{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:31:34Z","timestamp":1790742694164,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    There have been several Water, Sanitation, and Hygiene (WASH) interventions in Lao People's Democratic Republic (Lao PDR). We aimed to determine the relationship of exposure to two faecal\u2010orally transmitted pathogens, hepatitis A virus (HAV) and hepatitis E virus (HEV), with WASH levels and other factors. A cross\u2010sectional study conducted in three districts in Khammouane Province enrolled 2300 participants aged 5 to 87 years by random sampling. Anti\u2010HAV and anti\u2010HEV antibodies were detected by enzyme\u2010linked immunosorbent assay. The relationship between serology (outcome), WASH and other variables was determined by bivariate and multivariable analysis. Overall, 12.0% of participants had surface water as a water source, 22.0% practiced open defecation and 66.9% had basic hygiene facilities. Anti\u2010HAV IgG seropositivity was 63.2% and 57.5% were anti\u2010HEV seropositive. The mean age at which 50% of the population were positive for anti\u2010HAV and anti\u2010HEV was 24 and 27 years old, respectively. Anti\u2010HAV seroprevalence was lower in those with improved sanitation than those practicing open defecation (OR\u2009=\u20090.6, 95%CI\u2009=\u20090.4\u20130.8,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001) and higher in adults consuming undercooked meat (OR\u2009=\u20091.5, 95%CI\u2009=\u20091.1\u20132.0,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). It also varied by district, ethnicity, education and age. Anti\u2010HEV seroprevalence was lower in those with improved water source than those using surface water (OR\u2009=\u20090.6, 95%CI\u2009=\u20090.4\u20130.8,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) and higher in adults consuming raw meat (OR\u2009=\u20091.3, 95%CI\u2009=\u20091.0\u20131.7,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04). Anti\u2010HEV seroprevalence varied by district, sex, education, and age. Khammouane province has low levels of WASH leading to high transmission of HAV and HEV. Reducing the practice of open defecation and other risk practices such as undercooked meat consumption may reduce transmission as well as consideration of HAV vaccine introduction for younger ages.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70524","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:55:17Z","timestamp":1753872917000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hepatitis A and E Virus Seroprevalence and Water, Sanitation and Hygiene Levels in Rural Areas of Khammouane Province, Lao People's Democratic Republic: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7251-4973","authenticated-orcid":false,"given":"Vilaysone","family":"Khounvisith","sequence":"first","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"},{"name":"Swiss Tropical and Public Health Institute Allschwil Switzerland"},{"name":"University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Odermatt","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute Allschwil Switzerland"},{"name":"University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siriphone","family":"Virachith","sequence":"additional","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouna","family":"Innoula","sequence":"additional","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bounta","family":"Vongphachanh","sequence":"additional","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latdavone","family":"Khenkha","sequence":"additional","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hattendoft","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute Allschwil Switzerland"},{"name":"University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M.","family":"H\u00fcbschen","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity Luxembourg Institute of Health Esch\u2010sur\u2010Alzette, Grand\u2010Duchy of Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony P.","family":"Black","sequence":"additional","affiliation":[{"name":"LaoLuxLab\/Vaccine Preventable Diseases Laboratory Institut Pasteur du Laos Vientiane Lao PDR"},{"name":"School of life sciences University of Westminster London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinmicnews.2020.10.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15081725"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mran.2020.100155"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12560-021-09461-5"},{"key":"e_1_2_12_6_1","unstructured":"WHO. Weekly Epidemiological Record. Who Position Paper on Hepatitis a Vaccines \u2013 October 2022. [cited 2024 August 20]. Available from https:\/\/www.who.int\/publications\/i\/item\/who-wer9740-493-512."},{"key":"e_1_2_12_7_1","unstructured":"WHO and Hepatitis E [Internet]. [cited 2024 August 20]. Available from https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-e."},{"key":"e_1_2_12_8_1","unstructured":"WHO\/UNICEF. Progress on Household Drinking Water Sanitation and Hygiene 2000\u20102017. WHO\/UNICEF [Internet]. 2019;140. Available from https:\/\/washdata.org\/sites\/default\/files\/documents\/reports\/2019-07\/jmp-2019-wash-households.pdf."},{"key":"e_1_2_12_9_1","unstructured":"WHO. Water Sanitation Hygiene and Health. Geneva World Heal Organ 2019 (WHO\/CED\/PHE\/WSH\/19149) [Internet].2019; Available from who.int\/iris\/bitstream\/handle\/10665\/330100\/WHO\u2010CED."},{"issue":"9","key":"e_1_2_12_10_1","first-page":"1689","article-title":"Lao Social Indicator Survey II (LSIS II). Lao Statistics Bureau (LBS), Ministry of Health and Ministry of Education and Sport","volume":"53","author":"Ministry of Health and Lao Statistics Bureau 2018","year":"2019","journal-title":"Journal of Chemical Information and Modeling"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0451"},{"key":"e_1_2_12_12_1","unstructured":"WHO Immunization Data portal \u2010 Global [Internet]. [cited 2025 May 19]. 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I.","year":"2024","journal-title":"Journal of Pharmacological and Toxicological Methods"},{"issue":"4","key":"e_1_2_12_30_1","first-page":"50","article-title":"Drinking Water and Sanitation Facility in India and its Linkages With Diarrhoea Among Children Under Five: Evidences From Recent Data","volume":"3","author":"Kumar A.","year":"2014","journal-title":"International Journal of Social Sciences and Humanities Invention"},{"key":"e_1_2_12_31_1","first-page":"1","article-title":"Prevalence of Hepatitis E Virus in China From 1997 to 2022: A Systematic Review and Meta\u2010Analysis","volume":"11","author":"Cao K.","year":"2023","journal-title":"Frontiers in Public Health"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15020484"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines12020204"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00290-0"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70524","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.70524","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:02:59Z","timestamp":1783832579000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.70524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jmv.70524"],"URL":"https:\/\/doi.org\/10.1002\/jmv.70524","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"assertion":[{"value":"2025-03-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70524"}}