The Seroprevalence of hepatitis A in children of different age group socioeconomic status in the center of Adana city

THE SEROPREVALENCE OF HEPATITIS A IN CHILDREN OF DIFFERENT AGE GROUP AND SOCIOECONOMIC STATUS IN THE CENTER OF ADANA CITY ABSTRACT This study was carried on children of different age groups and socioeconomic status (SES) living in the center of Adana province to determine the seroprevalence of anti-HAV amongst them to mark out an immunization strategy. For the study, the various living quarters were grouped based on their infrastructural characteristics and estimated socioeconomic status of their inhabitants into high, middle and low socioeconomic groups; from the groups three residential quarters were selected based on the stratified cluster sampling and from each residential quarters based on the random numbers table, three streets were chosen. From a total of 71 1 children, blood samples were taken and a questionnaire that examined SES were filled out. In this questionnaire, monthly income of the family, whether the house is selfowned, rented, a state-owned, and if rented the price, as well as the source of the water used and the household items found in their homes were asked. By pointing, SES of these families were determined. Those with SES points between 5-9 were placed in Group I (Low), those between 10-14 in Group II (Middle) and those between 15-24 in Group III (High). The total anti-HAV were analysed at the central laboratories of the Çukurova University Faculty of Medicine, Balcali Hospital with AXSYM equipment and using the MEIA (Microparticle Enzyme Immunoassay) method. The average age of the children was 99.4 months (low-high: 24-198 months). 355 of the children were boys and 356 were girls. Amongst the 71 1 children who participated in the study whilist no difference was found between sexes in terms of anti-HAV seroprevalence; an increase in seropositivity was observed as age increased (p<0.0001). Anti-HAV seropositivity was found to be affected by both the educational status of the parents and their occupations. Anti-HAV prevalence was lowest among the children of university graduates. For children younger than 72 months, no difference was observed in the seropositivity between those in nurseries and those not in nurseries (PX).5). Of the participating children, %20.8 had been admitted at least once to the hospital, but no difference was observed between those admitted and those not admitted in terms of anti-HAV seroprevalence (p>0.05). Among children who had a positive personal or family history of jaundice, anti-HAV seroprevalence vnwas higher than those without a history of jaundice (p<0.0001, p<0.001). %84 of the children was found to have experienced hepatit A infection unicterically. Although the seropositivity of anti-HAV did not differ as the number of 0-6 year brothers in the household increase (p>0.05), an increase in anti-HAV seropositivity was observed as the number of 7-12 year old brothers increased (p<0.0001). Likewise, an increase in seropositivity was observed as the number of family members increase(p<0.0001). As the monthly incomes and the socioeconomic status improved, anti-HAV seropositivity of the children was observed to decrease (pO.OOOl, p<0.005 respectively). Amongst the 24-47 month old children whilist no difference was observed in anti-HAV seropositivity in terms of the SES groups (p>0.05) among the 72-143 month old children anti-HAV seropositivity was found to be significantly lower in the SES group III than the SES group I (p<0.05). The difference was statistically significant between the SES group I and SES group III and between the SES group II and SES group III in the 144-198 month-olds (p<0.005, p<0.001 respectively). Whilist the seroprevalence ratios for the 72-143 month-olds were %60 for SES group I, %52.5 for SES group II and %39.6 for SES group III, among the 144-198 month-olds the seropositivity was %86.9, %78.1 and %53.4 for the SES group I, II and III respectively. In conclusion, it was found that anti-HAV seroprevalence showed an increase with age and for children up to age 6 years, the socioeconomic status did not affect the prevalence of anti-HAV, but after this age awards, the anti-HAV prevalence found to be significantly lower in the high socioeconomic than those for the middle and low socioeconomic groups. Among the SES group III of children from the 72-143 and 144-198 month-olds one in every three or two children was found to be sensitive for HAV and therefore we are of the opinion that an HAV immunization can be recommended for the children in this group. Key Words: Hepatitis A, Seroprevalence, Socioeconomic Status, Children. VIII