Hepatitis B virus, human immunodeficiency virus type-1 and syphilis among women attending prenatal clinics in Belize, Central America

Women and their infants may benefit from therapeutic interventions when hepatitis B, human immunodeficiency virus (HIV), or syphilis are detected during the prenatal period. We initiated hepatitis B and HIV screening of women attending prenatal clinics in Belize. Risk factor assessment information for hepatitis B infection and demographic data were determined by interview. Of 543 evaluable women, 81 (14.9 percent) were seropositive for hepatitis B core antibody (anti-HBc); one woman had asymptomatic hepatitis B surface antigenemia. Antibodies to HIV-1 were detected in one woman. Reactive syphilis serologies were detected in 15 (2.8 percent) women. Anti-HBc seroprevalence varied by district (range 3.1-43.5 percent) and ethnicity (range 0.0-40.9 percent). Significant identified risks for anti-HBc seropositivity from univariate analyses included being of the Garifuna ethnic group, residence or birth in the Stann Creek or Toledo districts, a reactive syphilis serology, a household size of eight or greater, and five or more lifetime sexual partners. Multivariate analyses identified ethnicity and a reactive rapid plasma reagin as the best predictors of anti-HBc seropositivity. Highly variable differences in anti-HBc prevalence by district may permit the targeting of limited public health resources for education, screening, and prevention programs.(AU)

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)

A survey of hepatitis B among health workers in Jamaica

One thousand, five hundred and thirty-seven health staff, presenting for hepatitis B vaccination in Jamaica, were surveyed in 1990/91 for hepatitis B markers and/or expose to blood or hepatitis. Antibodies to either hepatitis B surface antigen (HBsAg) or hepatitis B core (HBc) were found in 19.8 percent of 817 persons tested. Males were more likely to have antibodies to Hepatitis B Virus (HBV) than females (29 percent compared with 18 percent, Odds Ratio 1.6;95 percent CI 0.98-2.9). HBsAg was found in 5.3 percent of 562 persons tested compared with 1 percent of blood donors. One or more needlestick accidents were reported by 60 percent of the sample, and blood or liquid splashing on the face was reported by 48 percent. Jaundice and hepatitis were reported by 1.2 percent and 3.5 percent of health staff, respectively. HBaAg carrier status was associated with years of service (p=0.039). Prevalence of antibodies to HBV increased with age (p=0.004) and years of service (p=0.028). The effect of age and years of service appears to be largely independent (r=0.44). This survey reaffirms the importance of health workers being immunized with hepatitis B vaccine, and adhering rigorously to universal precautions in patient care and laboratory practice (AU)

The prevalence of hepatitis A and B infection among different ethnic groups in Belize - abstract

Little is known about the prevalence of infection with hepatitis viruses in Belize, Central America. We conducted a serological survey among members of the Belize Defence Force (BDF), which comprises the five major ethnic groups in Belize, in order to estimate the prevalence of hepatitis A and B among men and women of military age in Belize. Of approximately 600 men and women in the BDF, 394 (66 per cent) volunteered to participate. Antibody to hepatitis A was found in 95 per cent with similar rates by age, rank and ethnicity. Antibody to hepatitis B core antigen (anti-HBc) was found in 31 per cent. The prevalence of anti-HBc varied significantly among the ethnic groups, with the lowest rates in Mayan Indians (5 per cent) and Mestizo (7 per cent), with significantly higher rates among Creoles (30 per cent) and Garifuna (54 per cent). Rates increased with increasing age from 25 per cent in those 18 - 24 years to 35 per cent in those over 35 years of age (p = 0.6, chi-square for trend). Hepatitis B surface antigen was found in 15 (4 per cent) overall. Rates of hepatitis A and B antibodies among 70 military recruits (mean age 20 years) were similar to those among regular forces; anti-HAV was found in 91 per cent, anti-HBc in 34 per cent, and HBsAg in 6 per cent. In this young healthy population, exposure to hepatitis A before the age of 18 years is almost universal, while exposure to hepatitis B is related to age and ethnicity (AU)

A survey of hepatitis B among health workers in Jamaica - abstract

A convenience sample of 1537 health staff in Jamaica were surveyed in 1990/91 for hepatitis B markers and/or exposure to blood or hepatitis. Antibodies to either hepatitis B surface antigen (HBsAg) or hepatitis B core (HBc) were found in 19.8 per cent of 817 persons tested. HBsAg was found in 5.3 per cent persons tested. One or more needlestick accidents were reported by 60 per cent of the sample and blood or liquor splashing on the face was reported by 48 per cent. Jaundice and hepatitis was reported by 1.2 per cent and 3.5 per cent respectively. Prevalence of antibodies to hepatitis B virus (HBV) increased with age (p = 0.004) and years of service (p = 0.28) while HBsAg carrier status was associated with years of service (p = 0.039). Males were more likely to have antibodies to HBV than females (Odds Ratio 1.63, 95 per cent, CI 0.98 - 2.71). This survey reaffirms the importance of health workers being immunized with hepatitis B vaccine and adhering rigorously to universal precautions in patient care and laboratory practice (AU)

Hepatitis B antibody levels in health-care workers of a large general hospital in Barbados

In order to assess the immune status to Hepatitis B in a general hospital population in the Caribbean, we studied the antibody level to Hepatitis B surface antigen (anti HBs) and to core antigen (anti HBc) in 90 health-care workers at the Queen Elizbeth Hospital in Barbados, West Indies. There was one asymptomatic carrier with Hepatitis B antigen (HBsAg). Thirteen (14.6 percent) of the remaining 89 possessed anti HBs; 10 of these (11.2 percent) were considered to be immune, and three non-immune. The 10 immune subjects were also positive for anti HBc whereas the other three "non-immune" positives were not. One person in the study had strong anti HBc immunity but was negative for anti HBs. There appeared to be no relationship between immunity and age, sex, profession or duration of work years. From the study, 76 individuals (84 percent were easily identified as being susceptible to Hepatitis B and were candidates for HBV vaccine. (AU)