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...

Full description

Bibliographic Details
Main Authors: A Enoch, D Hardie, B Kagina, G Hussey
Format: Article
Language:English
Published: Health and Medical Publishing Group 2019-05-01
Series:South African Medical Journal
Online Access:http://www.samj.org.za/index.php/samj/article/download/12599/8812
id doaj-7f43c72dd79d4f15969d3d9d081e3e1d
record_format Article
spelling 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 AT aenoch hepatitisaseroprevalenceinwesterncapeprovincesouthafricaareweinepidemiologicaltransition
AT dhardie hepatitisaseroprevalenceinwesterncapeprovincesouthafricaareweinepidemiologicaltransition
AT bkagina hepatitisaseroprevalenceinwesterncapeprovincesouthafricaareweinepidemiologicaltransition
AT ghussey hepatitisaseroprevalenceinwesterncapeprovincesouthafricaareweinepidemiologicaltransition
_version_ 1724982347723440128