Seroprevalence of hepatitis B virus among school-age children in the Stann Creek District of Belize, Central America

Adults in the Stann Creek district of Belize have a high prevalence of hepatitis B virus (HBV) infection, but the age of onset of these infections is unclear. We conducted a seroprevalence study of hepatitis B markers among Stann Creek school-age children to provide information for planning a hepatitis B vaccine program. The overall prevalence in 587 students was high for antibody to hepatitis B core antigen (anti-HBc) (43.3percent) and hepatitis B surface antigen (HBsAg) (7.7 percent). There was marked variation of anti-HBc by school and by the predominant ethnic groups attending those schools. Maya had the highest prevalence (76 percent), followed by Mestizo (50 percent), Garifuna (37 percent), and Creole (25 percent). Children less than nine years of age attending the rural primary schools (mostly Garifuna and Creole) (p< 0.05). Anti-HBc was found in 42 percent and 36 percent of students at the two high schools. Of the five schools tested, only at the urban primary school did anti-HBc positivity increase with age. Based on an analysis of the cost of serologic screening before immunization compared with mass vaccination, preimmunization serologic screening resulted in vaccine program cost savings in four of the five schools. Because most children in the rural areas contract hepatitis B before entering school, immunization against HBV should be integrated into the routine infant immunization program (AU)

Prevalence of hepatitis B virus among health care workers in Belize, Central America

A seroprevalence survey of hepatitis B virus (HBV) markers was conducted among health care workers in Belize to help determine the epidemiology of hepatitis B and to determine if screening before immunization might lower vaccine costs. Of the 330 workers tested, 94 (29 percent) were positive for antibody to HBV core antigen (anti-HBc) and three (1 percent) had HBV surface antigen. The presence of anti-HBc increased significantly with age from 12 percent in those 18-24 years old to 52 percent in those o 50 years old. The rate was 17 percent of 48 men compared with 30 percent of 282 women (P = 0.05). Rates increased with years of medical service and were higher among nurses (69 of 228; 30 percent) and nonprofessional staff (15 of 44; 34 percent) than among physicians (0 of 20). The presence of anti-HBc also differed significantly among ethnic groups: Mestizo, 4 percent; Creole, 33 percent and Garifuna, 57 percent. Rates differed by district ranging from 3 percent in a northern district (mostly Mestizo) to 67 percent in a southern district (mostly Garifuna). Parenteral exposure to hepatitis B through needle stick injuries and blood transfusions was not associated with anti-HBc. Multiple logistic regression analysis confirmed ethnicity, district of residence, and age as the best predictors of anti-HBc in health care workers. Cost analysis suggests that because of regional differences in exposure, testing of health care workers for anti-HBc in the Belize and Stann Creek districts in southern Belize before hepatitis B immunization would result in vaccine program cost savings (AU)

Seroprevalence of hepatitis B virus, HIV-1, and syphilis among women attending prenatal clinics in Belize, Central America - abstract

We initiated hepatitis B (HB) screening of women attending selected prenatal clinics in Belize. Risk factors for HB infection and demographic data were determined by interview. Of 548 women, 81 (15 percent) were seropositive for HB Core Antibody (anti-HBc); one had HB surface antigenemia. Antibodies to the HIV-1 were detected in one woman. Fifteen women had reactive syphilis serologies. Anti-HBc seroprevalence varied by district (range 3 percent - 44 percent) and by ethnicity (Creole, 19 percent; Garifuna, 43 percent; East Indian, 6 percent; Mayan, 22 percent; Mestizo/Spanish, 8 percent; Dutch German-Menonite, 0 percent). Risk factors for anti-HBc identified from univariate analyses included: being of the Garifuna ethnic group (p<.00001), residence in the Stann Creek, district (p<0.00001), a reactive syphilis serology (p=0.02), a house-hold size of 8 or greater (p=0.02), and five or more lifetime sexual partners )p=0.01). Health care work, tattoos and intravenous drug use were not identified as risks. Multivariate analyses by stepwise logistic regression identified ethnicity (p=0.0001) and a reactive rapid plasma reagin (RPR) (p=0.02), as significant independent predictors of anti-HBc seropositivity. Strategies to screen all pregnant women and provide immunoprophylaxis to susceptible infants may be effective in interrupting neonatal HB in Belize. Highly variable differences in anti-HBc rates by district may permit the targeting of limited public health resources for education and prevention of HB and other sexually transmitted diseases (AU)

An unique seroepidemiological situation for hepatitis B markers in Guadeloupe: results of a prospective study in blood donors - abstract

Screening for HBsAG, anti-HBc, anti-HCV and ALAT levels is now performed on donor blood to prevent post-transfusion hepatitis. A prospective study of 2368 blood donors was performed in Guadeloupe (French West Indies) to determine risk factors associated with serologic abnormalities: 571 blood donations (24 percent) were positive for at least 1 of the 4 markers with 3.2 percent positive for HBsAG, 22 percent for anti-HBc, 0.8 percent for anti-HCV and 1.4 percent for ALAT (<45 IU/L). The anti-HCV prevalence was significantly different according to ALAT levels (P<10). Transfusion histosry and employment status (worker or serviceman) were found to be risk factors, with an odds ratio (OR) of 1.94 for serviceman population. Other unexpected risk factors were: number of years' residency in Guadeloupe (progressively increased risk with increasing number of years); birthplace and residence in the southern part of the island as well as the existence of gastrointestinal discomfort unrelated to viral hepatitis (OR=2.91). The results of this study show a unique epidemiological situation for hepatitis B virus in Guadeloupe necessitating careful selection of blood donors (AU)

The seroprevalence of hepatitis and retroviral infection in Jamaican haemodialysis patients

63 haemodialysis (HD) patients and 63 age and gender matched controls were investigated for hepatitis B surface antigen (HbsAg) and antibodies to hepatitis B virus (anti-HBV), hepatitis C virus (anti-HCV), hepatitis D virus (anti-HDV), human immunodeficiency virus types 1 and 2 (anti-HIV-1 and 2) and human T-cell lymphotropic virus type-1 (anti-HTLV-1). The notable finding was an increase in hepatitis B markers, 34.9 percent in HD patients compared to 19.0 percent in controls (p < 0.02). The seroprevalence of anti-HCV (7.9 percent, p < 0.03) and anti-HTLV-1 (9.5 percent; p < 0.006) was also increased in the patients. Four of the five patients positive for anti-HCV were also seropositive for HBV. Anti-HIV and anti-HDV were not detectable in the HD patients in this study. The possibility of HTLV-1 being transmitted by organ transplantation is raised. The seropositivity rate for hepatitis B and C increased with duration on dialysis, but it is likely that it was related to the number of blood transfusions since 50 percent with no transfusion were HBV seropositive.(AU)