TY - JOUR
T1 - High hepatitis e seroprevalence among displaced persons in South Sudan
AU - Azman, Andrew S.
AU - Bouhenia, Malika
AU - Iyer, Anita S.
AU - Rumunu, John
AU - Laku, Richard Lino
AU - Wamala, Joseph F.
AU - Rodriguez-Barraquer, Isabel
AU - Lessler, Justin
AU - Gignoux, Etienne
AU - Luquero, Francisco J.
AU - Leung, Daniel T.
AU - Gurley, Emily S.
AU - Ciglenecki, Iza
N1 - Publisher Copyright:
Copyright © 2017 by The American Society of Tropical Medicine and Hygiene.
PY - 2017
Y1 - 2017
N2 - 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 from206 residents of an internally displaced person campin Juba, South Sudan.We tested serumfor anti-HEV antibodies (IgMand 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.
AB - 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 from206 residents of an internally displaced person campin Juba, South Sudan.We tested serumfor anti-HEV antibodies (IgMand 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.
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U2 - 10.4269/ajtmh.16-0620
DO - 10.4269/ajtmh.16-0620
M3 - Article
C2 - 28719276
AN - SCOPUS:85020385216
SN - 0002-9637
VL - 96
SP - 1296
EP - 1301
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -