Hepatitis E Prevalence among Acute Febrile Jaundice Patients in Senegal, 2008-2020

Hepatitis E, caused by hepatitis E virus (HEV), is a highly endemic disease with a major public health impact. In Senegal, the first HEV outbreak was identified in 2014 in Kedougou, and a recent study focusing on pregnant women showed a seroprevalence of 7.8%. Apart from these data, very little is known about its burden in Senegal, and there is no specific surveillance program. We describe HEV prevalence among acute febrile jaundice patients in Senegal. A retrospective analysis using jaundice samples (2008-2020) collected through the national yellow fever surveillance program were tested for HEV by IgM/IgG ELISA and reverse transcription polymerase chain reaction (RT-PCR). Sequencing and phylogenetic analyses were performed on RT-PCR-positive samples. Statistical tools were used to analyze the HEV prevalence. In total, 2,387 samples were tested, and 174 IgG, 135 IgM/IgG, and 29 IgM positive samples were detected. Among the IgM-positive samples, 74 were positive by RT-PCR. The results showed an overall HEV prevalence of 14% in febrile jaundice patients in Senegal. Phylogenetic analyses showed the circulation of genotype 2b. Our data confirmed the HEV outbreak in Kedougou in 2014 and showed the detection of acute cases in other regions. We also detected in these regions genotype 2b, which is usually associated with large outbreaks in many African countries, suggesting a high risk of HEV outbreak occurrence in Senegal. Finally, our data showed that the yellow fever surveillance program, which is based on jaundice and already exists in many countries, could be a valuable tool for HEV surveillance.