Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Contrasting Geographical Areas in Indonesia
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Anti-HAV IgG Testing and Endemicity Measure
2.3. Measuring Risk Factors and Associations with HAV Seroprevalence
2.4. Data Management and Analysis
3. Results
3.1. Participant Characteristics
3.2. Seroprevalence and Endemicity
3.3. Household SES
3.4. Knowledge of Hepatitis A and Hygienic Food Intake
3.5. Multivariate Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total n = 1280 | Living Area | p Value * | Anti-HAV IgG | p Values * | ||
---|---|---|---|---|---|---|---|
Urban n = 640 | Rural n = 640 | Positive n = 647 (50.55%) | Negative n = 633 (49.45%) | ||||
Sex: | 0.001 | 0.001 | |||||
Male | 506 (39.5%) | 283 (44.2%) | 223 (34.8%) | 227 (44.9%) | 279 (55.1%) | ||
Female | 774 (60.5%) | 357 (55.8%) | 417 (65.2%) | 420 (54.3%) | 354 (45.7%) | ||
Age (years): | 1.00 | <0.001 | |||||
1–2 | 110 (8.6%) | 55 (8.6%) | 55 (8.6%) | 5 (4.5%) | 105 (95.5%) | ||
3–4 | 110 (8.6%) | 55 (8.6%) | 55 (8.6%) | 7 (6.4%) | 103 (93.6%) | ||
5–9 | 100 (7.8%) | 50 (7.8%) | 50 (7.8%) | 10 (10.0%) | 90 (90.0%) | ||
10–14 | 100 (7.8%) | 50 (7.8%) | 50 (7.8%) | 29 (29.0%) | 71 (71.0%) | ||
15–19 | 140 (10.9%) | 70 (10.9%) | 70 (10.9%) | 49 (35.0%) | 91 (65.0%) | ||
20–24 | 150 (11.7%) | 75 (11.7%) | 75 (11.7%) | 75 (50.0%) | 75 (50.0%) | ||
25–29 | 150 (11.7%) | 75 (11.7%) | 75 (11.7%) | 97 (64.7%) | 53(35.3%) | ||
30–34 | 130 (10.2%) | 65 (10.2%) | 65 (10.2%) | 105 (80.8%) | 25 (19.2%) | ||
35–39 | 130 (10.2%) | 65 (10.2%) | 65 (10.2%) | 114 (87.7%) | 16 (12.3%) | ||
40–49 | 100 (7.8%) | 50 (7.8%) | 50 (7.8%) | 96 (96.0%) | 4 (4.0%) | ||
≥50 | 60 (4.7%) | 30 (4.7%) | 30 (4.7%) | 60 (100%) | 0 (0%) | ||
Education of father: | <0.001 | <0.001 | |||||
Illiterate | 9 (0.7%) | 6 (0.9%) | 3 (0.5%) | 9 (100%) | 0 (0%) | ||
Primary school (6 years) | 382 (29.9%) | 182 (28.5%) | 200 (31.3%) | 277 (72.5%) | 105 (27.5%) | ||
Middle school (9 years) | 274 (21.5%) | 114 (17.8%) | 160 (25.1%) | 143 (52.2%) | 131 (47.8%) | ||
High school (13 years) | 531 (41.6%) | 278 (43.5%) | 253 (39.7%) | 188 (35.4%) | 343 (64.6%) | ||
Graduate/post-graduate (16+ years) | 81 (6.3%) | 59 (9.2%) | 22 (3.4%) | 27 (33.3%) | 54 (66.7%) | ||
Education of mother: | <0.001 | <0.001 | |||||
Illiterate | 7 (0.5%) | 6 (0.9%) | 1 (0.2%) | 7 (100%) | 0 (0%) | ||
