Mukadi-Kakoni Patrick, Munyeku-Bazitama Yannick, Kashitu-Mujinga Gracia, Manwana-Pemba Marguerite, Zenga-Bibi Niclette, Okitale-Talunda Patient, Mbelu-Kabongo Christelle, Domai-Mbuyakala Fleurette, Pukuta-Simbu Elisabeth, Mutantu-Nsele Pierre, Kubo Yoshinao, Makiala-Mandanda Sheila, Ahuka-Mundeke Steve, Ariyoshi Koya, Muyembe-Tamfum Jean-Jacques
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Trop Med Health. 2025 Feb 5;53(1):17. doi: 10.1186/s41182-025-00687-8.
Yellow fever surveillance systems are designed to identify cases of acute febrile jaundice, a clinical syndrome used to monitor the emergence of yellow fever outbreaks. However, this syndrome has diverse etiologies, particularly viral hepatitis. This study investigates the seroepidemiology of viral hepatitis A (HAV), B (HBV), C (HCV), and E (HEV) among cases initially suspected to be yellow fever, aiming to elucidate the epidemiology of viral hepatitis in the Democratic Republic of Congo (DRC) and provide insights for improving public health interventions.
A retrospective cross-sectional study was conducted using serum samples collected between 2017 and 2018 through national yellow fever surveillance in the DRC. Samples from individuals testing negative for yellow fever were tested for IgM antibodies against HAV, HBc, HCV, and HEV and HBs antigen using validated ELISA kits. Acute HBV infection was defined by both HBc IgM and HBs antigen positivity. Multivariable logistic regression was used to assess the association of demographic, geographic, and environmental factors with each hepatitis type.
Among 1239 participants (58.8% male; median age: 16 years), seroprevalence was 16.1, 11.2, 5.0, and 3.1% for HAV, HBV, HCV and HEV, respectively. HAV prevalence was highest in the youngest age group and rural residents. In contrast, the youngest group was most protected from HBV. HCV prevalence was highest in the oldest age groups. HEV exhibited higher prevalence during the dry season and in a humid subtropical climate. Several provinces were identified as hotspots of HAV, HCV and HEV.
Viral hepatitis is a major cause of acute febrile jaundice in the DRC with notable geographic and seasonal trends. National yellow fever surveillance is a valuable resource for understanding hepatitis epidemiology, though careful interpretation is necessary. Tailored interventions are required for mitigating the burden of viral hepatitis in each province.
黄热病监测系统旨在识别急性发热性黄疸病例，这是一种用于监测黄热病疫情出现的临床综合征。然而，该综合征病因多样，尤其是病毒性肝炎。本研究调查了最初疑似为黄热病的病例中甲型（HAV）、乙型（HBV）、丙型（HCV）和戊型（HEV）病毒性肝炎的血清流行病学，旨在阐明刚果民主共和国（DRC）病毒性肝炎的流行病学，并为改善公共卫生干预措施提供见解。
采用回顾性横断面研究，使用2017年至2018年期间通过刚果民主共和国国家黄热病监测收集的血清样本。对黄热病检测呈阴性的个体样本，使用经过验证的酶联免疫吸附测定（ELISA）试剂盒检测抗HAV、抗-HBc、抗-HCV和抗-HEV IgM抗体以及HBs抗原。急性HBV感染定义为抗-HBc IgM和HBs抗原均呈阳性。采用多变量逻辑回归评估人口统计学、地理和环境因素与每种肝炎类型的关联。
在1239名参与者中（58.8%为男性；中位年龄：16岁），HAV、HBV、HCV和HEV的血清流行率分别为16.1%、11.2%、5.0%和3.1%。HAV流行率在最年轻年龄组和农村居民中最高。相比之下，最年轻组受HBV感染的可能性最小。HCV流行率在最年长年龄组中最高。HEV在旱季和湿润亚热带气候地区的流行率较高。几个省份被确定为HAV、HCV和HEV的热点地区。
病毒性肝炎是刚果民主共和国急性发热性黄疸的主要原因，具有明显的地理和季节性趋势。国家黄热病监测是了解肝炎流行病学的宝贵资源，不过需要仔细解读。需要采取针对性干预措施以减轻每个省份病毒性肝炎的负担。
