following an incubation period of approximately 28 days (range: 15 to 50 days). Signs and symptoms of infection can include nausea, vomiting, diarrhea, dark urine, jaundice, fever, headache, weight loss, and abdominal pain, as well as a loss of desire for cigarette smoking or alcohol.…”

Climate change vis-a-vis climate and change: the military public health paradigm

“…Population-based seroprevalence surveys provide evidence for public health policy decisions, especially where mass vaccination and health-care worker protection are indicated, which need to be taken pragmatically, after due cost-effectiveness and cost-benefit analyses. In this issue of the journal, Kushwaha et al 17 and Gupta et al 18 have separately reported upon H1NI seroprevalence and hepatitis A virus (HAV), respectively, and commented on vaccination. With climate change happening since our yesterday, we have to accept that we will increasingly see the resurgence and emergence of diseases, with some vaccine protectable, most not.…”