High Hepatitis E Seroprevalence Among Displaced Persons in South Sudan.
High Hepatitis E Seroprevalence Among Displaced Persons in South Sudan.
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DOI：
10.4269/ajtmh.16-0620
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
Ciglenecki I
中科院分区：
文献类型：
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作者：
Azman AS;Bouhenia M;Iyer AS;Rumunu J;Laku RL;Wamala JF;Rodriguez-Barraquer I;Lessler J;Gignoux E;Luquero FJ;Leung DT;Gurley ES;Ciglenecki I
在过去十年中，在非洲流离失所的人群中记录了戊型肝炎病毒（HEV）的大规模持久爆发，尽管这些特殊环境之外的数据有限。血清学研究可以为改善监测和疾病控制提供有用的见解。我们使用先前为另一项研究从南苏丹朱巴境内流离失所者营地的206名居民中收集的样本进行了年龄分层血清学调查。我们检测了血清中的抗HEV抗体（IgM和IgG），并估计了近期和历史暴露于该病毒的患病率。使用个人的血清状态，营地到达日期和原产地的状态的数据，我们使用催化传播模型来估计HEV感染的相对风险在营地相比，在参与者的家庭状态。年龄校正的抗-HEV IgG血清阳性率为71%（95%置信区间= 63-78），4%有近期暴露证据（IgM）。我们估计营地中的HEV暴露率比参与者的家乡州高出2倍以上（风险比= 2.3，95%可信区间= 0.3-5.8），尽管这种差异在统计学上并不显著。即使在没有报告病例的情况下，HEV传播也可能高于以前的估计。需要在类似情况下改进监测，以了解疾病负担，并通过早期发现和应对尽量减少流行病的影响。
Large protracted outbreaks of hepatitis E virus (HEV) have been documented in displaced populations in Africa over the past decade though data are limited outside these exceptional settings. Serological studies can provide insights useful for improving surveillance and disease control. We conducted an age-stratified serological survey using samples previously collected for another research study from 206 residents of an internally displaced person camp in Juba, South Sudan. We tested serum for anti-HEV antibodies (IgM and IgG) and estimated the prevalence of recent and historical exposure to the virus. Using data on individuals' serostatus, camp arrival date, and state of origin, we used catalytic transmission models to estimate the relative risk of HEV infection in the camp compared with that in the participants' home states. The age-adjusted seroprevalence of anti-HEV IgG was 71% (95% confidence interval = 63–78), and 4% had evidence of recent exposure (IgM). We estimated HEV exposure rates to be more than 2-fold (hazard ratio = 2.3, 95% credible interval = 0.3–5.8) higher in the camp than in the participants' home states, although this difference was not statistically significant. HEV transmission may be higher than previously appreciated, even in the absence of reported cases. Improved surveillance in similar settings is needed to understand the burden of disease and minimize epidemic impact through early detection and response.