Primary school (6 years) | 428 (33.5%) | 191 (29.9%) | 237 (37.1%) | 308 (72.0%) | 120 (28.0%) | ||
Middle school (9 years) | 310 (24.3%) | 147 (23.0%) | 163 (25.5%) | 155 (50.0%) | 155 (50.0%) | ||
High school (13 years) | 468 (36.6%) | 246 (38.5%) | 222 (34.7%) | 152 (32.5%) | 316 (67.5%) | ||
Graduate/post-graduate (16+ years) | 65 (5.1%) | 49 (7.7%) | 16 (2.5%) | 23 (35.4%) | 42 (64.6%) | ||
Occupation: | 0.004 | <0.001 | |||||
Professional | 69 (5.4%) | 41 (6.4%) | 28 (4.4%) | 48 (69.6%) | 21 (30.4%) | ||
Semi-professional | 3 (0.2%) | 1 (0.2%) | 2 (0.3%) | 3 (100%) | 0 (0%) | ||
Clerical/shop owner | 37 (2.9%) | 22 (3.4%) | 15 (2.3%) | 27 (73.0%) | 10 (27.0%) | ||
Skilled worker | 66 (5.2%) | 34 (5.3%) | 32 (5.0%) | 44 (66.7%) | 22 (33.3%) | ||
Semi-skilled worker | 35 (2.7%) | 19 (3.0%) | 16 (2.5%) | 23 (65.7%) | 12 (34.3%) | ||
Unskilled worker | 103 (8.1%) | 66 (10.3%) | 37 (5.8%) | 86 (83.6%) | 17 (16.5%) | ||
Household duties | 319 (24.9%) | 133 (20.8%) | 186 (29.1%) | 262 (82.1%) | 57 (17.9%) | ||
Unemployed (adults) | 73 (5.7%) | 36 (5.6%) | 37 (5.8%) | 39 (53.4%) | 34 (46.6%) | ||
Attending school | 318 (24.9%) | 158 (24.7%) | 160 (25.0%) | 93 (29.2%) | 225 (70.8%) | ||
Attending garderie/pre-school | 40 (3.1%) | 23 (3.6%) | 17 (2.7%) | 4 (10.0%) | 36 (90.0%) | ||
At home (children) | 208 (16.3%) | 99 (15.5%) | 109 (17.0%) | 12 (5.8%) | 196 (94.2%) | ||
Other | 8 (0.6%) | 7 (1.1%) | 1 (0.2%) | 6 (75.0%) | 2 (25.0%) | ||
Total number of family members living in the same household: | 0.029 | 0.001 | |||||
<2 | 21 (1.6%) | 11 (1.7%) | 10 (1.6%) | 18 (85.7%) | 3 (14.3%) | ||
2–3 | 241 (18.9%) | 107 (16.7%) | 134 (21.0%) | 140 (57.6%) | 103 (42.4%) | ||
4–5 | 683 (53.4%) | 337 (52.7%) | 346 (54.2%) | 334 (48.9%) | 349 (51.1%) | ||
6–9 | 291 (22.8%) | 156 (24.4%) | 135 (21.2%) | 138 (57.3%) | 153 (52.6%) | ||
≥10 | 42 (3.3%) | 29 (4.5%) | 13 (2.0%) | 17 (40.5%) | 25 (59.5%) | ||
The number of rooms in house: | 0.058 | 0.800 | |||||
<2 | 270 (21.1%) | 140 (21.9%) | 133 (20.8%) | 138 (51.1%) | 132 (48.9%) | ||
2–3 | 758 (59.4%) | 358 (56.0%) | 400 (62.5%) | 385 (50.8%) | 373 (49.2%) | ||
4–5 | 216 (16.9%) | 122 (19.0%) | 94 (14.7%) | 107 (49.5%) | 109 (50.5%) | ||
≥5 | 33 (2.6%) | 20 (3.1%) | 13 (2.0%) | 14 (42.4%) | 19 (57.6%) | ||
WAMI: | |||||||
W score | 0.095 (0.083) | 0.089 (0.066) | 0.15 | 0.100 (0.087) * | 0.090 (0.079) * | 0.097 | |
