Hepatitis A virus
(HAV) infection which is usually asymptomatic in the childhood, is a severe
disease in the elder causing high morbidity. Hepatitis A seroprevelance
increases proportionally with age and correlates with socioeconomic level
(SEL).
Thanks to hepatitis
A vaccine HAV infection became a preventable disease in recent years. In order
to determine a vaccination strategy and cost effectiveness of preimmune testing
(PIT) in our region and country anti-HAV seroprevelance among 711 randomly selected
children with various SEL and with a mean age of 8.3 years (range: 2-16.5
years) residing in three different central districts of Adana were found to be
44.4%.
Anti-HAV
seroprevelance in Adana among children with low, medium, and high SEL was
51.9%, 48.9%. and 36.3%, respectively and seroprevelance was found to be
increased with age (p<0.0001).
In this study we
observed that SEL has no statistically significant effect on seroprevelance
until age 6 (p>0.05), however after this age seroprevelance decreased
significantly in children with medium and high SEL compared to children with
low SEL (p<0.005).
As a result, we
found that in children between 2 to 6 years old PIT decreased the vaccination
cost just 11.9%, however after 6 and 12 years of age this cost decreased 40.2%,
and 59.3%, respectively.
For the best-cost effectiveness in our country, we propose direct vaccination in children under 6 years of age, and PIT in elderly.