孟加拉国农村地区儿童大规模疫苗接种前乙型肝炎病毒感染的血清流行率

M. Mohsena, A. Mitra, M. Sayeed, A. Banu, J. Haq
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引用次数: 0

摘要

背景和目的:关于孟加拉国一般人群中乙型肝炎病毒(HBV)感染流行情况的细节很少。关于在扩大免疫规划(EPI)引入乙型肝炎疫苗之前出生的儿童和青少年中乙型肝炎病毒感染流行率的数据缺乏。本研究的目的是利用存档数据描述孟加拉国特定农村地区学龄儿童HBV感染(HBsAg和抗hbc抗体)的血清流行病学。此外,该研究将一部分儿童的血清维生素A水平与HBV感染状况联系起来。材料和方法:本研究分析了2003年和2004年进行的一项研究的存档数据。这些样本是从1995名5至15岁的儿童中收集的,他们来自首都达卡东北约100公里处的一个有意选择的农村地区。ELISA法检测HBV表面抗原(HBsAg)和抗hbc抗体。采用高效液相色谱法测定血液中维生素A(视黄醇)含量。HBsAg和抗hbc抗体阳性率采用简单百分比法测定。不同特征间的关联均采用卡方检验。结果:1995例患儿中,男988例(49.5%),女1007例(50.5%)。其中HBsAg阳性或HBV携带者23例(1.2%),抗hbc抗体阳性79例(8.1%)。男女儿童HBsAg和抗hbc抗体阳性率均无差异。不同年龄组儿童HBsAg阳性率差异无统计学意义;抗hbc抗体阳性率随年龄的增加而显著升高(p <0.005)。对一部分儿童的血清维生素A进行了估计。与年龄和性别匹配的健康对照组相比,HBsAg阳性儿童的平均血清维生素A浓度显著降低(p<0.05)。结论:本研究表明农村儿童存在暴露于HBV感染的危险。随着年龄的增长,乙型肝炎病毒血清阳性反应增加,这强调了制定预防战略和在农村儿童中提高认识的必要性。需要进一步的研究,以找出迄今未被发现的来源,即隐性乙型肝炎病例和HBV在社区中的传播途径。中华医学会医学杂志。2023;17(2): 007。DOI: https://doi.org/10.55010/imcjms.17.017*Correspondence: M Abu Sayeed, Ibrahim医学院社区医学系,1/A, Ibrahim Sarani, Segunbagicha,孟加拉国达卡1000;电子邮件:sayeed1950@gmail.com;J. Ashraful Haq,孟加拉国达卡Segunbagicha易卜拉欣医学院微生物系;电子邮件:jahaq54@yahoo.com
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Seroprevalence of hepatitis B virus infection in pre-mass vaccination era among children residing in a rural area of Bangladesh
Background and objectives: There are few details available regarding the prevalence of hepatitis B virus (HBV) infection in the general Bangladeshi population. There is a dearth of data on prevalence of HBV infection in children and adolescents who were born before the hepatitis B vaccine was introduced in the Expanded Program on Immunization (EPI). The objective of the current study was to use archived data to describe the seroepidemiology of HBV infection (HBsAg and anti-HBc Antibody) among school children in a particular rural area of Bangladesh. Also, the study correlated serum vitamin A level with the HBV infection status among a subset of children. Materials and method: The study analyzed the archived data of a study conducted in 2003 and 2004. The samples were collected from 1995 children, aged 5 to 15 years, from a purposively selected rural area located about 100 km north-east of capital Dhaka. HBsAg (HBV surface antigen) and anti-HBc antibody were determined by ELISA method. Vitamin A (retinol) in blood was assayed by HPLC technique. The prevalence rates of HBsAg and anti-HBc antibody was determined by simple percentages. All associations between different characteristics were tested by Chi square test. Results: Of the total 1995 children, 988 (49.5%) and 1007 (50.5%) were male and female respectively. Among them, 23 (1.2%) were HBsAg positive or HBV carriers and 79 (8.1%) were anti-HBc antibody positive. Neither HBsAg nor anti-HBc antibody positivity rate showed any difference in male and female children. There was also no significant difference of HBsAg positivity rate amongst children of different age groups; whereas, anti-HBc antibody positivity rate increased significantly (p <0.005) with increase of age. Serum vitamin A was estimated in a subset of children. The mean serum vitamin A concentration was found significantly (p<0.05) lower among HBsAg positive children compared to their age and sex matched healthy control group. Conclusion: This study has demonstrated that rural children are in risk of exposure to HBV infection. Increasing HBV seropositivity with age emphasizes the need for devising prevention strategies and to create awareness among the rural children. Further studies are necessary to find out the hitherto undetected sources namely occult hepatitis B cases and the ways of spread of HBV in the community. IMC J Med Sci. 2023; 17(2):007. DOI: https://doi.org/10.55010/imcjms.17.017 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh; Email: sayeed1950@gmail.com; J. Ashraful Haq, Department of Microbiology, Ibrahim Medical College, Segunbagicha, Dhaka, Bangladesh; Email: jahaq54@yahoo.com
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