A score | 0.141 (0.048) | 0.130 (0.053) | <0.001 | 0.142 (0.049) * | 0.139 (0.048) * | 0.47 | |
M score | 0.152 (0.050) | 0.142 (0.044) | <0.001 | 0.133 (0.050) * | 0.168 (0.044) * | <0.001 | |
I score | 0.168 (0.055) | 0.171 (0.051) | 0.217 | 0.171 (0.052) * | 0.165 (0.057) * | 0.1.61 | |
WAMI index: | 0.003 | 0.164 | |||||
Mean (SD) | 0.555 (0.139) | 0.532 (0.130) | 0.547 (0.143) * | 0.562 (0.135) * | |||
Median | 0.562 | 0.547 | 0.547 | 0.562 | |||
Range | 0.219–0.969 | 0.188–0.906 | 0.234–0.938 | 0.219–0.969 | |||
0.188–0.344 | 50 (7.8%) | 67 (10.5%) | 24 (8.1%) | 26 (7.6%) | |||
>0.344–0.500 | 202 (31.6%) | 209 (32.7%) | 103 (34.7%) | 99 (28.9%) | |||
>0.500–0.656 | 219 (34.2%) | 230 (35.9%) | 94 (31.6%) | 125 (36.4%) | |||
>0.656–0.813 | 149 (23.3%) | 131 (20.5%) | 67 (22.6%) | 82 (23.9%) | |||
>0.813–0.969 | 20 (3.1%) | 3 (0.5%) | 9 (3.0%) | 11 (3.2%) | |||
The main source of drinking water for members of the household: | <0.001 | <0.001 | |||||
a. Piped water into dwelling (i) | 100 (15.6%) | 22 (3.4%) | 63 (9.7%) | 59 (9.3%) | |||
b. Tubewell/bore-hole (i) | 69 (10.8%) | 9 (1.4%) | 44 (6.8%) | 34 (5.4%) | |||
c. Protected dug well (i) | 8 (1.3%) | 3 (0.5%) | 3 (0.5%) | 8 (1.3%) | |||
d. Unprotected dug well (un) | 2 (0.3%) | 0 | 0 | 2 (0.3%) | |||
e. Protected spring (i) | 8 (1.3%) | 0 | 4 (0.6%) | 4 (0.6%) | |||
f. Unprotected spring (un) | 2 (0.3%) | 0 | 1 (0.2%) | 1 (0.2%) | |||
g. Bottled water (un) | 451 (70.5%) | 361 (56.4%) | 441 (68.2%) | 371 (58.6%) | |||
h. Cart with small tank/drum (un) | 0 | 6 (0.9%) | 5 (0.8%) | 1 (0.2%) | |||
i. Other: refill gallon (un) | 0 | 239 (37.3%) | 86 (13.3%) | 153 (24.2%) | |||
Source of drinking water: | 0.003 | 0.624 | |||||
Improved | 185 (28.9%) | 34 (5.3%) | 114 (17.6%) | 105 (16.6%) | |||
Unimproved | 455 (71.1%) | 606 (94.7%) | 533 (82.4%) | 528 (83.4.%) | |||
Sanitation: If using a “flush” or “pour flush” probe, where does the waste go? | <0.001 | 0.010 | |||||
a. Piped sewer system (i) | 56 (4.4%) | 11 (1.7%) | 45 (7.0%) | 36 (5.6%) | 20 (3.2%) | ||
b. Septic tank (i) | 659 (51.5%) | 289 (45.2%) | 370 (57.8%) | 351 (54.3%) | 308 (48.7%) | ||
c. Pit latrine (i) | 5 (0.4%) | 0 | 5 (0.8%) | 4 (0.6%) | 1 (0.2%) | ||
d. Elsewhere (un) | 30 (2.3%) | 24 (3.8%) | 6 (0.9%) | 12 (1.9%) | 18 (2.8%) | ||
e. No facilities or bush or field (un) | 2 (0.2%) | 0 | 2 (0.3%) | 2 (0.3%) | 0 | ||
f. Other: ditch (river) (un) | 521 (40.7%) | 314 (49.1%) | 207 (32.3%) | 240 (37.1%) | 281 (44.4%) | ||
g. Do not know (un) | 7 (0.5%) | 2 (0.3%) | 5 (0.8%) | 2 (0.3%) | 5 (0.8%) | ||
Sanitation facility: | <0.001 | 0.002 | |||||
Improved | 720 (56.25%) | 300 (46.9) | 420 (65.6) | 391 (60.4) | 329 (52.0) | ||
Unimproved | 560 (43.75%) | 340 (53.1 | 220 (34.4) | 256 (39.6) | 304 (48.0) |
Anti-HAV IgG (S/CO) | Living Area | p Value | Anti-HAV IgG | Total (S/CO) | ||
---|---|---|---|---|---|---|
Urban n = 640 | Rural n = 640 | Positive n = 647 | Negative n = 633 | |||
Average (SD) | 4.75 (5.048) | 5.73 (5.29) | <0.001 * | 10.192 (1.953) | 0.186 (0.121) | 5.24 (5.19) |
Median | 0.32 | 7.89 | 10.62 | 0.15 | 1.96 | |
Range | 0.07–13.06 | 0.05–19.29 | 1.01–19.29 | 0.05 –0.95 | 0.05–19.29 | |
Seroprotected | 0.003 ** | |||||
Positive | 297 (46.4%) | 350 (54.7%) | 647 (50.6%) | |||
Negative | 343 (53.6%) | 290 (45.3%) | 633 (49.4%) |
Characteristics | Urban | p Value * | Rural | p Value ** | Positivity Between Urban and Rural p Value *** | ||
---|---|---|---|---|---|---|---|
Positive n (%) 297 (46.4) | Negative n (%) 343 (53.6) | Positive n (%) 350 (54.7) | Negative n (%) 290 (45.3) | ||||
Sex | 0.049 | 0.020 | |||||
Male | 119 (42.0%) | 164 (58.0%) | 108 (48.4%) | 115 (51.6%) | 0.152 | ||
Female | 178 (49.9%) | 179 (50.1%) | 242 (58.0%) | 175 (42.0%) | 0.023 | ||
Age (Years) | <0.001 * | <0.001 * | |||||
1–2 | 1 (1.8%) | 54 (98.2%) | 4 (7.3%) | 51 (92.7%) | 0.363 | ||
3–4 | 3 (5.5%) | 52 (94.5%) | 4 (7.3%) | 51 (92.7%) | 1.000 | ||
5–9 | 6 (12.0%) | 44 (88.0%) | 4 (8.0%) | 46 (92.0%) | 0.741 | ||
10–14 | 7 (14.0%) | 43 (86.0%) | 22 (44.0%) | 28 (56.0%) | 0.001 | ||
15–19 | 19 (27.1%) | 51 (72.9%) | 30 (42.9%) | 40 (57.1%) | 0.051 | ||
20–24 | 32 (42.7%) | 43 (57.3%) | 43 (57.3%) | 32 (42.7%) | 0.072 | ||
25–29 | 43 (57.3%) | 32 (42.7%) | 54 (72.0%) | 21 (28.0%) | 0.060 | ||
30–34 | 52 (80.0%) | 13 (20.0%) | 53 (81.5%) | 12 (18.5%) | 0.824 | ||
35–39 | 56 (86.1%) | 9 (13.9%) | 58 (89.2%) | 7 (10.8%) | 0.593 | ||
40–49 | 48 (96.0%) | 2 (4.0%) | 48 (96.0%) | 2 (4.0%) | 1.000 | ||
≥50 | 30 (100%) | 0 | 30 (100%) | 0 | 1.000 |
Variables | Total | Living Area | p Value | Anti-HAV Ig G | p Value | ||
---|---|---|---|---|---|---|---|
Urban | Rural | Positive | Negative | ||||
Knowledge of disease | |||||||
