A seroepidemiologic study of hepatitis a in Spanish children. Relationship of prevalence to age and socio-environmental factors

Morales, Jaime; Huber, Larissa R. Brunner; Gallego, Soledad; Alvarez, G. Gabilondo; Diez-Delgado, Javier; González, Antonio; Aguilar, Lorenzo; Dal‐Ré, Rafael

doi:10.1007/bf02033057

Cited by 22 publications

(17 citation statements)

References 4 publications

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“…11,20 The association between SES and anti-HAV status in this context has been documented elsewhere in the world as well as in Chile. 10,18,[20][21][22][23] Although ingestion of shellfish or raw shellfish has been found to be associated with HAV, 2,24,25 our data do not support this association after adjusting for age. However, the results of the adjusted analysis, although not significant, are consistent with such an association.…”

Section: Discussionmentioning

confidence: 74%

“…Residence in areas of lower SES and fewer maternal or paternal years of education were significantly associated with a higher anti-HAV prevalence. HAV infection has been found to be significantly associated with poor hygiene and crowded living situations 2,[16][17][18] as well as with more general measures of SES. 10,19 In the age-stratified analyses, use of potable water, use of a municipal sewage system, use of a toilet/ outhouse, and use of a refrigerator were all significantly associated with anti-HAV serostatus.…”

Section: Discussionmentioning

confidence: 99%

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Age-specific prevalence of antibodies to hepatitis A in Santiago, Chile: risk factors and shift in age of infection among children and young adults.

Fix¹,

Martin²,

Gallicchio³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. Transition from high to lower endemicity of hepatitis A virus (HAV) infection may portend increased public health burden with the shift of infection to older ages and increasing morbidity and mortality. This report describes age-specific prevalence of antibodies to HAV (anti-HAV) among children and young adults in Santiago, Chile, compared with previous prevalence data and assesses factors predictive for anti-HAV. In 1998, a serosurvey was performed in Metropolitan Santiago, designed to enroll a representative, age-stratified population on the basis of area of residence. A total of 784 individuals (age range, 1-24 years) were enrolled. Anti-HAV prevalence by year of life was as follows: ages 1 to 4, 12.5%; 5 to 9, 26.2%; 10 to 14, 43.4%; 15 to 19, 57.4%; 20 to 24, 73.9%. Adjusting for age, factors associated (inversely) with anti-HAV included residential areas of higher socioeconomic status (SES), parental education, and household characteristics of potable water, municipal sewage system, and the presence of a toilet or refrigerator in the house. In logistic regression analysis, only maternal years of education and residence in areas of higher SES remained independently associated with anti-HAV. Excluding those from higher SES areas, comparison of the agespecific anti-HAV prevalence data from previous studies of similar methodology in areas of lower SES revealed consistent decreases across all age groups; the age-standardized prevalence for this age range (1-24 years) dropped from 53.7% in 1990 to 40.6% in 1998. In light of the growing pool of susceptible individuals at older ages, with HAV continuing to circulate in the communities, evaluation of the feasibility of vaccination programs would be judicious.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Age-specific prevalence of antibodies to hepatitis A in Santiago, Chile: risk factors and shift in age of infection among children and young adults.

Fix¹,

Martin²,

Gallicchio³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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“…Intermediate rates of seropositivity are found in the Mediterranean. In Spain, the effect of socioeconomic level is shown by the 63% anti-HAV positive rate among gypsy children aged 1 to 14 years, compared with 46% for children in an orphanage and 23% for nongypsy families (174). In Italy, seropositive rates are higher in the southern part of the country, e.g., 27% anti-HAV positivity in persons aged 3 to 19 years, compared with 5% in northern Italy (235).…”

Section: Why Prevent Hepatitis A?mentioning

confidence: 99%

Hepatitis A: Old and New

2001

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The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the disease is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated

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“…A study in Spain34 found a seroprevalence of HAV antibodies of 82% in deprived Roma children compared with 9.3% of more affluent non-Roma children. In another Spanish study,35 three groups were compared; non-Roma children, Roma children, and children in orphanages. From seven upwards there was an excess in age specific seroprevalence of hepatitis A virus of Roma children over other groups.…”

Section: Resultsmentioning

confidence: 99%

The health of the Roma people: a review of the published literature

Hajioff

2000

Journal of Epidemiology &Amp; Community Health

243

190

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Background-The Roma people originated in northern India and have been known in Europe for nearly a thousand years. For much of that time they have been the subjects of discrimination and oppression, culminating in the extermination of half a million Roma in the Nazi death camps. While it is widely believed that the health of Roma people is often poorer than the majority population, these inequalities remain largely unresearched. Methods-Published literature on the health of the Roma people was identified using Medline. Opinion pieces were excluded, as were papers relating to anthropometry and to genetic markers. The resultant papers were analysed by country of study and by disease type or care group. Results-Some 70% of papers identified related to just three countries; Spain and the Czech and Slovak Republics. Much literature concentrates upon communicable disease or reproductive health. The limited evidence suggests increased morbidity from non-communicable disease, but there is little published on this topic. Evidence on health care, though fragmentary, suggests poorer access to health services and uptake of preventative care. Discussion-Published research on the health needs of the Roma population is sparse. The topics that have received attention suggest a focus on concepts of contagion or social Darwinism, indicating a greater concern with the health needs of the majority populations with which they live. There is a need for both further research into the health of Roma people; with particular emphasis on noncommunicable disease; and also for interventions that improve Roma health. Such research must, however, be handled with sensitivity, recognising the social and political context of the society concerned.

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A seroepidemiologic study of hepatitis a in Spanish children. Relationship of prevalence to age and socio-environmental factors

Cited by 22 publications

References 4 publications

Age-specific prevalence of antibodies to hepatitis A in Santiago, Chile: risk factors and shift in age of infection among children and young adults.

Age-specific prevalence of antibodies to hepatitis A in Santiago, Chile: risk factors and shift in age of infection among children and young adults.

Hepatitis A: Old and New

The health of the Roma people: a review of the published literature

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