Table 1_Epidemiology of hepatitis A in Saudi Arabia: a retrospective analysis of Ministry of Health surveillance and yearbook data, 2006–2023.xlsx

BackgroundThis study investigates the epidemiology of hepatitis A virus (HAV) infection in Saudi Arabia from 2006 to 2023, focusing on temporal, demographic, and geographic variations in incidence. The aim was to characterize long-term national trends and identify high-risk subgroups to inform prevention strategies.
MethodsNational HAV surveillance data were obtained from the Saudi Ministry of Health Statistical Yearbooks. Crude incidence rates (CIRs) were calculated using mid-year population estimates. Temporal trends were assessed via Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Regional differences were analyzed with negative binomial regression using Riyadh as the reference. Group comparisons employed nonparametric tests, with statistical significance set at α=0.05.
ResultsBetween 2006 and 2023, 9,820 HAV cases were reported (mean 546/year). National CIR declined from 11.1 per 100,000 in 2006 to 0.48 in 2023, with an AAPC of −19.5% (95% CI −24.2 to −14.4; p < 0.001). Children aged 5–14 years bore the highest burden (53.5% of cases). Significant regional heterogeneity was observed, with persistently higher CIRs in Najran and Qurayyat, while urban centers showed lower, stable rates. Negative binomial regression identified higher adjusted risks in Qurayyat (IRR 2.89) and Najran (IRR 2.52). Saudis initially showed higher incidence than non-Saudis, but rates converged by 2023. Males consistently outnumbered females (ratio ∼1.6).
ConclusionHAV incidence in Saudi Arabia has markedly declined over the past two decades, reflecting improved sanitation and public health measures. This decline may, in part, reflect the impact of the national hepatitis A vaccination program introduced in 2008. However, age-, region-, and nationality-specific disparities remain, underscoring the need for geographically tailored interventions and consideration of targeted vaccination strategies to sustain progress and prevent resurgence.