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

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)