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

ABSTRACT

A seroprevalence survey of hepatitis B 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 save vaccine costs. Of the 330 workers tested, 94 (29 percent) were positive for anti-HBc and 3 (1 percent) had HBsAg. Anti-HBc increased significantly with age from 12 percent in those 18-24 tears old to 52 percent in those 25-50 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 (69/228; 30 percent) and domestic workers (15/44; 34 percent) than among physicians (0/20). Anti-HBc differed significantly among ethnic groups Mestizo, 4 percent; Creole, 33 percent and Garifuna, 57 percent 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 injjuries and blood transfusions was not associated with anti-HBs. Multiple logistic regression analysis confirmed ethnicity, district of residence and age as the best predictors of anti-HBc. Regional differences in exposure suggest that testing of health care workers for anti-HBc before hepatitis B immunization in the 3 southern districts of Belize may result in vaccine cost savings (AU)