Differences in prevalence of hepatitis B virus infection and genotypes between ethnic populations in Suriname, South America.

Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.

Trends in incidence and mortality of female breast cancer in Suriname for the period 1980–2014: Implications for the healthcare system

OBJECTIVE: The aim was to analyse current breast cancer burden in relation to demographic and socio-economic indicators. This paper presents preliminary analysis of temporal trends in incidence and mortality for 1980–2013. SUBJECTS AND METHODS: data were retrieved from the histopathology database, the mortality database and the General Bureau of Statistics. Crude five-year incidence and mortality rates were calculated and expressed per 100000 women. Data are presented with 95% confidence intervals and average annual per cent changes (AAPC) over each period. Statistical significance was tested using Chi-squared for trend. RESULTS: Breast cancer incidence increased by 48% between 1980–1984 and 2000–2004 (÷2 2.32, p = 0.0004), from 13.5 (95% CI 11.1, 15.9) to 19.9 (95% CI 17.4, 22.5). From 2005 onward, the incidence rose exponentially (÷2 48.54, p-value < 0.0000001), from 19.9 (95% 17.4, 22.5) to 48.9 (95% 45.2, 52.6). The AAPC between 1980 and 2004 was 2%, but increased to 16% between 2005 and 2014, signifying the substantial rise in incidence. The upward trend for 1980–2014 was statistically significant(÷2 399.07, p-value < 0.0000001). Breast cancer mortality increased by 80.3%, from 5.33 (95% CI 3.84, 6.82) to 10.50 (95% CI 8.56, 12.43) during the period 2000–2004, with an AAPC of 3.3% (÷2 17.71, p = 0.00003). From 2005 on, the increase was 9%, with an AAPC of 0.7% (÷2 0.40, p = 0.53). The upward trend for 1980–2013 was statistically significant (÷2 44.83, p < 0.0000001). CONCLUSION: Results show that breast cancer incidence in Suriname is increasing while mortality remains stable, suggesting improvements in diagnostic and treatment services. These results are a first step to understanding breast cancer burden and establishing an evidence-based cancer control programme.