Clinical Research
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Ulusal aşı programı ve kitlesel göçün, 2013-2018 arasında çocuklarda hepatit A epidemiyolojisine etkileri

Year 2022, Volume: 3 Issue: 3, 211 - 215, 26.09.2022
https://doi.org/10.47582/jompac.1166127

Abstract

Amaç: Akut hepatit A, az gelişmiş ve gelişmekte olan ülkelerde yaygın olarak görülen bir halk sağlığı sorunudur. Hepatit A aşısı, Kasım 2012’de Türkiye’de Ulusal Bağışıklama Programının bir parçası olarak uygulanmaya başlanmıştır. Bu çalışma, ulusal aşılama programının ve kitlesel göçün hepatit A enfeksiyonunun epidemiyolojisi ve klinik yükü üzerindeki etkilerini araştırmayı amaçlamıştır.
Gereç ve Yöntem: Çalışma, Cengiz Gökçek Kadın Doğum ve Çocuk Hastanesi, Türkiye’de Ocak 2013 ile Şubat 2018 arasında 0-18 yaş arasında viral hepatit A enfeksiyonu tanısı alan çocuklar arasında tek merkezli, geriye dönük yapılmıştır. Tüm olguların yaş, tanı zamanı, uyruk ve cinsiyet bilgileri değerlendirildi. Hastanede yatan vakalarda kalış süresi, alanin transaminaz ve aspartat aminotransferazın maksimum değerleri ve hastaneye yatışın doğrudan tıbbi maliyeti de değerlendirildi.
Bulgular: Çalışma süresince toplam 1039 vakaya hepatit A enfeksiyonu tanısı konuldu. Bu vakaların %53’ü erkek, %14’ü Suriyeli mülteci ve ortanca yaş 7,9 yıldı. Yılda (2013-2017) vaka sayısı sırasıyla 321, 360, 157, 119 ve 73 idi. Vakaların çoğu Kasım, Aralık ve Ocak aylarında tespit edildi. Yıllar içerisinde toplam vaka sayısı azalırken, Suriyeli vaka sayısının arttığını gördük. 2013 ve 2017 yıllarında toplam vakalarda Suriyeli çocukların oranı sırasıyla %6,5 ve %52,1’dir. Hastanede yatış oranı %49.4, medyan kalış süresi dört gün ve ortalama hastanede yatış maliyeti 246,8$/vaka idi.
Sonuç: Ulusal aşılama programı ile prevalans azalmaktadır ancak toplumdaki duyarlı birey sayısı halen hastalığın epidemiyolojisini olumsuz etkilemektedir. Enfeksiyon kontrolü için epidemiyolojik verilerin sürekli izlenmesi ve aşı kapsamını genişletme çabaları gereklidir.

References

  • Jacobsen KH, Wiersma ST. Hepatitis A virus seroprevalence by age and world region, 1990 and 2005. Vaccine 2010; 28: 6653-7.
  • Lee DY, Chae SJ, Cho SR, Choi W, Kim CK, Han MG. Nationwide seroprevalence of hepatitis A in South Korea from 2009 to 2019. PLoS One 2021; 16: e0245162.
  • Enoch A, Hardie DR, Hussey GD, Kagina BM. Hepatitis A seroprevalence in Western Cape Province, South Africa: Are we in epidemiological transition? S Afr Med J 2019; 109: 314–8.
  • Demiray T, Köroğlu M, Jacobsen KH, Özbek A, Terzi HA, Altındiş M. Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: seroprevalence and endemicity by region. Turk J Pediatr 2016; 58: 480-91.
  • Chatziprodromidou IP, Dimitrakopoulou ME, Apostolou T, Katopodi T, Charalambous E, Vantarakis A. Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47: 102283.
  • Ceran N, Yüksel Kocdogan F, Mert D, et al. Hepatitis A seroprevalence in children and young adults in Istanbul, Turkey: seroprevalence change and associated factors. J Viral Hepat 2012; 19: 72–6.
  • Badur S, Öztürk S, Ozakay A, Khalaf M, Saha D, Van Damme P. A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region. Hum Vaccin Immunother 2021; 17: 3710–28.
  • Akman AÖ, Burhan BY, Uzun AK, Taş D. Türkiye’de Hepatit A aşısının uygulanmasından sonra yaşa özel seroprevalans: Tek merkezli çocuk hastanesinin sonuçları. Türk Pediatr Arşivi 2020; 55: 370-5.
  • Halicioglu O, Akman SA, Tatar B, Atesli R, Kose S. Hepatitis A seroprevalence in children and adolescents aged 1-18 years among a low socioeconomic population in Izmir, Turkey. Travel Med Infect Dis 2012; 10: 43-7.
  • Karadeniz A, Akduman Alaşehir E, Yeşilbağ Z, Balıkçı A, Yaman G. The seroprevalence of hepatitis A in Istanbul, Turkey. Marmara Med J 2017; 30: 14-7.
  • Kurugol Z, Aslan A, Turkoglu E, Koturoglu G. Changing epidemiology of hepatitis A infection in Izmir, Turkey. Vaccine 2011; 29: 6259-61.
  • Bizri AR, Fares J, Musharrafieh U. Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon. Avicenna J Med 2018; 8: 147-52.
  • Köse Ş, Ödemiş I, Çelik D, Gireniz Tatar B, Akbulut I, Çiftdoğan DY. Hepatitis A, B, C and HIV seroprevalence among Syrian refugee children admitted to outpatient clinics. Le Infez Med 2017; 25: 339-43.
  • Michaelis K, Wenzel JJ, Stark K, Faber M. Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016. Emerg Microbes Infect 2017; 6: e26.
  • Mellou K, Chrisostomou A, Sideroglou T, et al. Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016. Euro Surveill 2017; 22: pii=30448.
  • Ekmekci PE. Syrian Refugees, Health and Migration Legislation in Turkey. J Immigr Minor Heal 2017; 19: 1434-41.
  • Doganay M, Demiraslan H. Refugees of the Syrian Civil War: impact on reemerging infections, health services, and biosecurity in Turkey. Heal Secur 2016; 14: 220–5.
  • Ergönül Ö, Tülek N, Kayı I, Irmak H, Erdem O, Dara M. Profiling infectious diseases in Turkey after the influx of 3.5 million Syrian refugees. Clin Microbiol Infect 2020; 26: 307–12.
  • Freidl GS, Tostmann A, Curvers M, et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016. Vaccine 2018; 36: 1664-72.
  • Mülteciler Derneği. Türkiye’deki Suriyeli Sayısı Ağustos 2022. Available from: https://multeciler.org.tr/turkiyedeki-suriyeli-sayisi/. [Accessed 2022 Aug 22].
  • Hofmeister MG, Yin S, Aslam MV, Teshale EH, Spradling PR. Hepatitis A Hospitalization Costs, United States, 2017. Emerg Infect Dis 2020; 26: 1040-1.
  • Rajan E, Shattock AG, Fielding JF. Cost-effective analysis of hepatitis a prevention in Ireland. Am J Gastroenterol 2000; 95: 223-6.

The effects of the national vaccination program and massive migration on the epidemiology of hepatitis A in children from 2013 to 2018

Year 2022, Volume: 3 Issue: 3, 211 - 215, 26.09.2022
https://doi.org/10.47582/jompac.1166127

Abstract

Aim: Acute hepatitis A is a common public health problem in underdeveloped and developing countries. The hepatitis A vaccine was implemented as part of the National Immunization Program in Turkey in November 2012. The present study aimed to investigate the effects of the national vaccination program and massive migration on the epidemiology and clinical burden of hepatitis A infection.
Material and Method: The study was a single center, retrospective chart review study among children diagnosed with viral hepatitis A infection between 0 and 18 years of age from January 2013 to February 2018 in Gaziantep Cengiz Gökçek Maternity and Children Hospital, Turkey. All cases’ age, diagnosis time, nationality, and gender information were evaluated. The length of stay, the maximum value of alanine transaminase and aspartate aminotransferase, and the direct medical cost of hospitalization were also evaluated in hospitalized cases.
Results: During the study period total of 1039 cases were diagnosed with hepatitis A infection. Of these cases, 53% were males, 14% were Syrian refugees, and the median age was 7.9-year. The number of cases per year (2013 through 2017) was 321, 360, 157, 119, and 73, respectively. The majority of the cases were detected in November, December, and January. While the total number of cases was declining, we saw that the number of Syrian cases was increasing. The percentage of Syrian children in total cases in 2013 and 2017 was 6.5% and 52.1%, respectively. The hospitalization rate was %49.4, the median length of stay was four days, and the average medical cost of hospitalization was 246.8$/case.
Conclusion: With the national vaccination program, prevalence is declining, but the number of susceptible individuals in society is still adversely affecting the epidemiology of the disease. Continuous monitoring of epidemiological data and efforts to expand vaccine coverage are required for infection control.

