Tufenkeji H
Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Vaccine. 2000 Feb 18;18 Suppl 1:S65-7. doi: 10.1016/s0264-410x(99)00468-5.
Data on the endemicity of hepatitis A virus (HAV) infection in Africa and the Middle East are scant, but most of Africa appears to remain a high endemicity region, with the exception of subpopulations in some areas, e.g. White people in South Africa. Saudi Arabia is a model for the Middle East, and is a country in which shifting HAV epidemiology has been documented in recent years, concurrent with the social and economic development that has occurred over the last two decades. Earlier studies generally showed very high prevalence rates, with most people becoming infected in early childhood. Between 1989 and 1995, however, there was a significant fall in the seroprevalence of antibodies to HAV in children up to 12 years old throughout the country except in one region bordering the Yemen. The highest seroprevalence is found in children from rural backgrounds, while the seroprevalences in Bedouin and urban children are similar. Seroprevalence is related to socioeconomic status, being highest in the lowest groups. Similar findings have been reported from other countries in the Middle East. The existence of pockets of high endemicity for HAV infection with surrounding areas shifting towards intermediate endemicity may lead to outbreaks, and widespread vaccination should be considered.
关于非洲和中东地区甲型肝炎病毒（HAV）感染的流行情况数据匮乏，但除了某些地区的亚人群体（如南非的白人）外，非洲大部分地区似乎仍是高流行区。沙特阿拉伯是中东地区的一个典型例子，该国近年来记录了甲型肝炎病毒流行病学的变化，这与过去二十年发生的社会和经济发展同步。早期研究普遍显示患病率很高，大多数人在幼儿期就受到感染。然而，在1989年至1995年期间，除了与也门接壤的一个地区外，全国12岁以下儿童中甲型肝炎病毒抗体的血清阳性率显著下降。农村背景儿童的血清阳性率最高，而贝都因儿童和城市儿童的血清阳性率相似。血清阳性率与社会经济地位相关，在最低社会经济群体中最高。中东其他国家也报告了类似的发现。甲型肝炎病毒感染高流行区的存在以及周边地区向中等流行区的转变可能导致疫情爆发，因此应考虑广泛接种疫苗。
