Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition
Background. Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A.Objectives. To determine the seropreval...
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doaj-7f43c72dd79d4f15969d3d9d081e3e1d2020-11-25T01:55:59ZengHealth and Medical Publishing GroupSouth African Medical Journal0256-95742078-51352019-05-01109531431810.7196/SAMJ.2019.v109i5.13410Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transitionA EnochD HardieB KaginaG HusseyBackground. Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A.Objectives. To determine the seroprevalence of hepatitis A infection in Western Cape Province (WCP), South Africa.Methods. We conducted a cross-sectional seroprevalence study in the 1 - 7-year age group in WCP. Our samples (N=482) were blood specimens left over after laboratory testing obtained from referral hospitals between August and October 2015. A Siemens enzyme immunoassay was used to test for total hepatitis A antibodies. We also analysed hepatitis A immunoglobulin G antibody results from the National Health Laboratory Service (NHLS) Disa*Lab database at Groote Schuur Hospital from 2009 to 2014, and included 2009 - 2014 acute hepatitis A (immunoglobulin M-positive) surveillance data from the National Institute for Communicable Diseases to look at trends in notified acute infections over the same period.Results. Our cross-sectional study showed 44.1% seroprevalence in the 1 - 7-year age group. Hepatitis A data from the NHLS database indicated a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The surveillance data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7 - 40-year age group, suggesting that an increasing proportion of the population is susceptible to HAV infection.Conclusions. These results suggest an urgent need for detailed evidence-based considerations to introduce hepatitis A vaccine into the EPI-SA.http://www.samj.org.za/index.php/samj/article/download/12599/8812 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
A Enoch D Hardie B Kagina G Hussey |
spellingShingle |
A Enoch D Hardie B Kagina G Hussey Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition South African Medical Journal |
author_facet |
A Enoch D Hardie B Kagina G Hussey |
author_sort |
A Enoch |
title |
Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition |
title_short |
Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition |
title_full |
Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition |
title_fullStr |
Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition |
title_full_unstemmed |
Hepatitis A seroprevalence in Western Cape Province South Africa: Are we in epidemiological transition |
title_sort |
hepatitis a seroprevalence in western cape province south africa: are we in epidemiological transition |
publisher |
Health and Medical Publishing Group |
series |
South African Medical Journal |
issn |
0256-9574 2078-5135 |
publishDate |
2019-05-01 |
description |
Background. Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A.Objectives. To determine the seroprevalence of hepatitis A infection in Western Cape Province (WCP), South Africa.Methods. We conducted a cross-sectional seroprevalence study in the 1 - 7-year age group in WCP. Our samples (N=482) were blood specimens left over after laboratory testing obtained from referral hospitals between August and October 2015. A Siemens enzyme immunoassay was used to test for total hepatitis A antibodies. We also analysed hepatitis A immunoglobulin G antibody results from the National Health Laboratory Service (NHLS) Disa*Lab database at Groote Schuur Hospital from 2009 to 2014, and included 2009 - 2014 acute hepatitis A (immunoglobulin M-positive) surveillance data from the National Institute for Communicable Diseases to look at trends in notified acute infections over the same period.Results. Our cross-sectional study showed 44.1% seroprevalence in the 1 - 7-year age group. Hepatitis A data from the NHLS database indicated a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The surveillance data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7 - 40-year age group, suggesting that an increasing proportion of the population is susceptible to HAV infection.Conclusions. These results suggest an urgent need for detailed evidence-based considerations to introduce hepatitis A vaccine into the EPI-SA. |
url |
http://www.samj.org.za/index.php/samj/article/download/12599/8812 |
work_keys_str_mv |
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