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Citation

Azman, Andrew S.; Bouhenia, Malika; Iyer, Anita S.; Rumunu, John; Laku, Richard Lino; Wamala, Joseph F.; Rodriguez-Barraquer, Isabel; Lessler, Justin; Gignoux, Etienne; & Luquero, Francisco J., et al. (2017). High Hepatitis E Seroprevalence among Displaced Persons in South Sudan. American Journal of Tropical Medicine and Hygiene, 96(6), 1296-1301. PMCID: PMC5462562

Abstract

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.

URL

http://dx.doi.org/10.4269/ajtmh.16-0620

Reference Type

Journal Article

Year Published

2017

Journal Title

American Journal of Tropical Medicine and Hygiene

Author(s)

Azman, Andrew S.
Bouhenia, Malika
Iyer, Anita S.
Rumunu, John
Laku, Richard Lino
Wamala, Joseph F.
Rodriguez-Barraquer, Isabel
Lessler, Justin
Gignoux, Etienne
Luquero, Francisco J.
Leung, Daniel T.
Gurley, Emily S.
Ciglenecki, Iza

Article Type

Regular

PMCID

PMC5462562

Continent/Country

South Sudan

ORCiD

Lessler - 0000-0002-9741-8109