1. Heard about a disease called hepatitis A before (yes) Kind of disease: | 437 (34.1%) | 276 (43.1%) | 161 (25.2%) | 217 (33.5%) | 220 (34.8%) | ||
a. Communicable | 222 (50.8%) | 125 (45.3%) | 97 (60.2%) | <0.001 | 117 (53.4%) | 105 (47.3%) | 0.647 |
b. Non-communicable | 102 (23.5%) | 64 (23.2%) | 38 (23.6%) | 0.001 | 47 (21.55) | 55 (24.8%) | 0.433 |
c. Do not know | 113 (25.8%) | 87 (31.5%) | 26 (16.1%) | 55 (25.1%) | 62 (27.9%) | ||
2. The main way of transmission | <0.001 | 0.009 | |||||
a. By blood | 71 (20.5%) | 57 (24.6%) | 14 (12.3%) | 24 (14.4%) | 47 (26.3%) | ||
b. By air | 55 (15.9%) | 46 (19.8%) | 9 (7.9%) | 21 (12.6%) | 34 (19.0%) | ||
c. Sexually transmitted | 14 (4.0%) | 13 (5.6%) | 1 (0.9%) | 6 (3.6%) | 8 (4.5%) | ||
d. By contaminated food/water | 151 (43.6%) | 81 (34.9%) | 70 (61.4%) | 81 (48.5%) | 70 (39.1%) | ||
e. By mosquito bite | 17 (4.9%) | 16 (6.9%) | 1 (0.9%) | 11 (6.6%) | 6 (3.4%) | ||
f. Combination | 38 (11.0%) | 19 (8.2%) | 19 (16.7%) | 24 (14.4%) | 14 (7.8%) | ||
3. A vaccine to prevent hepatitis A available in Indonesia | |||||||
| 257 (58.8%) | 165 (59.8%) | 92 (57.1%) | 0.522 | 128 (59.3%) | 129 (58.4%) | 0.494 |
| 35 (8.0%) | 19 (6.9%) | 16 (9.9%) | 14 (6.5%) | 21 (9.5%) | ||
| 145 (33.2%) | 92 (33.3%) | 53 (32.9%) | 74 (34.3%) | 71 (32.1%) | ||
4. The possible risk factor/factors | (n = 439) | (n = 279) | (n = 160) | ||||
| 191 (43.5%) | 125 (44.8%) | 66 (41.2%) | 0.470 | 97 (15.0%) | 94 (14.8%) | 0.943 |
| 193 (44.0%) | 100 (35.8%) | 93 (58.1%) | <0.001 | 93 (14.4%) | 99 (15.6%) | 0.526 |
| 60 (13.7%) | 30 (10.8%) | 30 (18.8%) | 0.019 | 28 (4.3%) | 32 (5.0%) | 0.538 |
| 70 (15.9%) | 45 (16.1%) | 25 (15.6%) | 0.890 | 33 (5.1%) | 37 (5.8%) | 0.558 |
| 108 (24.6%) | 86 (30.8%) | 22 (13.8%) | <0.001 | 55 (8.5%) | 53 (8.4%) | 0.934 |
5. The possible symptoms of hepatitis A | (n = 442) | (n = 280) | (n = 162) | ||||
| 317 (71.7%) | 193 (68.9%) | 124 (76.5%) | 0.087 | 165 (75.0%) | 152 (68.5%) | 0.029 |
| 188 (42.5%) | 118 (42.1%) | 70 (43.2%) | 0.827 | 93 (42.3%) | 95 (42.8%) | 0.078 |
| 78 (17.6%) | 53 (18.9%) | 25 (15.4%) | 0.353 | 37 (16.8%) | 41 (18.5%) | 0.737 |
| 195 (44.1%) | 134 (47.9%) | 61 (37.7%) | 0.038 | 98 (44.5%) | 97 (43.7%) | 0.981 |
| 83 (18.8%) | 52 (18.6%) | 31 (19.1%) | 0.884 | 40 (18.2%) | 43 (19.5%) | 0.750 |
| 261 (59.0%) | 179 (63.9%) | 82 (50.6%) | 0.006 | 130 (59.1%) | 131 (59.0%) | 0.618 |
| 146 (33.0%) | 96 (34.3%) | 50 (30.9%) | 0.462 | 69 (31.4%) | 77 (34.7%) | 0.678 |
