Socioeconomic factors such as access to clean water, HDI, and GDP are strong inverse predictors of Hepatitis A virus transmission rates globally.
BACKGROUND: Hepatitis A virus (HAV) infection confers long-term immunity, so mathematical analysis of age-specific seroprevalence in populations can reveal changes in the infection rate over time. HAV transmission is related to access to clean drinking water, personal hygiene and public sanitation. METHODS: We used an SIR (susceptible-infectious-recovered) compartmental model with age structure to fit a time-dependent logistic function for HAV force of infection for 157 published age-seroprevalence data sets. We then fit linear regression models for socioeconomic variables and infection rate. RESULTS: The proportion of the population with access to clean drinking water, the value of the human development index (HDI), and per capita gross domestic product (GDP) are all inverse predictors of HAV infection rates. Declining infection rates were observed in 65.6% of the surveys. Discussion This work demonstrates the utility of HAV seroprevalence studies to reveal patterns of change in force of infection and to assess the association between socioeconomic risk factors and transmission rates.
Jacobsen et al. (2005) studied this question.