title: Hepatitis A seroprevalence and risk factors among day-care educators.
abstract: BACKGROUND
  Day-care centres play a role in the epidemiology of hepatitis A virus (HAV). Up-to-date documentation on its seroprevalence and potential risk factors among day-care educators, who may be at risk for significant HAV morbidity, is nevertheless lacking. The availability of a hepatitis A vaccine provides an additional opportunity for prevention in this population. To determine the seroprevalence of previous HAV infection among day-care educators and to identify potential risk factors, we undertook a survey.
  
  
  METHODS
  Of 167 randomly selected centres, 81 centres participated. Directors and educators completed questionnaires on risk factors. Sera were collected during on-site visits from October through December 2001.
  
  
  RESULTS
  Seroprevalence of previous HAV infection in 492 participating educators was 35.6%. Significant risk factors in multivariate analysis included birth in a high-versus moderate/low-income country (odds ratio [OR] 20.8; 95% confidence interval [CI] 9.4-46.0); self-reported HAV vaccination (OR 6.1, CI 2.9-13.0); travel to endemic areas (OR 2.4, CI 1.3-4.2); and age (5-yr OR 1.5, CI 1.3-1.7). When Canadian-born educators were analyzed separately, an association was found between seropositivity and the number of years worked in daycare centres (5-yr OR 1.3, CI 1.0-1.8).
  
  
  CONCLUSIONS
  This represents the first study in Canada designed to examine risk factors for previous HAV infection among adult day-care educators. As a group, their risk factors for seropositivity are similar to those in the general population. However, educators born in Canada (a low-endemicity area for hepatitis A) appear to be at additional risk by working in day-care centres. The benefits of HAV screening and routine vaccination of day-care educators need to be examined.
authors.affiliation: Department of Epidemiology and Biostatistics, McGill University, Montréal, Que.
authors.forename: Cristin J
authors.initials: CJ
authors.lastname: Muecke
authors.forename: Claire
authors.initials: C
authors.lastname: Béliveau
authors.forename: Elham
authors.initials: E
authors.lastname: Rahme
authors.forename: Julio C
authors.initials: JC
authors.lastname: Soto
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D006506:Hepatitis A / Q000453:epidemiology*; D006801:Humans; D015999:Multivariate Analysis; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires