Hepatitis A immunity and region-of-origin in a Swiss prison
Abstract
Purpose
The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population.
Design/methodology/approach
The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland’s largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician.
Findings
In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026).
Originality/value
In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient’s area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.
Keywords
Acknowledgements
The authors would like to thank the physician/nurse team at the Champ-Dollon prison, as well as Giuseppe Togni, Agnès Lehmann and Jacqueline Bizet (Unilabs Laboratory). This work was supported by the Federal Office of Public Health (grant number 09.003678), Bern, Switzerland, and by the Medical Direction of the Geneva University Hospitals. The study was approved by the ethical research committee (CER 09-137) of the Geneva University Hospitals.
Citation
Getaz, L., Casillas, A., Motamed, S., Gaspoz, J.-M., Chappuis, F. and Wolff, H. (2016), "Hepatitis A immunity and region-of-origin in a Swiss prison", International Journal of Prisoner Health, Vol. 12 No. 2, pp. 98-105. https://doi.org/10.1108/IJPH-10-2015-0033
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited