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Modeling the hepatitis A epidemiological transition in Thailand.
Vaccine. 2016 Jan 20; 34(4):555-562.V

Abstract

BACKGROUND

In most low- and middle-income countries, hepatitis A virus (HAV) is shifting or expected to shift from high endemicity to intermediate or low endemicity. A decreased risk of HAV infection will cause an increase in the average age at infection and will therefore increase the proportion of infections that results in severe disease. Mathematical models can provide insights into the factors contributing to this epidemiological transition.

METHODS

An MSLIR compartmental dynamic transmission model stratified by age and setting (rural and urban) was developed and calibrated with demographic, environmental, and epidemiological data from Thailand. HAV transmission was modeled as a function of urbanization and access to clean drinking water. The model was used to project various epidemiological measures.

RESULTS

The age at midpoint of population immunity remains considerably younger in rural areas than in urban areas. The mean age of symptomatic hepatitis A infection in Thailand has shifted from childhood toward early adulthood in rural areas and is transitioning from early adulthood toward middle adulthood in urban areas. The model showed a significant decrease in incidence rates of total and symptomatic infections in rural and urban settings in Thailand over the past several decades as water access has increased, although the overall incidence rate of symptomatic HAV is projected to slightly increase in the coming decades.

CONCLUSIONS

Modeling the relationship between water, urbanization, and HAV endemicity is a novel approach in the estimation of HAV epidemiological trends and future projections. This approach provides insights about the shifting HAV epidemiology and could be used to evaluate the public health impact of vaccination and other interventions in a diversity of settings.

Authors+Show Affiliations

GSK Vaccines, Wavre, Belgium. Electronic address: THIERRY.VAN-EFFELTERRE@GSK.COM.GSK Vaccines, Wavre, Belgium.Department of Global and Community Health, George Mason University, Fairfax, VA, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26657185

Citation

Van Effelterre, Thierry, et al. "Modeling the Hepatitis a Epidemiological Transition in Thailand." Vaccine, vol. 34, no. 4, 2016, pp. 555-562.
Van Effelterre T, Marano C, Jacobsen KH. Modeling the hepatitis A epidemiological transition in Thailand. Vaccine. 2016;34(4):555-562.
Van Effelterre, T., Marano, C., & Jacobsen, K. H. (2016). Modeling the hepatitis A epidemiological transition in Thailand. Vaccine, 34(4), 555-562. https://doi.org/10.1016/j.vaccine.2015.11.052
Van Effelterre T, Marano C, Jacobsen KH. Modeling the Hepatitis a Epidemiological Transition in Thailand. Vaccine. 2016 Jan 20;34(4):555-562. PubMed PMID: 26657185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modeling the hepatitis A epidemiological transition in Thailand. AU - Van Effelterre,Thierry, AU - Marano,Cinzia, AU - Jacobsen,Kathryn H, Y1 - 2015/12/02/ PY - 2015/07/20/received PY - 2015/10/26/revised PY - 2015/11/19/accepted PY - 2015/12/15/entrez PY - 2015/12/15/pubmed PY - 2016/9/20/medline KW - Drinking water KW - Hepatitis A KW - Mathematical model KW - Seroprevalence KW - Thailand KW - Urbanization SP - 555 EP - 562 JF - Vaccine JO - Vaccine VL - 34 IS - 4 N2 - BACKGROUND: In most low- and middle-income countries, hepatitis A virus (HAV) is shifting or expected to shift from high endemicity to intermediate or low endemicity. A decreased risk of HAV infection will cause an increase in the average age at infection and will therefore increase the proportion of infections that results in severe disease. Mathematical models can provide insights into the factors contributing to this epidemiological transition. METHODS: An MSLIR compartmental dynamic transmission model stratified by age and setting (rural and urban) was developed and calibrated with demographic, environmental, and epidemiological data from Thailand. HAV transmission was modeled as a function of urbanization and access to clean drinking water. The model was used to project various epidemiological measures. RESULTS: The age at midpoint of population immunity remains considerably younger in rural areas than in urban areas. The mean age of symptomatic hepatitis A infection in Thailand has shifted from childhood toward early adulthood in rural areas and is transitioning from early adulthood toward middle adulthood in urban areas. The model showed a significant decrease in incidence rates of total and symptomatic infections in rural and urban settings in Thailand over the past several decades as water access has increased, although the overall incidence rate of symptomatic HAV is projected to slightly increase in the coming decades. CONCLUSIONS: Modeling the relationship between water, urbanization, and HAV endemicity is a novel approach in the estimation of HAV epidemiological trends and future projections. This approach provides insights about the shifting HAV epidemiology and could be used to evaluate the public health impact of vaccination and other interventions in a diversity of settings. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/26657185/Modeling_the_hepatitis_A_epidemiological_transition_in_Thailand_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)01702-8 DB - PRIME DP - Unbound Medicine ER -