Seroprevalence and risk factors of Hepatitis A virus among Palestinian refugees in North Lebanon A pilot study to inform vaccination and public health policy

Background Hepatitis A virus (HAV) is a vaccine-preventable cause of acute viral hepatitis, transmitted primarily via the fecal–oral route and occasionally leading to severe complications. While Lebanon has experienced major HAV outbreaks in recent years, data on Palestinian refugees remain limited. This study aimed to determine HAV seroprevalence, identify associated risk factors, and assess the potential healthcare burden within this vulnerable population in North Lebanon. 

Methods A cross-sectional study was conducted from December 2023 to May 2024, involving 84 systematically selected Palestinian refugees attending Safad Hospital in Al-Baddawi camp, North Lebanon. Socio-demographic and clinical data were collected using standardized questionnaire, and serum samples were tested for IgM and total anti-HAV antibodies. 

Results Overall, 78.6% of participants were seropositive for total anti-HAV antibodies, reflecting accumulated immunity resulting from prior vaccination and/or past natural infection, while 2.4% tested positive for IgM anti-HAV, indicating limited evidence of recent or acute infection at the time of the survey. Multivariable analysis showed that individuals aged 16–30 years were at higher risk of HAV seropositivity (P < 0.05). Vaccination coverage was high (96.4% reported receiving at least one dose), but challenges to achieving universal coverage remain within the broader refugee population. 

Conclusions These findings highlight the continued presence of susceptible individuals, particularly in younger age groups, and support the need for sustained vaccination efforts, improved surveillance, and targeted public health interventions in refugee settings.