Community-based cross-sectional seroprevalence study of hepatitis A in Bangladesh.
OBJECTIVE
To elucidate the age-distribution of anti-hepatitis A virus (HAV) seroprevalence across different socioeconomic status (SES) categories in Bangladesh which, despite scarce data, is generally deemed to have high endemicity.


METHODS
Blood samples of 818 subjects from a stratified sample of schools and hospitals, comprising different age categories and SES were collected. They were assayed for total anti-HAV antibodies. Social and medical history data were obtained using a questionnaire.


RESULTS
Overall anti-HAV seroprevalence was 69.6%, increasing with age from 1-5 years (40.4%) to > 30 years (98.4%). Seroprevalence was lowest (49.8%) in the high SES group and highest (96.5%) in the rural lower-middle SES group. Among subjects aged 6-20 years, anti-HAV seroprevalence was lowest in urban private school children (43.0%), followed by urban government school children (76.2%) and rural school children (96.5%) (P < 0.01). Within the high SES group, anti-HAV seroprevalence was 32.3% in subjects < 10 years and 51.7% in those aged 11-20 years. Until now Bangladesh has been deemed to have high endemicity for HAV.


CONCLUSIONS
The transition from high to intermediate HAV endemicity may be underway; high SES adolescents and adults remain particularly at risk of symptomatic illness. Preventive measures need consideration.
Saha
Samir K
SK
Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka 1207, Bangladesh. sksaha@bangla.net
Saha
Setarunnahar
S
Shakur
Salim
S
Hanif
Mohammed
M
Habib
Md Ahsan
MA
Datta
Sanjoy K
SK
Bock
Hans L
HL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology*; D035922:Hepatitis A Antibodies / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D016036:Seroepidemiologic Studies; D012923:Social Class; D011795:Surveys and Questionnaires; D014504:Urban Health; D055815:Young Adult
D035922:Hepatitis A Antibodies