Senior Registrar in Community Medicine, Ministry of Health, Sri Lanka.
Senior Professor in Community Medicine, Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
BMC Public Health. 2020 Mar 18;20(1):357. doi: 10.1186/s12889-020-08490-2.
Hepatitis A virus (HAV) is one of the commonest food and water borne infectious diseases. The objective of the study was to determine the risk factors of HAV infection in the Gampha District in Sri Lanka.
This was an unmatched case control study conducted between January 2015 and November 2016 comprising of 504 participants with a case control ratio of 1:1. The study population included individuals of age 1 year and above who were permanent residents of the district. Cases included participants admitted to four secondary care state hospitals with an acute HAV diagnosed by detecting serum anti-HAV IgM antibodies. Controls were randomly selected individuals from the community with serum negative for Anti-HAV IgM and IgG. An interviewer administered questionnaire was used for the data collection and multiple logistic regression was applied to determine the independent risk factors. The results are expressed as adjusted odds ratios (AOR) and 95% confidence intervals (CI).
Risk factors for HAV infection were poor knowledge regarding hepatitis (AOR;3.98, 95% CI = 1.97-8.05), unhygienic sanitary practices (OR = 2.73; 95% CI = 1.42-5.23), unhygienic practices related to drinking water (OR = 2.67; 95% CI = 1.37-5.21), residing in urban areas (OR = 5.94; 95% CI = 2.98-11.86) and lower family income (OR = 2.83; 95% CI = 1.30-6.13).
The independent modifiable risk factors for HAV infection were poor knowledge regarding hepatitis, unhygienic sanitary practices, and unhygienic practices related to drinking water. Community awareness must be raised on hygienic practices and safe water drinking practices. Inequities of social determinates of health must be addressed.
甲型肝炎病毒（HAV）是最常见的食源性和水源性传染病之一。本研究的目的是确定斯里兰卡 Gampha 区 HAV 感染的危险因素。
这是一项在 2015 年 1 月至 2016 年 11 月期间进行的病例对照研究，包括 504 名参与者，病例对照比例为 1:1。研究人群包括年龄在 1 岁及以上、该地区常住居民的个体。病例包括在四家二级保健州立医院住院的 HAV 急性患者，通过检测血清抗-HAV IgM 抗体诊断。对照组是从社区中随机选择的血清抗-HAV IgM 和 IgG 阴性的个体。采用问卷调查收集数据，并应用多变量逻辑回归确定独立的危险因素。结果表示为调整后的优势比（AOR）和 95%置信区间（CI）。
HAV 感染的危险因素包括对肝炎的知识匮乏（AOR：3.98，95%CI=1.97-8.05）、不卫生的卫生习惯（OR=2.73；95%CI=1.42-5.23）、不卫生的饮用水相关习惯（OR=2.67；95%CI=1.37-5.21）、居住在城市地区（OR=5.94；95%CI=2.98-11.86）和较低的家庭收入（OR=2.83；95%CI=1.30-6.13）。
HAV 感染的独立可改变危险因素包括对肝炎的知识匮乏、不卫生的卫生习惯和不卫生的饮用水相关习惯。必须提高社区对卫生习惯和安全饮用水习惯的认识。必须解决健康社会决定因素的不平等问题。
