The epidemiology of Hepatitis A in Portugal and in the World A comparative study

Abstract

Introduction: Hepatitis A is caused by a virus of the family Picornaviridae, of the genus Hepatovirus. It is a fecal-oral disease that can cause jaundice, nausea, abdominal pain, fever, dark urine, among other symptoms. In Portugal the vaccine is not part of the National Vaccination System, however it is advised to all individuals who travel to endemic areas. Currently the endemicity of a region is classified when 50% of a population, of a specific age group, has immunity against HAV. Objectives: To understand the epidemiological situation of Hepatitis A in Portugal and to compare it with the rest of the world. Methods: Two selection moments were created with the aid of four inclusion criteria. A total of 16 studies were selected for this systematic review. Discussion/Conclusion: Africa and Latin America present intermediate to very high endemicities, North America low endemicity, Asia low to very high endemicities, Australia low to high endemicities, Europe low to intermediate endemicities and Portugal low endemicity. As expected, richer regions have lower endemicities. There is an improvement in the living conditions of the general population, leading to the poorer regions presenting some countries with intermediate endemicities, thus pointing to a positive evolution against the Hepatitis A virus. The best strategy to improve this evolution is through vaccination.