Abstract:Context: Hepatitis A virus (HAV) infection is the most common type of acute viral hepatitis that has been proposed as an important public health issue. Most of the countries in WHO Eastern Mediterranean region (EMR) and Middle East (ME) have a high endemicity of HAV infection. To provide a comprehensive estimation of the epidemiology of HAV in this region, we carried out a systematic review on the literature reporting the prevalence of HAV infection in the EMR and ME.Evidence Acquisition: We conducted a system… Show more
“…These waters are the main source of agriculture irrigation and if contaminated they are also a source of infection for the human population. Consistent with previous reports [5], our results show that the prevalence of HAV Ab increases with age, suggesting the cumulative exposure to HAV with time. In other countries of the Eastern Mediterranean Region, high seroprevalence of HAV has been previously reported.…”
Section: Discussionsupporting
confidence: 93%
“…In Afghanistan (99%) [20], Iraq (96%) [21] and Palestine (93.7%) [22], with the lowest prevalence recorded in UAE and Kuwait with estimated prevalence rate below 50%. The overall HAV seroprevalence in Iran was estimated to be 62% and can be categorized as intermediate-endemicity for HAV infection [5]. Fig.…”
Section: Discussionmentioning
confidence: 99%
“…In a cross-sectional survey in southern Iran, HAV infection was found to be endemic in the region with an estimated anti-HAV seroprevalence of 67.7% [4]. The results of a systematic review and pooled analysis similarly revealed that 62.24% of Iranians are HAV seropositive [5]. Currently, there is no nationwide HAV vaccination in Iran.…”
BackgroundViral hepatitis is a global public health problem affecting millions of people worldwide, causing thousands of deaths due to acute and persistent infection, cirrhosis, and liver cancer. Providing updated serologic data can improve both surveillance and disease control programs. This study is aimed to determine the seroprevalence of markers for viral hepatitis (A, B, C, D and E) and the epidemiology of such infections in the general population of southern Iran’s Hormozgan province.MethodsBetween 2016 and 2017, a total of 562 individuals with ages ranging from 1 to 86 years, who visited governmental public laboratories for routine check-ups, were tested for the presence of serological markers to hepatitis virus types A to E using enzyme-linked immunosorbent assays.ResultsThe overall anti-hepatitis A virus (HAV) antibody seroprevalence was 93.2% (524/562). The prevalence of anti-hepatitis E virus (HEV) antibodies was 15.8% (89/562) among which 1.6% (9/562) of the seropositive individuals also had evidence of recent exposure to the virus (IgM positivity). Two and a half percent (14/562) were positive for hepatitis B surface (HBs) antigen, whereas 11.6% (65/562) tested positive for anti-hepatitis B core (HBc) antibodies. Among anti-HBc positive patients, 11% (7/65) had HBs Ag and 5% (3/65) were positive for anti-hepatitis D virus (HDV) antibodies. The prevalence of anti-hepatitis C virus (HCV) antibodies was 0.7% (4/562). The seroprevalence of anti-HAV, HEV IgG, anti-HBc antibodies, and HBs Ag increased with age.ConclusionThe present study confirms a high seroprevalence of HAV infection among the examined population and reveals high levels of endemicity for HEV in the region. Planned vaccination policies against HAV should be considered in all parts of Iran. In addition, improvements on public sanitation and hygiene management of drinking water sources for the studied area are recommended.
“…These waters are the main source of agriculture irrigation and if contaminated they are also a source of infection for the human population. Consistent with previous reports [5], our results show that the prevalence of HAV Ab increases with age, suggesting the cumulative exposure to HAV with time. In other countries of the Eastern Mediterranean Region, high seroprevalence of HAV has been previously reported.…”
Section: Discussionsupporting
confidence: 93%
“…In Afghanistan (99%) [20], Iraq (96%) [21] and Palestine (93.7%) [22], with the lowest prevalence recorded in UAE and Kuwait with estimated prevalence rate below 50%. The overall HAV seroprevalence in Iran was estimated to be 62% and can be categorized as intermediate-endemicity for HAV infection [5]. Fig.…”
Section: Discussionmentioning
confidence: 99%
“…In a cross-sectional survey in southern Iran, HAV infection was found to be endemic in the region with an estimated anti-HAV seroprevalence of 67.7% [4]. The results of a systematic review and pooled analysis similarly revealed that 62.24% of Iranians are HAV seropositive [5]. Currently, there is no nationwide HAV vaccination in Iran.…”
BackgroundViral hepatitis is a global public health problem affecting millions of people worldwide, causing thousands of deaths due to acute and persistent infection, cirrhosis, and liver cancer. Providing updated serologic data can improve both surveillance and disease control programs. This study is aimed to determine the seroprevalence of markers for viral hepatitis (A, B, C, D and E) and the epidemiology of such infections in the general population of southern Iran’s Hormozgan province.MethodsBetween 2016 and 2017, a total of 562 individuals with ages ranging from 1 to 86 years, who visited governmental public laboratories for routine check-ups, were tested for the presence of serological markers to hepatitis virus types A to E using enzyme-linked immunosorbent assays.ResultsThe overall anti-hepatitis A virus (HAV) antibody seroprevalence was 93.2% (524/562). The prevalence of anti-hepatitis E virus (HEV) antibodies was 15.8% (89/562) among which 1.6% (9/562) of the seropositive individuals also had evidence of recent exposure to the virus (IgM positivity). Two and a half percent (14/562) were positive for hepatitis B surface (HBs) antigen, whereas 11.6% (65/562) tested positive for anti-hepatitis B core (HBc) antibodies. Among anti-HBc positive patients, 11% (7/65) had HBs Ag and 5% (3/65) were positive for anti-hepatitis D virus (HDV) antibodies. The prevalence of anti-hepatitis C virus (HCV) antibodies was 0.7% (4/562). The seroprevalence of anti-HAV, HEV IgG, anti-HBc antibodies, and HBs Ag increased with age.ConclusionThe present study confirms a high seroprevalence of HAV infection among the examined population and reveals high levels of endemicity for HEV in the region. Planned vaccination policies against HAV should be considered in all parts of Iran. In addition, improvements on public sanitation and hygiene management of drinking water sources for the studied area are recommended.
