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In January 1989, the prevalence of antibodies to hepatitis A virus (anti-HAV) was determined by ELISA in 702 apparently healthy children 5-14 years old in Kumba City, Cameroon. Children were recruited from those attending six different primary schools, representative of the socio-demographic characteristics of the inhabitants, using a systematic random sampling. The overall IgG anti-HAV prevalence was 96.9%, reaching 100% by the age of 11 years. In primary school beginners the prevalence was very high, 94.0%, contrary to what has been observed in developed countries. The anti-HAV prevalence was not associated with family size, but was related to parent's occupation, children from the lower class having a 5.9 fold risk (C.I. = 1.9-18.3) of past exposure to HAV. These results suggest a persistently high prevalence of anti-HAV in children despite improving hygienic conditions. The spread of HAV in this population may be the result of domestic water and/or food contamination.

In May 1988, the hepatitis A antibody (anti-HAV) and hepatitis B virus (HBV) markers were studied by radioimmunoassay in 484 apparently healthy children between the ages of 7 and 12, attending a primary school in Naples, Italy. The overall anti-HAV prevalence was 11.2%, increasing from 5.2 in 7-year-old children to 28.2% in children between the ages of 11 and 12 years old. The overall prevalence of the hepatitis B surface antigen (HBsAg) and of other HBV markers were 0.8 and 6.8 respectively. Compared with a similar previous study conducted in Naples in 1980, the results show a significant reduction in the prevalence of anti-HAV in each of the two age-groups (P less than 0.01), in the prevalence of any HBV marker in the 11 to 12-year-old group, as well as in the total population (P less than 0.05). The findings of the present study indicate that today, children in Naples are less exposed to the hepatitis A virus than in the past, most likely because of improvements in both the socioeconomic conditions and in health education during recent years. These same reasons, as well as decreased family size and a lower prevalence of HBeAg among HBsAg carriers could explain the decline, although to a lesser degree, of exposure to HBV infection.