title: Decrease in seroprevalence of hepatitis A after the implementation of nationwide disposable tableware use in Taiwan.
abstract: BACKGROUND
  Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use.
  
  
  METHODS
  We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies.
  
  
  RESULTS
  The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from previous studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982.
  
  
  CONCLUSIONS
  Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A.
authors.affiliation: Department of Family Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.forename: Ching-Yih
authors.initials: CY
authors.lastname: Lin
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Sheu
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Kan
authors.forename: Hsien-Yi
authors.initials: HY
authors.lastname: Wang
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003297:Cooking and Eating Utensils; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D004209:Disposable Equipment; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D035922:Hepatitis A Antibodies / Q000097:blood / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D035922:Hepatitis A Antibodies