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Hepatitis A epidemiology in Australia: national seroprevalence and notifications
Author(s) -
Amin Janaki,
Gilbert Gwendolyn L,
Escott Rosslyn G,
Heath Timothy C,
Burgess Margaret A
Publication year - 2001
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2001.tb143309.x
Subject(s) - seroprevalence , medicine , epidemiology , demography , population , hepatitis a , vaccination , vaccination policy , notifiable disease , environmental health , hepatitis , immunology , serology , antibody , sociology
Objectives To determine hepatitis A seroprevalence and notification rates in Australia in order to inform vaccination policy. Design Seroprevalence was determined by cross‐sectional survey of opportunistically collected sera; notifications were extracted from the National Notifiable Diseases Surveillance System. Participants 3043 serum samples collected in 1998 were obtained from 46 laboratories around Australia. Sample size in each age group was based on expected seroprevalence, and States and Territories were sampled proportionally to their population size. Males and females were equally represented. Notifications were extracted for cases with onset between 1 January 1991 and 31 December 1998. Main outcome measures Seroprevalence and notifications were analysed by age, sex and State/Territory. Results 41.1% of serum samples were seropositive for hepatitis A (95% CI, 39.4%–42.9%) (population‐weighted seroprevalence, 38.3%). Seroprevalence was significantly associated with increasing age ( P <0.001), but did not differ between the sexes (male:female ratio. 1.04:1; 95% CI, 0.95–1.14). However, significantly more notifications were recorded for males than females (male:female ratio, 1,65:1: 95% CI, 1.60–1.70). The Northern Territory had the highest seroprevalence (68.8%; 95% CI, 52.7%–84.8%) and annual notification rates (48 7 per 100 000 population; 95% CI, 45.0–52.4 per 100 000). Conclusions These data show that about half the Australian population has not been exposed to hepatitis A and is therefore susceptible to infection. However, any decision on national routine childhood hepatitis A vaccination requires a cost–benefit analysis. Routine vaccination of high‐incidence communities remains controversial.