Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control.
A community-based seroepidemiological survey of Addis Ababa, Ethiopia was conducted in 1994 to inform on the transmission dynamics and control of hepatitis B virus (HBV) infection. