{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:27:54Z","timestamp":1699921674263},"reference-count":18,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science and Technology Major Project of China","award":["No. 2018ZX10201002"],"award-info":[{"award-number":["No. 2018ZX10201002"]}]},{"name":"Doctor Start-up Fund of Affiliated Hospital of Guizhou Medical University","award":["NO.GYFYBSKY-2023-24"],"award-info":[{"award-number":["NO.GYFYBSKY-2023-24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>Hepatitis A (HepA) vaccination and economic factors can change the epidemiology of HepA. In China, the implementation of free vaccination for children under 1.5 years of age in 2008 has resulted in a decline in the overall incidence of HepA. Nevertheless, further investigation is required to comprehensively understand the epidemiological patterns of HepA in economically disadvantaged regions of China.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Method<\/jats:title>\n               <jats:p>In this study, we evaluated the incidence, seroprevalence, and transmission characteristics of HepA in Shaanxi with less economically developed. We obtained data on reported cases of HepA from 2005 to 2020. Blood samples from 1,559 individuals aged 0 to 60 years were tested for anti-hepatitis A (HAV) antibodies. A questionnaire survey and blood sample collection were conducted in two sentinel sites from 2019 to 2021.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Result<\/jats:title>\n               <jats:p>Between 2008 to 2020, the number of reported cases of HepA decreased from 3.44\/100,000 person-years to 0.65\/100,000 person-years, indicating an 81.1% decrease, which was particularly pronounced among younger age groups (0\u201319 years). From 2015\u20132020, infections were more likely to occur in people in their 40s and those over the age of 60. Farmers were still the most common occupation of HepA in the last decade. The results of the serological investigation showed the highest anti-HAV seroprevalence was observed in adults aged 39\u201360 years (94.6%) and those aged 28\u201338 years (87.8%). The 10\u201315 years group had the lowest seroprevalence at 49.3%. During the study period, a total of 22 cases were reported by sentinel sites, but the common risk factors (like raw food exposure, travel history, and closed contact with patients) were not identified.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusion<\/jats:title>\n               <jats:p>Given the greater severity of illness in the adult population and the ambiguous transmission routine, enhanced surveillance for HepA and evaluations that identify feasible approaches to mitigate the risk of HAV transmission are urgent priorities.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.16305","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T09:32:16Z","timestamp":1699867936000},"page":"e16305","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology and transmission of hepatitis A in Shaanxi (western China) after more than ten years of universal vaccination"],"prefix":"10.7717","volume":"11","author":[{"given":"Xiaotong","family":"Hu","sequence":"first","affiliation":[{"name":"The Affiliated Hospital of Guizhou Medical University, Guizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weijun","family":"Hu","sequence":"additional","affiliation":[{"name":"Shaanxi Provincial Center for Disease Control and Prevention, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Dong","sequence":"additional","affiliation":[{"name":"Shaanxi Provincial Center for Disease Control and Prevention, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fujie","family":"Xu","sequence":"additional","affiliation":[{"name":"Bill& Melinda Gates Foundation, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaobai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shaanxi Provincial Center for Disease Control and Prevention, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2023,11,13]]},"reference":[{"key":"10.7717\/peerj.16305\/ref-1","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1097\/QCO.0000000000000188","article-title":"Hepatitis A: epidemiology in resource-poor countries","volume":"28","author":"Aggarwal","year":"2015","journal-title":"Current Opinions in Infectious 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2004\u20132017","volume":"24","author":"Kaifa","year":"2018","journal-title":"Chinese Journal of Vaccines and Immunization"},{"key":"10.7717\/peerj.16305\/ref-8","first-page":"95","article-title":"Analysis of a hepatitis A outbreak in a middle school of Qiyang county","volume":"24","author":"Kun","year":"2018","journal-title":"Anhui Journal of Preventive Medicine"},{"key":"10.7717\/peerj.16305\/ref-9","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1080\/21645515.2019.1688034","article-title":"Vaccination coverage and its determinants of live attenuated hepatitis A vaccine among children aged 24\u201359 months in 20 rural counties of 10 provinces of China in 2016","volume":"16","author":"Liu","year":"2020","journal-title":"Human Vaccines & Immunotherapeutics"},{"key":"10.7717\/peerj.16305\/ref-10","first-page":"129","article-title":"Analysis on 5 times of viral hepatitis A outbreaks in Bijie city","volume":"32","author":"Ning","year":"2016","journal-title":"Journal of Medical Pest Control"},{"key":"10.7717\/peerj.16305\/ref-11","doi-asserted-by":"publisher","first-page":"276","DOI":"10.3201\/2302.161095","article-title":"Changing epidemiology of hepatitis A and hepatitis E viruses in China, 1990\u20132014","volume":"23","author":"Ren","year":"2017","journal-title":"Emerging Infectious Diseases"},{"key":"10.7717\/peerj.16305\/ref-12","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1016\/j.vaccine.2018.01.043","article-title":"The impact of expanded program on immunization with live attenuated and inactivated Hepatitis A vaccines in China, 2004\u20132016","volume":"36","author":"Sun","year":"2018","journal-title":"Vaccine"},{"key":"10.7717\/peerj.16305\/ref-13","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s40249-019-0591-z","article-title":"Changes in the epidemiology of hepatitis A in three socio-economic regions of China, 1990\u20132017","volume":"8","author":"Sun","year":"2019","journal-title":"Infectious Diseases of 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