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HAV in the Middle East and North Africa region declined in younger populations

Seroprevalence trends in hepatitis A virus infection indicated a decline among younger populations in the Middle East and North Africa region, while areas with less access to improved water and sanitation facilities continue to have greater disease burden, according to data from a new study.

Nada M. Melhem, PhD, Assistant Professor in the Medical Laboratory Sciences Program, American University of Beirut, Lebanon, and colleagues conducted a systematic search of PubMed to find studies on anti-HAV seroprevalence in the Middle East and North Africa (MENA) region during the last 10 years. They sought to update anti-HAV seroprevalence data and assess risk factors associated with hepatitis A virus infection.

Nada M. Melhem

In examining available data from 12 of the 25 MENA region countries, researchers found that HAV incidence has declined among younger age groups and increased in adults and older individuals. They attributed this shift to improving standards of living.

Researchers said most studies on anti-HAV seroprevalence included Turkey and Iran. The overall anti-HAV prevalence rate among persons aged 19 years or younger in Turkey ranged between 13% and 64% during the last decade. It ranged from 29% to 63.8% up until 2008, then declined sharply in 2010 (13%) and 2012 (29.5%).

The overall anti-HAV prevalence in Iran was 83% in one study and 90% in another. Seroprevalence rates specific to Tehran increased with age, from 61.6% in persons aged 20 years or younger to 86% among those aged 18 to 65 years.

Anti-HAV seroprevalence declines were associated with a population’s access to improved water sources, sanitation facilities, waste water treatment and desalination. Researchers said poorer countries such as Mauritania and Somalia, however, are “lagging behind with less than 30% of the populations having access to improved drinking water and using improved sanitation facilities.”

“The intensification of the surveillance systems across the MENA region is essential to monitor the burden of the disease,” Melhem told Healio.com/Hepatology. “This is especially critical during the time of wars and conflicts as is the case of the displacement of Syrian refugees and their settlement in densely populated camps with unclean water sources, poor sanitation conditions and low-quality housing. All of these would contribute to the quick spread of disease and consequently are expected to influence the epidemiology of [HAV] and other infectious diseases.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.