Faculty of Medicine, Department of Pediatrics, Jordan University of Science and Technology, Irbid, Jordan.
J Med Virol. 2015 Apr;87(4):569-74. doi: 10.1002/jmv.24137. Epub 2015 Feb 3.
Hepatitis A Virus (HAV) has been a significant cause of infections among the children and adolescents of Jordan. Availability of safe vaccines made it necessary to identify the ill-defined temporal immunity trends for HAV and possible age-specific prevalence transitions. This community-based cross sectional study was conducted during the period July-August 2008 on 3,066 recruited subjects from the 12 governorates of Jordan, with pre-defined criteria. Several households were chosen at random within each selected block to enroll the subjects. They were interviewed and data were collected. Their sera were tested for total antibodies against HAV. A multivariate model was then performed to identify the possible risk factors. The HAV sero-prevalence rates among the age categories-second year, 2-4 years, 5-9 years, 10-14 years, 15-19 years, and those above 20 years were 26%, 32%, 44%, 63%, 78%, and 94%, respectively. The model revealed the association of several risk factors for higher HAV sero-prevalence rates: (i) older age groups; (ii) lower maternal education levels; (iii) residing in certain governorates; (iv) using public net drinking water; and (v) avoiding use of public net sewage system. This study provided strong evidence for continuous transition of HAV epidemiology towards intermediate endemicity in Jordan, with more susceptible adolescents and adults. Following the World Health Organization (WHO) recommendations for countries with intermediate endemicity, large-scale hepatitis A vaccination is recommended for children in Jordan. This is strengthened by the availability of effective and safe HAV vaccines, improving the socio-economic status of the Jordanians, and increasing life expectancy among Jordanians.
甲型肝炎病毒（HAV）一直是约旦儿童和青少年感染的主要原因。安全疫苗的出现使得有必要确定 HAV 免疫时间趋势不明确，并可能存在特定年龄组的患病率转变。这项基于社区的横断面研究于 2008 年 7 月至 8 月在约旦的 12 个省份进行，共招募了 3066 名符合既定标准的研究对象。在每个选定的街区内，随机选择几个家庭来招募研究对象。对他们进行访谈并收集数据。检测他们的血清中针对 HAV 的总抗体。然后进行多变量模型分析以确定可能的危险因素。各年龄段的 HAV 血清阳性率（第 2 年、2-4 岁、5-9 岁、10-14 岁、15-19 岁和 20 岁以上）分别为 26%、32%、44%、63%、78%和 94%。模型揭示了一些危险因素与较高的 HAV 血清阳性率相关：（i）年龄较大；（ii）母亲教育程度较低；（iii）居住在某些省份；（iv）使用公共网络饮用水；以及（v）避免使用公共网络污水系统。本研究为 HAV 流行病学在约旦向中间流行的持续转变提供了有力证据，约旦的青少年和成年人更容易受到感染。根据世界卫生组织（WHO）对中间流行地区国家的建议，建议约旦为儿童接种大规模甲型肝炎疫苗。这一建议得到了有效和安全的 HAV 疫苗的支持，这将改善约旦人的社会经济地位，并延长约旦人的预期寿命。
