Risk factors for horizontal transmission of hepatitis B virus in a rural district in Ghana.

ABSTRACT

PIP: Most hepatitis B virus (HBV) infections in sub-Saharan African infants and children are acquired through horizontal transmission. Findings are reported from a study conducted in rural Ghana to measure seroprevalence in a probability sample of 1385 people of all ages, and evaluate risk factors for the horizontal transmission of HBV in a subsample of 547 children aged 1-16 years who were not hepatitis B surface antigen (HBsAg) carriers. Most residents in the sample area live in compounds which typically contain 2-4 households each. The overall prevalence of HBV seropositives was 74.7% and the prevalence of HBsAg was 20.9%. These data suggest a continuous nonuniform acquisition of HBV infection with advancing age mainly through horizontal transmission in childhood, with the household, rather than the domestic compound, being the main place for transmission. The sharing of bath towels, sharing of chewing gum or partially eaten candies, sharing of dental cleaning materials, and biting of fingernails together with scratching the backs of carriers are the behaviors found to be most strongly associated with HBV prevalence.