Seroprevalence of hepatitis A immunity among children and adolescents in two cities of the Triângulo Mineiro region, state of Minas Gerais, Brazil

Seroprevalence of hepatitis A immunity among children and adolescents in two cities of the Triângulo Mineiro region, state of Minas Gerais, Brazil Dear Editor,Hepatitis A (HA) is a global disease whose incidence is closely associated with the development of a region, and there is an inverse relationship between its endemicity patterns and the population's socioeconomic level. 1 Several developing countries worldwide have changed their endemicity patterns from high to intermediate and from intermediate to low, as a result of improvements in hygiene, sanitation conditions, and in the quality of drinking water. 2 In Brazil, changes in HA endemicity patterns from high to intermediate have occurred in some regions, but not in others.3 The differences in seroprevalences among regions probably result from the socioeconomic and sanitation conditions found in these regions.4 The present study aimed to assess the prevalence of antibodies against HA in two cities of the state of Minas Gerais, and to associate it with socioeconomic and environmental conditions.This cross-sectional study was conducted in the cities of Uberlândia (604,013 inhabitants) and Limeira do Oeste (6,890 inhabitants), two of the 35 cities situated in the western area of the state of Minas Gerais, known as Triângulo Mineiro.Data collection was performed between May 2010 and May 2011.Students aged between 7-18 years and enrolled in public schools were randomly selected and divided according to gender and age (7-10 years; 11-14 years; and 15-18 years).In Limeira do Oeste, students of the two schools situated in the urban area participated; in Uberlândia, students of two central schools and two peripheral schools participated, and these schools were randomly selected.Serum total anti-HAV antibodies were determined by the ELISA method (Abbott, AXSYM HAVAB 2.0 -Wiesbaden, Germany) and the following data were collected: highest level of education among responsible adults, monthly household income in minimum wages, presence of a resident with a history of hepatitis, number of bathrooms in the home, number of residents, number of rooms, resident-room ratio, presence of water filter, presence of treated water supply, type of sewage disposal, and type of garbage disposal.Three students who