Risk factors for horizontal transmission of hepatitis B virus in a rural district in Ghana
Risk factors for horizontal transmission of hepatitis B virus in a rural district in Ghana
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DOI：
10.1093/oxfordjournals.aje.a009474
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发表时间：
1998-03-01
影响因子：
5
通讯作者：
Lemon, SM
中科院分区：
文献类型：
--
作者：
Martinson, FEA;Weigle, KA;Lemon, SM
在撒哈拉以南非洲的婴儿和儿童中，大多数乙型肝炎病毒（HBV）感染是通过水平传播获得的，但确切的传播机制尚未被记录。作者在加纳农村进行了一项研究，确定了1385个所有年龄个体的概率样本的血清阳性率，并评估了547名1-16岁非乙型肝炎表面抗原（HBsAg）携带者的儿童中HBV水平传播的危险因素。这个地区的大多数居民住在通常由2-4户家庭组成的小区里。HBV血清阳性（任何HBV标志物）的总体患病率为74.7%（95%可信区间（Cl） 72.5%-76.9%）。HBsAg患病率为20.9% （95% Cl 18.8% ~ 23.1%）。数据表明，随着年龄的增长，HBV感染的持续非均匀性主要通过儿童时期的水平传播，家庭而不是家庭复合，是传播的主要场所。与HBV流行最密切相关的行为是共用浴巾（OR = 3.1, 95% Cl 2.1-4.5），共用口香糖或吃了一部分的糖果（OR = 3.4, 95% Cl 2.3-5.0），共用洗牙用品（OR = 2.5, 95% Cl 1.3-4.6），咬指甲并抓携带者的背部（OR = 2.5, 95% Cl 1.6-4.3）。
Most hepatitis B virus (HBV) infections in sub-Saharan African infants and children are acquired through horizontal transmission, but the exact mechanisms of spread have not been documented, The authors conducted a study in rural Ghana which determined seroprevalence in a probability sample of 1,385 individuals of all ages, and evaluated risk factors for 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 this district live in compounds which typically contain 2-4 households each. Overall prevalence of HBV seropositives (any HBV marker) was 74.7% (95% confidence interval (Cl) 72.5%-76.9%). Prevalence of HBsAg was 20.9% (95% Cl 18.8%-23.1%). The data suggest a continuous nonuniform acquisition of HBV infection with advancing age predominantly through horizontal transmission in childhood, with the household, rather than the domestic compound, being the primary place for transmission. The behaviors most strongly associated with prevalence of HBV were sharing of bath towels (OR = 3.1, 95% Cl 2.1-4.5), sharing of chewing gum or partially eaten candies (OR = 3.4, 95% Cl 2.3-5.0), sharing of dental cleaning materials (OR = 2.5, 95% Cl 1.3-4.6), and biting of fingernails in conjunction with scratching the backs of carriers (OR = 2.5, 95% Cl 1.6-4.3).