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IJE Advance Access published online on April 14, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi062
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Accepted March 1, 2005

Original paper

The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns

K. H. Jacobsen 1* and J. S. Koopman 2

1 Department of Epidemiology, University of Michigan, Ann Arbor MI, USA; Calvin College, Grand Rapids MI, USA
2 Department of Epidemiology, University of Michigan, Ann Arbor MI, USA

* To whom correspondence should be addressed.
K. H. Jacobsen, E-mail: jacobsen{at}calvin.edu


  Abstract

Background Hepatitis A virus (HAV) infection confers long-term immunity, so mathematical analysis of age-specific seroprevalence in populations can reveal changes in the infection rate over time. HAV transmission is related to access to clean drinking water, personal hygiene and public sanitation.

Methods We used an SIR (susceptible-infectious-recovered) compartmental model with age structure to fit a time-dependent logistic function for HAV force of infection for 157 published age-seroprevalence data sets. We then fit linear regression models for socioeconomic variables and infection rate.

Results The proportion of the population with access to clean drinking water, the value of the human development index (HDI), and per capita gross domestic product (GDP) are all inverse predictors of HAV infection rates. Declining infection rates were observed in 65.6% of the surveys.

Discussion This work demonstrates the utility of HAV seroprevalence studies to reveal patterns of change in force of infection and to assess the association between socioeconomic risk factors and transmission rates.

Keywords: Hepatitis A virus; seroprevalence studies; socioeconomic development; water.
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