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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1382-1384
Prevention and control of Hepatitis A in developing nations: Public health perspective


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Prevention and control of Hepatitis A in developing nations: Public health perspective. Ann Trop Med Public Health 2017;10:1382-4

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Prevention and control of Hepatitis A in developing nations: Public health perspective. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 16];10:1382-4. Available from: http://www.atmph.org/text.asp?2017/10/5/1382/196683


Dear Sir,

Hepatitis A is a viral infectious condition of the liver, which results in devitalizing symptoms and acute liver failure, which, in turn, has been linked with high fatality.[1] It has been identified as one of the most common causes of food-borne infection and tends to occur in both sporadic and epidemic forms across the world, with cyclic recurrences as well.[1] Further, regions across the world have been categorized as high (developing nations with poor sanitation, risk of epidemics rare, and 90% of children acquiring the infection below 10 years of age), intermediate (developing nations with slightly better sanitary conditions, the risk of large outbreaks, and high risk of large outbreak), and low (developed nations with good sanitation and infection common among adolescents/adults in high-risk groups) levels of infection.[1],[2]

Although, the most common mode of disease transmission is through consumption of contaminated food and water, the virus can also be transmitted through direct contact with an infectious individual.[2] Further, anyone who has not been immunized or previously infected can acquire the infection, but presence of attributes like substandard sanitary conditions, limited access to safe water, poor hygiene, injecting drugs, living with an infected person, poor socioeconomic status, involvement in sexual activity with an infected partner, and unimmunized traveller visiting an endemic region significantly enhances the risk of being infected with the disease.[3],[4]

Despite being a self-limiting disease, hepatitis A's clinical severity increases as the age advances, with almost 50% of the infected children being asymptomatic, while individuals older than 50 years having a higher disease-specific death rate.[2],[4] In fact, out of the tens of millions of infections occurring each year, only 1.5 million individuals present with symptoms to the healthcare facilities.[2],[4] Moreover, apart from the associated morbidities, the disease results in significant social and financial after-effects like sickness absenteeism, prolonged absence from schools, reduced productivity of the households, and enormous impact on the food establishments detected with the virus.[1],[2],[3] Further, the condition is diagnosed by detection of virus-specific antibodies and managed with symptomatic therapy and rehydration, in the absence of specific treatment.[3],[5]

In order to control the incidence of the disease, measures like improving the basic sanitation, ensuring food safety and adequate supply of safe drinking water, adopting standardized measures for sewage disposal, and creating awareness among the mothers and the general population to improve personal hygiene practices like regular hand washing and immunization are the most effective interventions.[3],[4] The recommended vaccine has been administered either as a single-dose or two-dose regimen, based on the local context in the nation and the proportion of people who are susceptible to the infection.[1],[3] However, as the vaccine is expensive, the decision to introduce the same in the regular childhood immunization program depends on the economic burden posed on the health sector.[1],[3],[4]

To conclude, hepatitis A has been identified as a major public health concern, especially in the developing nations. As the disease can be controlled by immunization and improvement in sanitary conditions, all the concerned stakeholders should work to improve the socioeconomic status and expansion of immunization services.

Acknowledgements

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Hepatitis A-Fact sheet N 328; 2015. Available from: http://who.int/mediacentre/factsheets/fs328/en/. [Last accessed on 2016 June 24].  Back to cited text no. 1
    
2.
Wang Z, Chen Y, Xie S, Lv H. Changing epidemiological characteristics of Hepatitis A in Zhejiang province, China: Increased susceptibility in adults. PLoS ONE 2016;11:e0153804.  Back to cited text no. 2
[PUBMED]    
3.
World Health Organization. Global policy report on the prevention control of viral hepatitis in WHO member states. Geneva: WHO Press; 2013. 1-27.  Back to cited text no. 3
    
4.
Serrano-Aulló MT, Lorente-Perez S. Viral hepatitis: A health problem that requires appropriate planning. Rev Clin Esp 2016;216:253-4.  Back to cited text no. 4
    
5.
Sa-Nguanmoo P, Posuwan N, Vichaiwattana P, Vuthitanachot V, Saelao S, Foonoi M. Declining trend of hepatitis A seroepidemiology in association with improved public health and economic status of Thailand. PLoS ONE 2016;11:e0151304.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196683

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