A descriptive analysis of the spatiotemporal distribution of hepatitis A virus outbreak in Pacitan, East Java, Indonesia

Background: Hepatitis A virus (HAV) is one of the most serious notifiable viral hepatitis and causing public health problems in Indonesia. The outbreaks of HAV in Indonesia have been reported in several sites from 1998-2018, however systematic epidemiological data regarding Spatio-temporal distribution of HAV outbreak are lacking. Aims: To explore, visualize, and report systematically the recent HAV outbreak and identify the socioeconomic determinants associated with the risk of HAV outbreak. Methods: The study design was a retrospective crosssectional study. Data on the incidence and distribution of HAV outbreak 2019 were collected from the database of CDC District Level Health Office of Pacitan. Maps were constructed using qGIS software to visualize the Spatio-temporal distribution of HAV outbreaks. Results: Out of a total of 1 326 case records, 399 (30.1 %) were classified as probable cases of HAV, and 125 (9.4 %) as confirmed cases based on positive IgM Anti-HAV. Majorly the diagnosis was based on symptoms and exposures only, a limited number of tests was performed because testing capacity is insufficient. Majorly the cases occurred in sub-district that are passed with the same river as source water in the community. The pattern of outbreak transmission is a common source. Linear regression analysis showed that proportion of low-level education (r= 1.34; p-value= 0.012), number of household (r=-1.08; p-value= 0.003), and population density (r= 1.87; p-value= 0.005) for each sub-district were significantly correlated with number of cases.