“…Nonetheless, the reduced level of immunity against HAV as well as several major risk factors for HAV infection (e.g., neighboring Afghanistan and health hazard of hepatitis A for Iranian pilgrims to Karbala-based shrines in Iraq) make anti-HAV vaccination an essential priority (25,30). In a landmark study by Safiabadi et al, data indicated that the prevalence of hepatitis A virus antibody (IgG) seroprevalence among Afghan and Iraqi populations are more than 95% (31). The best measures to prevent the disease are to vaccinate and to enhance awareness of the transmission and prevention methods.…”
Background: Hepatitis A is globally spread and is an important public health problem. Objectives: This study aimed at investigating the seroepidemiology of hepatitis A in students aged seven to eighteen years in Birjand, during year 2016. Methods: This study was a descriptive-analytic research, in which 300 school children aged seven to eighteen years in Birjand city were selected through the cluster sampling method. Subsequently, participants and their parents were requested to fill the questionnaire and were referred to the laboratory for blood sampling in order to examine hepatitis A antibody titer. Data were analyzed using SPSS-21 software and the chi-square test. Results: Hepatitis A antibody test was positive for only 111 out of 300 participants (37%). Females (P = 0.009) and teenagers (P = 0.0001) had significantly higher levels of antibody against HAV. There was a significant difference between the presence of hepatitis A antibody, education level of the mothers of the studied individuals (P = 0.042), and the social level and size of the family (P = 0.041). However, no difference was seen regarding fathers' literacy level (P = 0.284).
Conclusions:The findings of the study showed that immunity against HAV was reduced during the past years. The reduced level of immunity against HAV along with several major risk factors for HAV infection, such as neighboring with Afghanistan and health hazards of hepatitis A for Iranian pilgrims visiting Karbala-based shrines in Iraq suggest anti-HAV vaccination as an essential priority.
“…Hepatitis A rates increased significantly over the 13 years, with an annual percentage change of 15.3%. Hepatitis A is endemic in Middle Eastern countries, and Iraq has a higher prevalence than Somalia and Palestine, but lower than Afghanistan (Safiabadi et al, 2017). The increased incidence of hepatitis A could be attributable to poor primary hygiene practices, interrupted water supplies, and population displacement, all common in conflict settings (Turky et al, 2011).…”
Section: Other Who Surveillance Diseasesmentioning
Background: The 2003 invasion of Iraq significantly undermined population health. However, there is a lack of understanding of how it undermined communicable disease control. This study was performed to assess the incidence trends of 32 communicable diseases in post-conflict Iraq. Methods: Reported incidence data for 32 communicable diseases (2004-2016) were collected from routine reports sent to the Iraqi Ministry of Health by primary health centers, and general and tertiary hospitals. Incidence (per 100 000) was defined as the number of reported incident cases divided by the population size. Joinpoint regression was used to examine the incidence trends and average annual percentage change (AAPC) for each disease, and the overall incidence rate across the period. Results: Communicable diseases increased significantly during the peak years of the war, especially during the US troop surge period (2007-2009). As US troops withdrew (after 2011), overall communicable diseases decreased. The incidence rate of nearly half of the 32 diseases decreased significantly, while the incidence rate of five increased significantly (hepatitis A, varicella, viral meningitis, cutaneous leishmaniasis, extrapulmonary tuberculosis). Conclusions: The early foundational strength of Iraq's health system may help explain why infectious disease failed to overwhelm the population following the invasion. Iraq's federal government could exercise its legal authority to manage threats to public health security by expanding the disease surveillance system.
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