Epidemiologic profile of Hepatitis A in Meknès, Morocco, 2013-2016.

Hepatitis A virus (HAV) is responsible for 1.5 million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222 cases were reported in 2015, 34 of them from the city of Meknes. The objective of this study is to describe the trends in HAV incidence in Meknes to improve preventive measures. For this cross-sectional descriptive study, we investigated each case reported to the HAV surveillance system between 2013 and 2016. The following data were collected: socio-demographic information, season of infection, mode of water supply, food consumed, food purchasing environment, and laboratory confirmation of cases (by an ELISA test to detect anti-HAV IgG). Data were analyzed by Epi info version 7.2.0.1, with mapping by QGIS version 2.18.1. In all, 192 cases were reported with a sex ratio (m/f) of 1.3 and an average age of 13 ± 10 years. Incidence fell from 10 per 100 000 inhabitants in 2013 to 1.6 per 100 000 in 2016. Most cases (n = 160, 83%) came from the urban environment, and 63 (32%) occurred in springtime. Two people died. The incidence of HAV in the Meknes area has fallen, but public awareness campaigns by health education in the field of personal hygiene remain necessary. It is also essential to improve implementation of regulations banning food handling by virus carriers. Sanitary control of informal markets must be improved.