title: Should aboriginals in the "top end" of the Northern Territory be vaccinated against hepatitis A?
abstract: OBJECTIVE
  To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the "Top End" of the Northern Territory.
  
  
  METHODS
  A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.
  
  
  RESULTS
  Overall, 337/344 samples (97.97%) tested positive for hepatitis A total antibodies--18/20 samples (90%) in the 1-5 year age group; 85/88 (96.6%) in the 6-10 year age group; 98/98 (100%) in the 11-15 year age group; 32/33 (97.0%) in the 16-20 year age group and 104/105 (99%) in the older than 20 year age group.
  
  
  CONCLUSIONS
  Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.
authors.affiliation: Northern Territory Department of Health and Community Services, Darwin.
authors.forename: F J
authors.initials: FJ
authors.lastname: Bowden
authors.forename: B J
authors.initials: BJ
authors.lastname: Currie
authors.forename: N C
authors.initials: NC
authors.lastname: Miller
authors.forename: S A
authors.initials: SA
authors.lastname: Locarnini
authors.forename: V L
authors.initials: VL
authors.lastname: Krause
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006301:Health Services Needs and Demand; D006506:Hepatitis A / Q000097:blood / Q000208:ethnology* / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies / Q000097:blood; D006507:Hepatovirus / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D015876:Northern Territory / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000009:adverse effects / Q000706:statistics & numerical data*; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines