Seroprevalence of hepatitis A virus infection in different age groups of children

Context: Hepatitis A is one of the most common causes of hepatitis in the pediatric age group and the most common cause of fulminant hepatic failure (FHF) among children in India. Hepatitis A is a waterborne disease. High endemicity obviates the need for vaccine in the community. Aims: We studied 116 children in the outpatient department (OPD) to know the seroprevalence of hepatitis A virus (HAV), total antibodies, and the effect of various demographic and water sanitation variables on it. Settings and Design: Children attending the pediatric OPD with minor problems in a medical college hospital were chosen for this study. It is a descriptive, cross-sectional, and seroepidemiologic investigative study. Materials and Methods: Blood samples of randomly selected children were collected and competitive enzyme-linked immunosorbent assay (ELISA) test was done for the detection of total anti-HAV antibodies, [both immunoglobulin M (IgM) and immunoglobulin G (IgG)], using a commercially available ELISA kit. "Dia.Pro" (Diagnostic Bioprobes srl via Columella n degrees 31 20128 Millano, Italy). Statistical Analysis Used: Statistical analysis was performed by the chi-square test using Epi Info software 3.5.4 version (2012) [Center for disease control and prevention (CDC), Atlanta, Georgia (USA)]. Results: Seroprevalence in children from the upper social class was 54.5% versus 87.2% in the lower social class (P = 0.00075). 90.9% of the children with rural background were seropositive compared to 77.1% of children with urban background. The mother's education above and below secondary level had a seropositivity for HAV in children up to 69.23% and 87.1%, respectively. The method of water treatment using boiled water, mechanical filtration, filtration plus ultraviolet (UV) light treatment, and no treatment had a seropositivity of 50.0%, 83.33%, 37.5%, and 84%, respectively, (P = 0.0036). Seropositivity was the highest when the water source was municipal bore well pipeline (88.88%), followed by municipal dam water through pipeline (79.16%), and personal bore well (68.16%) (P = 0.026). Conclusion: Children of this geographical area have high seroprevalence for HAV antibodies at a younger age with a significant difference between their social classes, water sources, and water treatment methods.