Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico.
Centro de Investigación sobre Evaluación y Encuestas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico.
Vaccine. 2018 Dec 18;36(52):8094-8099. doi: 10.1016/j.vaccine.2018.10.037. Epub 2018 Oct 15.
To describe hepatitis A virus (HAV) seroprevalence and associated factors in adolescents (10-19 years) and young adults (20-25 years) in different Mexican regions, using 2012 National Health and Nutrition Survey data. A random selection of 1581 serum samples was analyzed. Weighted HAV seroprevalence with 95% confidence intervals (95%CI) and its association with sociodemographic factors were estimated. Mean weighted HAV seroprevalence was 69.3% (95%CI: 64.8-73.4) overall, with 58.8% (95%CI: 53.4-64.1) in adolescents and 83.0% (95%CI: 75.3-88.7) in young adults. By age of 10, 46.7% (95%CI: 33.9-60.0) were seropositive and by age of 15, 52.8% (95%CI: 36.5-68.5), corresponding to intermediate endemicity nationally. Factors associated with HAV seropositivity (adjusted odds ratio, aOR) included: lower socioeconomic status (SES) (aOR = 4.09 for low and aOR = 2.31 for medium versus high SES), older age (aOR = 0.29 for adolescents versus young adults), living in the South (aOR = 2.12 versus Central Mexico) or in rural areas (aOR = 2.25 versus urban areas). Regional differences and increased seroprevalence of HAV in marginalized populations present an important public health issue, as a relatively large proportion of young adults are susceptible to infection. The burden of symptomatic disease must be addressed further to support specific programs of continued sanitation and education improvement, and the possibility of vaccination in more susceptible regions.
为了描述不同墨西哥地区青少年（10-19 岁）和青年（20-25 岁）的甲型肝炎病毒（HAV）血清流行率及其相关因素，我们使用了 2012 年国家健康和营养调查的数据。对 1581 份血清样本进行了随机选择并进行了分析。使用加权 HAV 血清流行率及其 95%置信区间（95%CI），并估计了其与社会人口因素的关联。总体而言，加权 HAV 血清流行率的平均值为 69.3%（95%CI：64.8-73.4），青少年为 58.8%（95%CI：53.4-64.1），青年为 83.0%（95%CI：75.3-88.7）。到 10 岁时，46.7%（95%CI：33.9-60.0）呈血清阳性，到 15 岁时，52.8%（95%CI：36.5-68.5）呈血清阳性，这反映了全国范围内的中度流行。与 HAV 血清阳性相关的因素（调整后的优势比，aOR）包括：较低的社会经济地位（SES）（低 SES 的 aOR=4.09，中 SES 的 aOR=2.31），年龄较大（青少年的 aOR=0.29，与青年相比），生活在南部（aOR=2.12 与中墨西哥相比）或农村地区（aOR=2.25 与城市地区相比）。边缘化人群中 HAV 的区域差异和感染率增加，是一个重要的公共卫生问题，因为相当大比例的年轻人容易感染。需要进一步解决有症状疾病的负担，以支持持续改善卫生和教育的具体方案，并在更容易感染的地区考虑接种疫苗的可能性。
