Hepatitis A virus in the Middle East and North Africa region: a new challenge

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• A notable epidemiological shift in Hepatitis A Virus (HAV) infection age from childhood to adulthood has occurred globally over the past three decades.
• Limited current data exists on HAV burden, incidence, and age-specific seroprevalence within the Middle East and North Africa (MENA) region.
• Anti-HAV seroprevalence serves as a crucial indicator for monitoring infection rates.

Purpose of the Study:

• To systematically review published anti-HAV seroprevalence data across MENA countries.
• To identify and analyze associated risk factors, including water quality and socioeconomic indicators, where available.
• To assess the current epidemiological landscape of HAV in the MENA region.

Main Methods:

• Literature search for published studies on anti-HAV seroprevalence in MENA countries.
• Data extraction and synthesis of seroprevalence rates and identified risk factors.
• Analysis of age-specific seroprevalence trends to identify shifts in infection patterns.

Main Results:

• Anti-HAV seroprevalence data was available for 12 out of 25 MENA countries reviewed.
• A clear epidemiological shift in HAV incidence was observed, with declining rates in younger populations and increasing rates in adults and older individuals.
• This demographic shift in infection is likely to correlate with increased morbidity and a higher risk of outbreaks in adult populations.

Conclusions:

• The observed shift in HAV incidence towards older age groups in MENA countries warrants attention due to potential increases in disease severity and outbreaks.
• Continuous surveillance of hepatitis A cases is essential for understanding and managing the evolving epidemiology.
• Integration of the hepatitis A vaccine into routine expanded immunization programs within MENA countries is recommended to mitigate the growing burden of adult infections.