Hepatitis A in the Eastern Mediterranean Region: A Review on the Prevalence

Abstract

Context: Hepatitis A continues to be a major health problem worldwide with 1.5 million symptomatic cases annually. As a result of improved sanitary conditions, several studies have reported a shifting epidemiological pattern for this viral infection from various parts of the world. Considering that most of Eastern Mediterranean countries have been known endemic for HAV, this review was performed to make its current magnitude more clarified in this area. Evidence Acquisitions: This review summarizes the publications on HAV epidemiology in EMRO countries. A relatively complete search was performed in MEDLINE and EMBASE to identify the most relevant manuscripts published from 1980 to 2010. Results: Besides some studies illustrated a down sloping prevalence in some countries, still there are some areas with intermediate and high seropositivity of HAV in EMRO. Additionally, considering the ever-increasing relationships between different countries and nations following globalization, there are a large number of HAV susceptible people from nonendemic and low endemic regions who travel to EMRO countries each year. This heterogeneous HAV exposure profile among population should be considered as a serious threat which makes HAV outbreaks happening more probable in EMRO. Conclusions: Regarding the heterogeneity of HAV prevalence in different regions shown here, more accurate prevalence data should be obtained from the whole area to be able to design more efficient protective strategies against HAV in EMRO.