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.
Highlights
Hepatitis A is an acute viral infection of the liver that is mainly transmitted via the fecal−oral route [1]
This is a cross-sectional study that was conducted at Jordan University Hospital (JUH)
The multinomial logistic regression analysis showed that negativity for hepatitis A virus (HAV) immunoglobulin G (IgG) was correlated with reporting the use of filtered municipal water compared with unfiltered municipal water
Summary
Hepatitis A is an acute viral infection of the liver that is mainly transmitted via the fecal−oral route [1]. Each year, this infection results in approximately 1.4 million cases of clinically apparent disease worldwide, with higher rates of inapparent infections [1,2]. The transmission of hepatitis A virus (HAV) through the fecal−oral route implies that hygienic and sanitary conditions are important factors in the epidemiology of the disease, with a higher sero-prevalence in developing countries [2,6]. The delayed exposure to HAV in developed countries can result in a higher possibility of large symptomatic outbreaks of hepatitis A [7,8]. Large-scale outbreaks of hepatitis A are frequently associated with the consumption of contaminated water or food (e.g., leafy green vegetables, frozen fruits, and ready-to-eat salads) [9,10,11]
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