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Article

Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital

by
Nariman Kareem
1,
Khaled Al-Salahat
1,2,
Faris G. Bakri
3,4,
Yaser Rayyan
3,5,
Azmi Mahafzah
1,2 and
Malik Sallam
1,2,*
1
Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
2
Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
3
Department of Internal Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
4
Infectious Diseases and Vaccine Center, The University of Jordan, Amman 11942, Jordan
5
Gastroenterology and Liver Division, Department of Internal Medicine, Jordan University Hospital, Amman 11942, Jordan
*
Author to whom correspondence should be addressed.
Pathogens 2021, 10(9), 1081; https://doi.org/10.3390/pathogens10091081
Submission received: 26 July 2021 / Revised: 24 August 2021 / Accepted: 25 August 2021 / Published: 26 August 2021
(This article belongs to the Special Issue Global Elimination of Viral Hepatitis)
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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.
Keywords: epidemiology; immunization; vaccine; sanitation; seroprevalence; Middle East epidemiology; immunization; vaccine; sanitation; seroprevalence; Middle East

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MDPI and ACS Style

Kareem, N.; Al-Salahat, K.; Bakri, F.G.; Rayyan, Y.; Mahafzah, A.; Sallam, M. Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital. Pathogens 2021, 10, 1081. https://doi.org/10.3390/pathogens10091081

AMA Style

Kareem N, Al-Salahat K, Bakri FG, Rayyan Y, Mahafzah A, Sallam M. Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital. Pathogens. 2021; 10(9):1081. https://doi.org/10.3390/pathogens10091081

Chicago/Turabian Style

Kareem, Nariman, Khaled Al-Salahat, Faris G. Bakri, Yaser Rayyan, Azmi Mahafzah, and Malik Sallam. 2021. "Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital" Pathogens 10, no. 9: 1081. https://doi.org/10.3390/pathogens10091081

APA Style

Kareem, N., Al-Salahat, K., Bakri, F. G., Rayyan, Y., Mahafzah, A., & Sallam, M. (2021). Tracking the Epidemiologic Shifts in Hepatitis A Sero-Prevalence Using Age Stratification: A Cross-Sectional Study at Jordan University Hospital. Pathogens, 10(9), 1081. https://doi.org/10.3390/pathogens10091081

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