Hepatitis B virus, human immunodeficiency virus type-1 and syphilis among women attending prenatal clinics in Belize, Central America

Women and their infants may benefit from therapeutic interventions when hepatitis B, human immunodeficiency virus (HIV), or syphilis are detected during the prenatal period. We initiated hepatitis B and HIV screening of women attending prenatal clinics in Belize. Risk factor assessment information for hepatitis B infection and demographic data were determined by interview. Of 543 evaluable women, 81 (14.9 percent) were seropositive for hepatitis B core antibody (anti-HBc); one woman had asymptomatic hepatitis B surface antigenemia. Antibodies to HIV-1 were detected in one woman. Reactive syphilis serologies were detected in 15 (2.8 percent) women. Anti-HBc seroprevalence varied by district (range 3.1-43.5 percent) and ethnicity (range 0.0-40.9 percent). Significant identified risks for anti-HBc seropositivity from univariate analyses included being of the Garifuna ethnic group, residence or birth in the Stann Creek or Toledo districts, a reactive syphilis serology, a household size of eight or greater, and five or more lifetime sexual partners. Multivariate analyses identified ethnicity and a reactive rapid plasma reagin as the best predictors of anti-HBc seropositivity. Highly variable differences in anti-HBc prevalence by district may permit the targeting of limited public health resources for education, screening, and prevention programs.(AU)

Seroprevalence of hepatitis B virus, HIV-1, and syphilis among women attending prenatal clinics in Belize, Central America - abstract

We initiated hepatitis B (HB) screening of women attending selected prenatal clinics in Belize. Risk factors for HB infection and demographic data were determined by interview. Of 548 women, 81 (15 percent) were seropositive for HB Core Antibody (anti-HBc); one had HB surface antigenemia. Antibodies to the HIV-1 were detected in one woman. Fifteen women had reactive syphilis serologies. Anti-HBc seroprevalence varied by district (range 3 percent - 44 percent) and by ethnicity (Creole, 19 percent; Garifuna, 43 percent; East Indian, 6 percent; Mayan, 22 percent; Mestizo/Spanish, 8 percent; Dutch German-Menonite, 0 percent). Risk factors for anti-HBc identified from univariate analyses included: being of the Garifuna ethnic group (p<.00001), residence in the Stann Creek, district (p<0.00001), a reactive syphilis serology (p=0.02), a house-hold size of 8 or greater (p=0.02), and five or more lifetime sexual partners )p=0.01). Health care work, tattoos and intravenous drug use were not identified as risks. Multivariate analyses by stepwise logistic regression identified ethnicity (p=0.0001) and a reactive rapid plasma reagin (RPR) (p=0.02), as significant independent predictors of anti-HBc seropositivity. Strategies to screen all pregnant women and provide immunoprophylaxis to susceptible infants may be effective in interrupting neonatal HB in Belize. Highly variable differences in anti-HBc rates by district may permit the targeting of limited public health resources for education and prevention of HB and other sexually transmitted diseases (AU)

Initial report of a hepatitis investigation in rural Belize

In spring 1991, Belizian health officials expressed concern about a possible hepatitis outbreak in a banana farming district. A study was designed to identify cases and to address the serological prevalence of hepatitis virus markers. Three populations were studied: (i) persons meeting a clinical case definition for hepatitis; (ii) designated banana workers; and (iii) people in a random sample of households in the community. Information was collected using questionnaires and sera were collected for laboratory testing. This report presents the preliminary results of a study conducted in June 1991. Among people who met the clinical case definition, 24 percent of 42 tested had immunoglobulin M antibody to hepatitis B virus (HBV) core antigen (anti-HBc IgM). In the worker and household survey populations, 248 and 280 people, respectively, were tested for anti-HBc IgM. In each group, 4 percent were positive. HBV surface antigen was found in 37 percent of 43 clinical cases, 18 percent of workers, and 13 percent of people in the household survey. Among the 3 study populations, the prevalence of HBV core antibody (anti-HBc) ranged from 73 percent to 81 percent. Almost all tested persons had evidence of prior infection with hepatitis viruses A and B was widespread, but an aetiology could not be established for most of the clinical cases. However, the prevalence of hepatitis B markers in this population was very high compared to other reports from the Caribbean (AU)

Initial report of a viral hepatitis investigation in rural Belize - abstract

In spring 1991, concern was expressed in Belize about a hepatitis outbreak. A cross-sectional study was designed to address hepatitis prevalence in a farming district. Three populations were identified: anyone meeting a case definition for hepatitis, any designated worker, and a random sample of the community by household. Survey information was collected on the farm, household, and individual. Sera were collected for laboratory study. This study reports on the current findings from 509 sera collected in June 1991. There had been widespread exposure to hepatitis A(98 percent). New hepatitis was primarily due to hepatitis B(24 percent of clinical cases, 4 percent of people in the random household sample, and 5 percent of workers). In our total, 16 percent had hepatitis B surface antigen and were potential carriers, while 73 percent had evidence of past hepatitis C by our detection method, and delta particle was not present in any of the tested cases. Hepatitis E antibody was detected in two cases. One risk revolved around perceptions of good medical care, using injectable medications. (AU)