Should Aboriginals in the "Top End" of the Northern Territory be vaccinated against hepatitis A?

Francis J. Bowden, Bart J. Currie, Nan C. Miller, Stephen A. Locarnini, Vicki L. Krause

    Research output: Contribution to journalEditorialResearchpeer-review

    Abstract

    Objective: To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the "Top End" of the Northern Territory.

    Methods: A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.

    Result: Overall, 337/344 samples (97.97%) tested positive for hepatitis A total antibodies--18/20 samples (90%) in the 1-5 year age group; 85/88 (96.6%) in the 6-10 year age group; 98/98 (100%) in the 11-15 year age group; 32/33 (97.0%) in the 16-20 year age group and 104/105 (99%) in the older than 20 year age group.

    Conclusion: Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.
    Original languageEnglish
    Pages (from-to)678-679
    Number of pages2
    JournalThe Medical journal of Australia
    Volume200
    Issue number11
    Publication statusPublished - 16 Jun 2014

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    Northern Territory
    Hepatitis A
    Age Groups
    Hepatitis A Antibodies
    Immunity
    Vaccination
    Hepatitis A virus
    Seroepidemiologic Studies
    Rural Population
    Virus Diseases
    Health Education
    Population
    Tissue Donors
    Viruses
    Infection
    Serum

    Cite this

    Bowden, Francis J. ; Currie, Bart J. ; Miller, Nan C. ; Locarnini, Stephen A. ; Krause, Vicki L. / Should Aboriginals in the "Top End" of the Northern Territory be vaccinated against hepatitis A?. In: The Medical journal of Australia. 2014 ; Vol. 200, No. 11. pp. 678-679.
    @article{77d4316a79fa4a7a8c72332b60ce3355,
    title = "Should Aboriginals in the {"}Top End{"} of the Northern Territory be vaccinated against hepatitis A?",
    abstract = "Objective: To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the {"}Top End{"} of the Northern Territory.Methods: A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.Result: Overall, 337/344 samples (97.97{\%}) tested positive for hepatitis A total antibodies--18/20 samples (90{\%}) in the 1-5 year age group; 85/88 (96.6{\%}) in the 6-10 year age group; 98/98 (100{\%}) in the 11-15 year age group; 32/33 (97.0{\%}) in the 16-20 year age group and 104/105 (99{\%}) in the older than 20 year age group.Conclusion: Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.",
    author = "Bowden, {Francis J.} and Currie, {Bart J.} and Miller, {Nan C.} and Locarnini, {Stephen A.} and Krause, {Vicki L.}",
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    Should Aboriginals in the "Top End" of the Northern Territory be vaccinated against hepatitis A? / Bowden, Francis J.; Currie, Bart J.; Miller, Nan C.; Locarnini, Stephen A.; Krause, Vicki L.

    In: The Medical journal of Australia, Vol. 200, No. 11, 16.06.2014, p. 678-679.

    Research output: Contribution to journalEditorialResearchpeer-review

    TY - JOUR

    T1 - Should Aboriginals in the "Top End" of the Northern Territory be vaccinated against hepatitis A?

    AU - Bowden, Francis J.

    AU - Currie, Bart J.

    AU - Miller, Nan C.

    AU - Locarnini, Stephen A.

    AU - Krause, Vicki L.

    PY - 2014/6/16

    Y1 - 2014/6/16

    N2 - Objective: To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the "Top End" of the Northern Territory.Methods: A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.Result: Overall, 337/344 samples (97.97%) tested positive for hepatitis A total antibodies--18/20 samples (90%) in the 1-5 year age group; 85/88 (96.6%) in the 6-10 year age group; 98/98 (100%) in the 11-15 year age group; 32/33 (97.0%) in the 16-20 year age group and 104/105 (99%) in the older than 20 year age group.Conclusion: Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.

    AB - Objective: To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the "Top End" of the Northern Territory.Methods: A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.Result: Overall, 337/344 samples (97.97%) tested positive for hepatitis A total antibodies--18/20 samples (90%) in the 1-5 year age group; 85/88 (96.6%) in the 6-10 year age group; 98/98 (100%) in the 11-15 year age group; 32/33 (97.0%) in the 16-20 year age group and 104/105 (99%) in the older than 20 year age group.Conclusion: Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.

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