6. Knowledge of HAV ** | <0.001 | 0.645 * | |||||
Adequate | 839 (65.5%) | 361 (56.4%) | 478 (74.7%) | 428 (66.2%) | 411 (64.9%) | ||
Inadequate | 441 (34.5%) | 279 (43.6%) | 162 (25.3%) | 219 (33.8%) | 222 (35.1%) | ||
Hygienic food intake | |||||||
1. Prepare food at home | <0.001 | 0.278 | |||||
| 288 (22.5%) | 90 (14.1%) | 198 (30.9%) | 157 (24.3%) | 131 (20.7%) | ||
| 447 (34.9%) | 203 (31.6%) | 245 (38.3%) | 217 (33.5%) | 230 (36.4%) | ||
| 544 (42.5%) | 347 (54.3%) | 197 (30.8%) | 273 (42.2%) | 271 (42.9%) | ||
2. Main meals from home | <0.001 | 0.004 | |||||
a. Never | 22 (1.7%) | 10 (1.6%) | 12 (1.9%) | 15 (2.3%) | 7 (1.1%) | ||
b. Sometimes | 300 (23.4%) | 115 (18.0%) | 185 (28.9%) | 168 (26.0%) | 132 (20.9%) | ||
c. Most of the time | 194 (15.2%) | 157 (24.5%) | 37 (5.8%) | 108 (16.7%) | 86 (13.6%) | ||
d. Always | 764 (59.7%) | 358 (55.9%) | 406 (63.4%) | 356 (55.0%) | 408 (64.5%) | ||
3. Main meals from street | <0.001 | 0.075 | |||||
| 393 (30.7%) | 208 (32.5%) | 185 (28.9%) | 206 (31.8%) | 187 (29.5%) | ||
| 760 (59.4%) | 349 (54.5%) | 411 (64.2%) | 365 (56.4%) | 395 (62.4%) | ||
| 98 (7.7%) | 68 (10.6%) | 30 (4.7%) | 59 (9.1%) | 39 (6.2%) | ||
| 29 (2.3%) | 15 (2.3%) | 14 (2.2%) | 17 (2.6%) | 12 (1.9%) | ||
4. Wash hands before handling food | <0.001 | 0.032 | |||||
| 15 (1.2%) | 3 (0.5%) | 12 (1.9%) | 13 (2.0%) | 2 (0.3%) | ||
| 210 (16.4%) | 64 (10.0%) | 146 (22.8%) | 109 (16.9%) | 101 (16.0%) | ||
| 178 (13.9%) | 28 (4.4%) | 150 (23.5%) | 93 (14.4%) | 85 (13.4%) | ||
| 876 (68.5%) | 545 (85.2%) | 331 (51.8%) | 431 (66.7%) | 445 (70.3%) | ||
5. Wash hands before eating food | <0.001 | 0.402 | |||||
| 3 (0.2%) | 0 | 3 (0.5%) | 2 (0.3%) | 1 (0.2%) | ||
| 75 (5.9%) | 4 (0.6%) | 38 (5.9%) | 32 (4.9%) | 43 (6.8%) | ||
| 123 (9.6%) | 8 (1.3%) | 103 (16.1%) | 67 (10.4%) | 56 (8.8%) | ||
| 1079 (84.3%) | 627 (98.1%) | 496 (77.5%) | 546 (84.4%) | 533 (84.2%) | ||
6. Wash hands after defecation (in case of younger children) | 0.024 | 0.006 | |||||
| 1 (0.1%) | 0 | 1 (0.2%) | 0 | 1 (0.2%) | ||
| 21 (1.6%) | 4 (0.6%) | 17 (2.7%) | 3 (0.5%) | 18 (2.8%) | ||
| 14 (1.1%) | 8 (1.3%) | 6 (0.9%) | 7 (1.1%) | 7 (1.1%) | ||
| 1242 (97.2%) | 627 (98.1%) | 615 (96.2%) | 636 (98.5%) | 606 (95.9%) | ||
7. The kitchen which prepared the food: free of insects and rodents | <0.001 | 0.077 | |||||
