الفهرس 
Structure of Hepatitis AOnly 14 pages are availabe for public view
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Abstract
In this study, we aimed to assess the seroprevalence of hepatitis A IgG antibody in a group of Egyptian children and adolescents and to correlate the findings with possible socioeconomic and demographic risk factors.
This was a cross sectional study conducted at Ain Shams University Children’s hospital outpatient clinic (OPC), Cairo, Egypt during the period from September 2023 to March 2024 and performed on 200 Egyptian children and adolescents above the age of 1 and below the age of 16 years.
All enrolled cases were subjected to history taking focusing on the cause of the presenting complain and demographic risk factors, clinical examination was conducted including general, chest, cardiac and abdominal examination, evaluation of socioeconomic status was done by El-Gilani and serum blood sample was withdrawn for assessment of Hepatitis A IgG antibody seropositivity using enzyme linked immunosorbent assay (ELISA) method.
Among the 200 cases enrolled in our study, 68% were serologically positive for HAV IgG antibodies. It was found that, 55.5% of the serologically positive cases were male and 45.5% were female. The mean age of studied cases was 6.7 ± 4.1 years.
As regards the gender of the cases, there was no statistically significant association between gender and seropositivity.
There was also no statistically significant difference regarding anthropometric measures between seropositive and negative cases.
As regards presenting symptoms , respiratory and GIT symptoms were the most frequent presenting symptoms among studied cases with a frequency of 38% and 30% respectively.
As regards socioeconomic evaluation, most of the enrolled cases lied between low and middle socioeconomic levels according to El-Gilany socioeconomic scale, which were 49% and 35% respectively.
Our study showed that the seropositivity of HAV antibodies increased significantly with decreasing social class; from 4.4% among children in the high social class to 33.1% in the middle social class to 55.1% in the low social class.
Despite improvements in socioeconomic standards, Egypt is still highly endemic for Hepatitis A infection, especially among those living in a low socioeconomic status.
Our results showed that HAV IgG antibody negative cases were least frequent in 11-15 years (15.6%), followed by 6-10 years (28.1%) and most frequent in 1-5 years (56.3%), the differences were statistically significant. This is presumably due to increased likelihood exposure to HAV with advancing age.
As regards residence, HAV IgG antibody negative cases were most frequent in those living in Greater Cairo (90.6%), and less frequent in cases from Lower Egypt (4.7%), the differences were statistically significant possibly due to diversity in standards for environmental hygiene and safety of water supply.
We concluded that age above 6 years, residence in lower Egypt and low and middle socioeconomic status were significant risk factors that increased the likelihood of having positive Hepatitis A IgG antibodies denoting past exposure to Hepatitis A virus.
Whereas paternal high education was a significant protective factor. that increased the likelihood of being negative for Hepatitis A IgG antibodies, from 12.5% to 32.8%, among children of illiterate and highly educated parents respectively.
Conclusion
Seroprevalence of Hepatitis A IgG antibody among our 200 Egyptian children and adolescents was 68%.
Age and residential categorization of studied cases showed that older children and those from Lower Egypt were more Hepatitis A IgG seropositive.
Paternal high education was a significant independent protective factor associated with lower seroprevalence of Hepatitis A IgG antibodies.
Recommendations
An evaluation of the Hepatitis A virus epidemiology among different areas of the country is warranted before nationwide vaccine implementation for cost effectiveness.
Hepatitis A vaccination schedule needs to be timed properly based on disease epidemiology using periodic sero-epidemiologic surveys.
Because of the high seroprevalence of hepatitis A IgG antibody among Egyptian children and adolescents, testing for hepatitis A antibody is advised before recommending the vaccine on individual basis.
Raising the socioeconomic standard of the population through improving parents’ education and awareness campaigns about modes of infection and transmission of hepatitis A infection are needed to lower hepatitis A endemicity in Egypt.