Differences in the regional prevalence of chronic hepatitis B in southern Africa--implications for vaccination.
Chronic hepatitis B infection is an important cause of cirrhosis and subsequent hepatocellular carcinoma in South Africa. The disease can now be prevented by vaccination, but second-generation genetically engineered vaccines still necessitate planned allotment. We have tested 29,312 black southern African mineworkers for hepatitis B surface antigen (HBsAg) to indirectly ascertain the relative prevalence of hepatitis B infection in diverse linguistic and ethnic groups. The overall prevalence of HBsAg in this cohort of predominantly rural men was 9.9%, but the prevalence in men from different regions varied from 5.5% to 14%. The relative prevalence in 200 magisterial districts was ranked; these percentage prevalences ranged from 0% to 17%. A significantly lower mean prevalence was detected in Southern Sotho subjects than in those from coastal districts (Nguni). Based on these data, we believe that there are perhaps 2 million hepatitis B carriers in South Africa. The collected data in this report could provide a basis for a broad-based vaccine campaign whereby hepatitis B vaccine could be targeted to high-priority districts initially. This strategy could rapidly reduce the critical mass of carriers, and hasten control of the disease.
Dusheiko
G M
GM
Department of Medicine, University of Witwatersrand, Johannesburg.
Conradie
J D
JD
Brink
B A
BA
Marimuthu
T
T
Sher
R
R
D000293:Adolescent; D000328:Adult; D000353:Africa, Southern; D001741:Black or African American; D000368:Aged; D044383:Black People; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines; D006521:Hepatitis, Chronic / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D008906:Mining; D014611:Vaccination; D014761:Viral Hepatitis Vaccines
D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines