Acute Hepatitis A in Mongolia: Risk factors and preventive measures

Background: Hepatitis A is a common infectious disease in Mongolia that accounted for 21.2 percent of all infectious diseases reported in 2007. Most cases of Hepatitis A have been occurred during a community-wide outbreak that was difficult to control.

Objective. To identify risk factors for acute hepatitis A infection among children living in communities with the highest rates of infection during the community-wide outbreak.

Design. A matched case control study.

Participants. Study has been conducted in a capital Ulaanbaatar city between October and December 2008. One hundred forty two hepatitis A cases laboratory confirmed were selected from the National Center for Communicable Diseases using stratified random sampling. One matched control was selected for each case from the neighborhood of cases. A parent or grandparent of the children were interviewed to obtain the related information. In a total116 schoolchildren, 90 kindergarten children and 78 children cared at home have been selected.

Results. HAV infection among children was person-to-person contact, and may have been an important risk of transmission within and between kindergarten, school and households. 22 percent of cases lived in a household where a previous case occurred. A statistically significant low hygiene was found among the cases ( p < 0.001) and those with a lower education of parent's ( p < 0.03).

Conclusion. During a community-wide outbreak, HAV infection among children was common, risk factor was difficult to control. It is necessary to highlight the importance of an immunization strategy against HAV in reducing the incidence of the infection.