Abstract:
Viral hepatitis is a public health problem worldwide. Hepatitis A, transmitted by
fecal-oral route, is an infectious viral disease caused by hepatitis A virus (HAV) and
occurs mainly due to poor sanitation. Hepatitis A, the most common cause of acute
hepatitis, is wrongly considered a benign disease despite the risk of fulminant hepatic
failure. This study aimed to determine the prevalence and phylogenetic
characteristics of HAV in patients attending Mpanda General Hospital in Burundi.
The association between demographic factors and HAV cases was also established.
A cross-sectional study was used. Participants were recruited using a consecutive
sampling technique. Data and blood samples took three months (October to
December 2017). Data from consented/assented participants were collected using
questionnaires. Five milliliters of venous blood were collected from 385 participants
and analyzed. Anti-HAV IgM and IgG antibodies were screened using Rapid test and
Enzyme Linked Immunosorbent Assay Kits. Anti-HAV IgM positive samples were
used for molecular analysis. A nested Reverse Transcription-PCR was performed to
detect HAV genome using gene specific primers and the positive samples sequenced
for HAV genotype. The prevalence of HAV infection and the 95% CI were
calculated. The association between HAV cases and independent variables was
assessed by a bivariate logistic regression and p-value ≤ 0.05 was considered
significant. The median age was 23 and the range 72 [2-74] years. The overall
prevalence of Hepatitis A virus was 60.3% (232/385). There was a significant
association between age, lack of clean water, traditional latrines and Hepatitis A
Virus cases. Of the 124 cases positive for anti-HAV IgM, nine were positive for
HAV RNA. Phylogenetic analysis revealed that all isolates belonged to genotype IB.
From findings, good hygienic practices and sanitation would reduce the incidence of
the HAV infection. Further research aimed at HAV genotype characterization should
be performed in other parts of Burundi to identify the genotype most common in the
country. There is need for a nationwide survey of HAV infection in Burundi
involving a nationwide sample to determine the overall prevalence and molecular
characterization of HAV in the country
