Seropositivity of Hepatitis A, B and E Viruses in Two Socio-Economically Distinct Neighbouring Urban Communities in Lusaka, Zambia DOI: https://dx.doi.org/10.4314/ajhs.v38i3.5

Abstract

Background: Viral hepatitis is prevalent in Africa, but the epidemiological data available are limited. In Zambia, the prevalence of the hepatitis B virus (HBV) is approximately 4-6%, while the hepatitis C virus (HCV) is much less common. The epidemiology of hepatitis A (HAV) and E (HEV) viruses is less defined, and the relationship between HEV and socio-economic status has been scarcely explored. We set out to determine the seropositivity of HAV, HBV and HEV in two adjacent residential areas of urban Lusaka with sharply contrasting housing and wealth.

Methods: A cross-sectional study surveyed adults in a ‘high density’ (lower SES) and a nearby ‘medium density’ (higher SES) area. Blood samples were analysed for HAV and HEV IgG antibodies and hepatitis B surface antigen (HBsAg). Demographic and household data were collected; Fisher's exact test assessed statistical significance, while logistic regression compared seropositivity rates.

Results: The study included 59 and 38 participants from low and high SES communities, respectively, of whom 35 (36%) were male, and 62 (64%) were female. Seropositivity to HAV, HBsAg and HEV were 98%, 5% and 26%, respectively. HEV seropositivity was much higher in the low SES community (37%) than in the high SES (8%; P=0.001), but that of HAV and HBV did not differ between the two communities.

Conclusions: The higher seropositivity rate of anti-HEV IgG antibodies in the low SES community compared to the high SES community indicates that poor sanitation and unsatisfactory environmental hygiene conditions are associated with increased risk of hepatitis E exposure.