Epidemiology of hepatitis A virus in Jamaica

ABSTRACT

OBJECTIVE: Between January 1995 and August 1998, a study was conducted to elucidate the epidemiology of hepatitis A virus (HAV) in Jamaica. DESIGN AND METHODS: Participants were recruited from seven sites located in rural and urban areas of Jamaica. There were 128 and 211 females. The ages of the participants ranged from 3 to 90 years. The average ages of males and females were 24.9 and 25.6 years, respectively. Social and demographic data were collected by questionnaire. Potential risk factors which were studied included age of the individual, gender residence in an urban and rural are, type of toilet facilities and source of domestic water supply (indoor or outdoor plumbing). RESULTS: The seroprevalence of HAV in the study population using ELISA was 59.9 percent. Based on logistic regression, age and source of domestic water supply were found to be the major contributors to exposure to HAV (p<0.001) and p=0.006, respectively). The rate of exposure to the virus increased with age. By age 10 years, 30 percent of children were exposed. This was followed by a steady increase to about 73 percent by age 30 years. Prevalence remained at a plateau up to age 50 years after which there was an increase to almost 100 percent in the oldest individuals. Rates of exposure to HAV were higher amongst households with outdoor plumbing which included standpipes, rivers and tanks than those with indoor plumbing. CONCLUSIONS: The seroprevalence of HAV in Jamaica is higher than that seen generally in developed countries, although the age related acquisition of infection was similar. It is expected that the pattern and severity of disease from the virus is similar to that seen in developed countries. Improved water supply and educating the public on the epidemiology of HAV could reduce the prevalence of HAV in Jamaica.(AU)