| 392 (30.6%) | 148 (23.1%) | 244 (38.1%) | 207 (32.0%) | 185 (29.2%) | ||
| 686 (53.6%) | 391 (61.1%) | 295 (46.1%) | 326 (50.4%) | 360 (56.9%) | ||
| 85 (6.6%) | 40 (6.3%) | 45 (7.0%) | 51 (7.9%) | 34 (5.4%) | ||
| 117 (9.1%) | 61 (9.5%) | 56 (8.8%) | 63 (9.7%) | 54 (8.5%) |
Variables | Coeff B | SE (B) | p-Value | PRadj (95% CI) |
---|---|---|---|---|
Living area (rural vs. urban) | 0.485 | 0.154 | 0.002 | 1.62 (1.20–2.19) |
Age (years) * | ||||
3–4 | 0.124 | 0.577 | 0.830 | 1.13 (0.37–3.50) |
5–9 | 0.705 | 0.539 | 0.198 | 2.02 (0.70–5.82) |
10–14 | 2.029 | 0.480 | <0.001 | 7.60 (2.97–19.47) |
15–19 | 2.247 | 0.459 | <0.001 | 9.46 (3.84–23.26) |
20–24 | 2.927 | 0.454 | <0.001 | 18.68 (7.67–45.46) |
25–29 | 3.477 | 0.459 | <0.001 | 32.35 (13.16–79.57) |
30–34 | 4.254 | 0.483 | <0.001 | 69.75 (27.08–179.63) |
35–39 | 4.760 | 0.508 | <0.001 | 116.72 (43.12–315.90) |
≥40 | 6.433 | 0.666 | <0.001 | 621.97 (168.77–2292.18) |
Education of father ** | ||||
Illiterate and primary school (6 years) | 0.673 | 0.327 | 0.040 | 1.96 (1.03–3.72) |
Middle school (9 years) | 0.716 | 0.332 | 0.031 | 2.05 (1.07–3.92) |
High school (13 years) | 0.254 | 0.311 | 0.414 | 1.29 (0.70–2.37) |
The kitchen which prepared the food: free of insects and rodents | 0.596 | 0.217 | 0.006 | 1.82 (1.19–2.78) |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Prasetyo, D.; Ermaya, Y.S.; Hernandez-Suarez, G.; Guzman-Holst, A.; Kartasasmita, C.B. Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Contrasting Geographical Areas in Indonesia. Medicina 2025, 61, 806. https://doi.org/10.3390/medicina61050806
Prasetyo D, Ermaya YS, Hernandez-Suarez G, Guzman-Holst A, Kartasasmita CB. Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Contrasting Geographical Areas in Indonesia. Medicina. 2025; 61(5):806. https://doi.org/10.3390/medicina61050806
Chicago/Turabian StylePrasetyo, Dwi, Yudith Setiati Ermaya, Gustavo Hernandez-Suarez, Adriana Guzman-Holst, and Cissy B. Kartasasmita. 2025. "Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Contrasting Geographical Areas in Indonesia" Medicina 61, no. 5: 806. https://doi.org/10.3390/medicina61050806
APA StylePrasetyo, D., Ermaya, Y. S., Hernandez-Suarez, G., Guzman-Holst, A., & Kartasasmita, C. B. (2025). Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Contrasting Geographical Areas in Indonesia. Medicina, 61(5), 806. https://doi.org/10.3390/medicina61050806