Abstract
Aim: Acute hepatitis A is a common public health problem in underdeveloped and developing countries. The hepatitis A vaccine was implemented as part of the National Immunization Program in Turkey in November 2012. The present study aimed to investigate the effects of the national vaccination program and massive migration on the epidemiology and clinical burden of hepatitis A infection.
 Material and Method: The study was a single center, retrospective chart review study among children diagnosed with viral hepatitis A infection between 0 and 18 years of age from January 2013 to February 2018 in Gaziantep Cengiz Gökçek Maternity and Children Hospital, Turkey. All cases’ age, diagnosis time, nationality, and gender information were evaluated. The length of stay, the maximum value of alanine transaminase and aspartate aminotransferase, and the direct medical cost of hospitalization were also evaluated in hospitalized cases.
 Results: During the study period total of 1039 cases were diagnosed with hepatitis A infection. Of these cases, 53% were males, 14% were Syrian refugees, and the median age was 7.9-year. The number of cases per year (2013 through 2017) was 321, 360, 157, 119, and 73, respectively. The majority of the cases were detected in November, December, and January. While the total number of cases was declining, we saw that the number of Syrian cases was increasing. The percentage of Syrian children in total cases in 2013 and 2017 was 6.5% and 52.1%, respectively. The hospitalization rate was %49.4, the median length of stay was four days, and the average medical cost of hospitalization was 246.8$/case.
 Conclusion: With the national vaccination program, prevalence is declining, but the number of susceptible individuals in society is still adversely affecting the epidemiology of the disease. Continuous monitoring of epidemiological data and efforts to expand vaccine coverage are required for infection control.
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