Seroprevalence and risk factors of hepatitis E among women of childbearing age in the Xieng Khouang province (Lao People's Democratic Republic), a cross-sectional survey

Abstract

Background: Endemic hepatitis E in Southeast Asia increases the risk of death in pregnant women. In Lao People's Democratic Republic, infection with hepatitis E virus (HEV) is widespread in pig farms. No human data are available yet. This study determined the prevalence and risk factors for HEV infection among women of reproductive age living in urban and rural areas.

Methods: A cross-sectional study was conducted in Xieng Khouang province, selected for its high prevalence of HEV in pig farms, after a two-stage random sampling. Blood eluates of filter paper samples were tested by enzyme-linked immunosorbent assay for anti-HEV immunoglobulin G (IgG). Risk factors were investigated by bivariate and multivariate analyses.

Results: Of 226 women (112 rural and 114 urban), anti-HEV IgG was detected in 66 (29.2%), with more in rural than in urban areas (38.4% vs 20.2%; p=0.005). Age (25-29 y) and farming profession were associated with HEV positivity. Living in an urban area, a supply of clean drinking water and raw duck blood consumption were protective.

Conclusions: Risks of HEV infection are more related to lack of drinking water resources than to promiscuity with pigs. Women of childbearing age could be targeted by future vaccination programs. Consumption of drinking water should be recommended during pregnancy.

Keywords: Lao PDR; hepatitis E virus; pregnancy; prevention; seroprevalence; swine.