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research letter

Indian Pediatr 2011;48: 71-73

Seroprevalence of Hepatitis A Virus Antibody in Bijapur, Karnataka


CP Rath, Arvind Akki, SV Patil and SS Kalyanshettar

Department of Pediatrics, BLDEA’s Shri B M Patil Medical College & Research Centre,
Bijapur, Karnataka India.
Email:
[email protected]

 


We studied the seroprevalence of anti-HAV IgG in children of Bijapur a tier III city/backward district in Karnataka and its relation with sociodemographic parameters. Out of 142 children, 6 months to 15 years who were included, 63 (44.4%) were sero positive, suggesting that Bijapur is a low endemic area.

Key words: Hepatitis A, IgG, Seroprevalence, Socioeconomic condition.


In areas of high endemicity, most children are exposed to Hepatitis A virus (HAV) and the consequent acquisition of antibodies against the virus confers lifelong immunity. The changing scenario in the last 20 years in developing countries from high to low seroprevalence reflects the impact of living standards and environmental hygiene on prevalence of infection. In India, limited epidemiological data are available on HAV infection, with a seroprevalence of anti HAV IgG exceeding 90% in adults. However, there have been recent reports of a decreasing prevalence in this country, suggesting that the seroprevalence of HAV antibodies is becoming similar to industrialized world.

We determined seroprevalance of anti-HAV IgG in a cross-sectional study carried out between November 2006 to April 2008. Children 6 months to 5 years age attending our hospital and children between age 5 years to 15 years from an urban and rural/slum school of Bijapur, were included.

Detailed socioenviromental history and immunization history were taken. Children with history of jaundice, hepatobiliary disease and those who are already immunized against hepatitis A were excluded from the study. 2 mL of blood in plain vial was collected; ELISA test was done for anti HAV IgG (Wantai Biopharma antibody kit). Data was analyzed using Correlation coefficient and Z test.

The age distribution shows a significant transition of positivity for anti HAV IgG in the age group 3 to 4 years. As age increases seropositivity for anti HAV IgG also increases at the rate of correlation coefficient 0.684.

Relation between socioenviromental factors and HAV IgG seropositivity is shown in Table I. Urban/rural/slum background, family size, source of water supply, hand washing habit and socioeconomic strata had a significant association (P <0.05) with presence of anti HAV IgG.

TABLE I



Seropositivity in Relation to Socioenviromental Factors
  Factors Total Cases (n) Positive Cases %  Positive P Value
Sex Male 77 32 41.5 0.46
  Female 65 31 47.7  
Age 6mo-5 y 76 27 35.5 0.02
  5-15 y 66 36 54.5  
Background Urban 66 21 31.8 0.005
  Slum/Rural 76 42 55.3  
Family Size 3-5 76 24 31.6 <0.001
  ≥ 6 66 39 59.1  
Persons perroom > 2 78 36 46.1 0.636
  ≤ 2 68 27 42.2  
Source ofwater Outside house 79 41 51.9 0.043
  Inside house 63 22 34.9  
Type of toilet Open field 65 30 46.1 0.693
  Own 77 33 42.8  
Hand wash Unsatisfactory 93 49 52.7 0.006
Habit Satisfactory 49 14 28.6  
Socioeconomic Lower 76 41 53.9 0.022
Class Higher+middle 66 22 33.3  

Seroprevalence in all age groups was low in our study compared to other studies from India except the study by Arankalle, et al. [2] from Kerala. Previous studies from India have reported a seroprevalence rate varying from 4.5% to 94.1% among different age groups [6-11]. All these studies were done around the year 2000 [2-11]. Statistically significant association of socio-enviromental factors were also reported in previous studies [3-5].

Seroprevalence of HAV in our study population from Bijapur, a tier III city, India is lower than other studies conducted in different parts of India. Seroprevalence might have declined with improved sanitation and improved socioeconomic status or it may a low endemic area.

If a small city has a low seroprevalence of antibody it compels us to investigate in bigger cities with superior hygiene and socioeconomic conditions and larger studies from different parts of India from time to time to decide the immunization strategy against hepatitis A.

References

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