Risk Factors for Horizontal Transmission of Hepatitis B Virus in a Rural District in Ghana

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...

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Bibliographic Details
Published in:American journal of epidemiology 1998-03, Vol.147 (5), p.478-487
Main Authors: Martinson, Francis E. A., Weigle, Kristen A., Royce, Rachel A., Weber, David J., Suchindran, Chirayath M., Lemon, Stanley M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Africa
Aged
Biological and medical sciences
Child
Child Welfare
Child, Preschool
disease transmission
Disease Transmission, Infectious
Family Characteristics
Female
Ghana - epidemiology
Hepatitis Antibodies - analysis
Hepatitis B - transmission
hepatitis B surface antigen
Hepatitis B virus
Hepatitis B virus - immunology
horizontal
Human viral diseases
Humans
Infant
Infectious diseases
Male
Medical sciences
Middle Aged
Population
Prevalence
Risk Factors
Rural Health
Tropical medicine
Viral diseases
Viral hepatitis
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Summary: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 (CI) 72.5%-76.9%). Prevalence of HBsAg was 20.9% (95% CI 18.8%-23.1%). The data suggest a continous nonuniform acquisition of HBV infection with advancing age predominantly through horizontal transmission in childhood, with the household, rather that the domestic compound, being the primary place for transmission. The behaviours most strongly associated with prevalence of HBV were sharing of bath towels (OR = 3.1, 95% CI 2.10-4.5), sharing of chewing gum of partially eaten candies (OR = 3.4, 95% CI 2.3-5.0), sharing of dental cleaning materials (OR = 2.5, 95% CI 1.3-4.6), and biting of fingemails in conjuction with scratching the backs of carriers (OR = 2.5, 95% CI 1.6-4.3) Am J Epidemiol 1998; 147:478–87.
ISSN:0002-9262
1476-6256
DOI:10.1093/oxfordjournals.aje.a009474