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Seroepidemiology of Hepatitis B and Delta Virus Infections in Bangladesh

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Journal of Tropical Pediatrics

Volume 49, Issue 6, December 2003: pp. 371-374

Article

Seroepidemiology of Hepatitis B and Delta Virus Infections in Bangladesh

Md. Hasan Zaki1, L. Darmstadt2,3, Abdul Baten1, Chowdhury R. Ahsan1 and

Samir K. Saha2,4,5

1Department of Microbiology, University of Dhaka, Dhaka, Bangladesh

2Department of International Health, Bloomberg School of Public Health, The

s Hopkins Medical Institutions, Baltimore, MD, USA

3Office of Health, Save the Children Federation, Washington, DC, USA

4Department of Microbiology, Dhaka Shishu (Children) Hospital, Bangladesh

Institute of Child Health, Dhaka, Bangladesh

5Popular Diagnostic Centre, Dhaka, Bangladesh

Hepatitis B virus (HBV) infection is one of the most prevalent public health

problems worldwide, and causes 1 million deaths annually. In Bangladesh,

information about prevalence of HBV infection is scarce, and there is no

available data on HDV infection. We determined rates of HBsAg and anti-HBc

seropositivity in asymptomatic, healthy children (n = 181) and adults (n =

354) presenting to referral facilities in Dhaka, Bangladesh, and tested a

separate group of HBsAg-positive patients (n = 180) for prevalence of HDV.

Testing of serum was also performed for signs of liver disease. Overall,

seropositivity of HBsAg and anti-HBc in studied subjects was 3 per cent

(16/534) and 21.1 per cent (113/534), respectively. Prevalence of HBsAg was

highest in the 5- to 9-year-old (8.5 per cent, 7/82) and 10- to 14-year-old

(5.9 per cent, 2/34) age groups. Unlike HBsAg, prevalence of anti-HBc was

lower in children (14.9 per cent in those below the age of 15) than adults

(24.4 per cent in those aged 20-34 years) (p < 0.05). Most HBsAg-positive

individuals were symptomatic (n = 125, 69.4 per cent). A high rate (24.4 per

cent, 44/180) of simultaneous infection with HDV was observed among

HBsAg-positive subjects, with higher rates in older individuals. Anti-HDV

seropositivity rate was similar among asymptomatic (21.8 per cent, 12/55)

and symptomatic (25.6 per cent, 32/125) HBsAg carriers. Our data suggest

that Bangladesh is of moderate endemicity for HBV infection, and has

relatively high rates of co-infection with HDV. Control HBV and HDV

infection in Bangladesh may be best achieved by targeting preschool

children, which could fit readily within the existing EPI schedule.

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Journal of Tropical Pediatrics

Volume 49, Issue 6, December 2003: pp. 371-374

Article

Seroepidemiology of Hepatitis B and Delta Virus Infections in Bangladesh

Md. Hasan Zaki1, L. Darmstadt2,3, Abdul Baten1, Chowdhury R. Ahsan1 and

Samir K. Saha2,4,5

1Department of Microbiology, University of Dhaka, Dhaka, Bangladesh

2Department of International Health, Bloomberg School of Public Health, The

s Hopkins Medical Institutions, Baltimore, MD, USA

3Office of Health, Save the Children Federation, Washington, DC, USA

4Department of Microbiology, Dhaka Shishu (Children) Hospital, Bangladesh

Institute of Child Health, Dhaka, Bangladesh

5Popular Diagnostic Centre, Dhaka, Bangladesh

Hepatitis B virus (HBV) infection is one of the most prevalent public health

problems worldwide, and causes 1 million deaths annually. In Bangladesh,

information about prevalence of HBV infection is scarce, and there is no

available data on HDV infection. We determined rates of HBsAg and anti-HBc

seropositivity in asymptomatic, healthy children (n = 181) and adults (n =

354) presenting to referral facilities in Dhaka, Bangladesh, and tested a

separate group of HBsAg-positive patients (n = 180) for prevalence of HDV.

Testing of serum was also performed for signs of liver disease. Overall,

seropositivity of HBsAg and anti-HBc in studied subjects was 3 per cent

(16/534) and 21.1 per cent (113/534), respectively. Prevalence of HBsAg was

highest in the 5- to 9-year-old (8.5 per cent, 7/82) and 10- to 14-year-old

(5.9 per cent, 2/34) age groups. Unlike HBsAg, prevalence of anti-HBc was

lower in children (14.9 per cent in those below the age of 15) than adults

(24.4 per cent in those aged 20-34 years) (p < 0.05). Most HBsAg-positive

individuals were symptomatic (n = 125, 69.4 per cent). A high rate (24.4 per

cent, 44/180) of simultaneous infection with HDV was observed among

HBsAg-positive subjects, with higher rates in older individuals. Anti-HDV

seropositivity rate was similar among asymptomatic (21.8 per cent, 12/55)

and symptomatic (25.6 per cent, 32/125) HBsAg carriers. Our data suggest

that Bangladesh is of moderate endemicity for HBV infection, and has

relatively high rates of co-infection with HDV. Control HBV and HDV

infection in Bangladesh may be best achieved by targeting preschool

children, which could fit readily within the existing EPI schedule.

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