Date of Award

2007

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Environmental Science

First Advisor

Dr. Youssef Ali Abu Zeid

Second Advisor

Dr. Roos Bernsen

Third Advisor

Dr. Tareq Youssef

Abstract

Hepatitis A (HAV) is common worldwide, but with falling sero-prevalence in residents of developed countries is an indication of improved food and water hygiene. It is well known that the sero-prevalence of hepatitis A are highly correlated with socioeconomic status. The main objective of this study was to have base line data on the age-related sero-prevalence of HAV in Al Ain district and the possible risk factors.

Blood and a questionnaire data were obtained from 280 UAE citizens' outpatients of Tawam Hospital and 333 expatriates' inhabitants of Al Ain city. The expatriate subjects were heterogeneous coming from 24 different countries. UAE nationals in general have different social habits, higher income and better standard of living compared to expatriates. This study investigates mainly the effects of improvement in the living standard particularly hygiene and sanitation in Al Ain city as a symbol for UAE in general on the prevalence of hepatitis A. The age range of subjects was 0 to 39 years old. A micro-particle enzyme immunoassay (MEIA), "AxSYM system HAV AB® 2.0", was used for the detection of total antibodies for hepatitis A virus (HAV).

This study provides the first evidence that Al Ain should be considered as an area of intermediate endemicity. Furthermore, it points out to the need of considering the ethnic composition in perspective when analyzing the epidemiological data on hepatitis A, as differential exposure to the virus was evident in UAE nationals and expatriates. Using logistic regression; age, gender, subject education and occupation of the UAE nationals were found as possible risk factors. Age, subject education, occupation and history of international travel were found as possible risk factors within the expatriates. However, using multivariate logistic regression, age turned out to be the only significant independent risk factor for the UAE nationals, while occupation for the expatriates. The significance of the results is discussed in the light of the known world wide and regional prevalence and risk factors of HAV. The results of the present study considered as the first seroprevalence study to cover a wide range of age groups within both UAE nationals and expatriates in AI Ain strongly pointed to the need for more epidemiological studies, preferably nationwide, in order to assess the current and future of hepatitis A in UAE and the possible need to vaccinate susceptible groups in the population to avoid any possible hepatitis A out-break.

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