BACKGROUND:Recent data about hepatitis A virus (HAV) seroprevalence in industrialized countries and the impact of travels to endemic areas are sparse or absent, particularly for children. OBJECTIVE:To determine the impact of travel to endemic areas on HAV seroprevalence and estimate the overall HAV seroprevalence in children in France. To identify risk factors for positive HAV serologic results. STUDY DESIGN:This prospective multicentre cross-sectional seroprevalence study took place in eight paediatric emergency units throughout France. Children 1-16 years of age following all inclusion and exclusion criteria were included. Demographic, socioeconomic, and travel data were prospectively collected with a standardized questionnaire before measurement of specific HAV antibodies. HAV seroprevalence was determined and its association with diverse variables assessed by univariate and multivariate analyses. RESULTS:430 children were included, of whom 116 had travelled to endemic areas. The HAV seroprevalence in the overall population was 5% (95%CI, 3-7) and was higher among the travellers (12% [95%CI, 6-18]) than among the others (2% [95%CI, 0-3]), OR=7.0 [95%CI, 2.6-18.8]. Risk factors identified for positive serologic results for HAV were travel to an endemic area >7 days (adjusted OR [aOR]=4.3 [95%CI, 1.5-12]), age of 14-16 years (aOR=7.7 [95%CI, 1.6-38.3]) and mother's birth in an endemic area (aOR=5.2 [95%CI, 1.8-14.8]). CONCLUSION:Statistical evidence showed that travel to endemic areas and parents' place of birth both play a role in HAV serologic results in children with a significant difference of HAV seroprevalence between traveller and non-traveller children in France.

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背景:关于工业化国家中甲型肝炎病毒(HAV)血清流行率的最新数据以及前往流行地区的影响稀少或缺乏,特别是对儿童而言。
目的:确定前往流行地区的旅行对HAV血清阳性率的影响,并估算法国儿童的总体HAV血清阳性率。确定阳性HAV血清学结果的危险因素。
研究设计:这项前瞻性多中心横断面血清阳性率研究是在法国的八个儿科急诊室进行的。遵循所有纳入和排除标准的1-16岁儿童被纳入。在测量特定的HAV抗体之前,将使用标准化的调查表前瞻性地收集人口,社会经济和旅行数据。确定了HAV血清阳性率,并通过单因素和多因素分析评估了其与各种变量的相关性。
结果:包括430名儿童,其中116名曾前往流行地区。总人口中的HAV血清阳性率为5%(95%CI,3-7),旅行者中的HAV血清阳性率(12%[95%CI,6-18])高于其他人群(2%[95%CI, 0-3]),或= 7.0 [95%CI,2.6-18.8]。确诊为HAV阳性血清学结果的危险因素是前往> 7天的流行区(校正OR [aOR] = 4.3 [95%CI,1.5-12]),年龄14-16岁(aOR = 7.7 [95%] CI,1.6-38.3])和母亲在地方病地区的出生(aOR = 5.2 [95%CI,1.8-14.8])。
结论:统计证据表明,在法国,旅行者和非旅行者儿童的HAV血清阳性率存在显着差异,前往流行地区和父母的出生地均对HAV血清学结果有影响。

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