References

  • Jacobsen KH, Wiersma ST. Hepatitis A virus seroprevalence by age and world region, 1990 and 2005. Vaccine 2010; 28: 6653-7.
  • Lee DY, Chae SJ, Cho SR, Choi W, Kim CK, Han MG. Nationwide seroprevalence of hepatitis A in South Korea from 2009 to 2019. PLoS One 2021; 16: e0245162.
  • Enoch A, Hardie DR, Hussey GD, Kagina BM. Hepatitis A seroprevalence in Western Cape Province, South Africa: Are we in epidemiological transition? S Afr Med J 2019; 109: 314–8.
  • Demiray T, Köroğlu M, Jacobsen KH, Özbek A, Terzi HA, Altındiş M. Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: seroprevalence and endemicity by region. Turk J Pediatr 2016; 58: 480-91.
  • Chatziprodromidou IP, Dimitrakopoulou ME, Apostolou T, Katopodi T, Charalambous E, Vantarakis A. Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47: 102283.
  • Ceran N, Yüksel Kocdogan F, Mert D, et al. Hepatitis A seroprevalence in children and young adults in Istanbul, Turkey: seroprevalence change and associated factors. J Viral Hepat 2012; 19: 72–6.
  • Badur S, Öztürk S, Ozakay A, Khalaf M, Saha D, Van Damme P. A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region. Hum Vaccin Immunother 2021; 17: 3710–28.
  • Akman AÖ, Burhan BY, Uzun AK, Taş D. Türkiye’de Hepatit A aşısının uygulanmasından sonra yaşa özel seroprevalans: Tek merkezli çocuk hastanesinin sonuçları. Türk Pediatr Arşivi 2020; 55: 370-5.
  • Halicioglu O, Akman SA, Tatar B, Atesli R, Kose S. Hepatitis A seroprevalence in children and adolescents aged 1-18 years among a low socioeconomic population in Izmir, Turkey. Travel Med Infect Dis 2012; 10: 43-7.
  • Karadeniz A, Akduman Alaşehir E, Yeşilbağ Z, Balıkçı A, Yaman G. The seroprevalence of hepatitis A in Istanbul, Turkey. Marmara Med J 2017; 30: 14-7.
  • Kurugol Z, Aslan A, Turkoglu E, Koturoglu G. Changing epidemiology of hepatitis A infection in Izmir, Turkey. Vaccine 2011; 29: 6259-61.
  • Bizri AR, Fares J, Musharrafieh U. Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon. Avicenna J Med 2018; 8: 147-52.
  • Köse Ş, Ödemiş I, Çelik D, Gireniz Tatar B, Akbulut I, Çiftdoğan DY. Hepatitis A, B, C and HIV seroprevalence among Syrian refugee children admitted to outpatient clinics. Le Infez Med 2017; 25: 339-43.
  • Michaelis K, Wenzel JJ, Stark K, Faber M. Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016. Emerg Microbes Infect 2017; 6: e26.
  • Mellou K, Chrisostomou A, Sideroglou T, et al. Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016. Euro Surveill 2017; 22: pii=30448.
  • Ekmekci PE. Syrian Refugees, Health and Migration Legislation in Turkey. J Immigr Minor Heal 2017; 19: 1434-41.
  • Doganay M, Demiraslan H. Refugees of the Syrian Civil War: impact on reemerging infections, health services, and biosecurity in Turkey. Heal Secur 2016; 14: 220–5.
  • Ergönül Ö, Tülek N, Kayı I, Irmak H, Erdem O, Dara M. Profiling infectious diseases in Turkey after the influx of 3.5 million Syrian refugees. Clin Microbiol Infect 2020; 26: 307–12.
  • Freidl GS, Tostmann A, Curvers M, et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016. Vaccine 2018; 36: 1664-72.
  • Mülteciler Derneği. Türkiye’deki Suriyeli Sayısı Ağustos 2022. Available from: https://multeciler.org.tr/turkiyedeki-suriyeli-sayisi/. [Accessed 2022 Aug 22].
  • Hofmeister MG, Yin S, Aslam MV, Teshale EH, Spradling PR. Hepatitis A Hospitalization Costs, United States, 2017. Emerg Infect Dis 2020; 26: 1040-1.
  • Rajan E, Shattock AG, Fielding JF. Cost-effective analysis of hepatitis a prevention in Ireland. Am J Gastroenterol 2000; 95: 223-6.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Benhur Şirvan ÇETİN

Publication Date September 26, 2022
Published in Issue Year 2022 Volume: 3 Issue: 3

Cite

AMA ÇETİN BŞ. The effects of the national vaccination program and massive migration on the epidemiology of hepatitis A in children from 2013 to 2018. J Med Palliat Care / JOMPAC / jompac. September 2022;3(3):211-215. doi:10.47582/jompac.1166127

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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