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

ABSTRACT

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)