Changes in prevalence of hepatitis A and associated factors in Setif-Algeria.

Hepatitis A, a waterborne disease associated with fecal contamination, remains the most common acute hepatitis worldwide. Generally considered to be a disease affecting children living in poor sanitary conditions, hepatitis A affects the adult population if hygiene improves. Studies conducted during the 1980s ranked Algeria as a highly endemic area. Thirty years on, we conducted this cross-sectional epidemiological study with the main objective of estimating the seroprevalence of hepatitis A virus infection in the district of Setif, Algeria. A survey was carried out between June 2010 and September 2011 and focused on 1061 individuals aged 5-19 years old. The seroprevalence of hepatitis A was estimated at 72.3% and varied with age: 56.9% in children aged 5-9 years, 70.4% among those aged 10-14 years, and 85.4% for the 15-19-year-old age group. Factors associated with lower seroprevalence were mainly related to a higher socioeconomic level, including living in an urban area, small household size, parents with a higher educational level, and consumption of bottled mineral water. This study highlights an epidemiological change and predicts that Algeria is in a period of gradual transition to intermediary endemicity. This change is synonymous with a susceptible population growing older, suggesting that serious forms of hepatitis can be expected more frequently. The current preventive strategy against hepatitis A should be revisited.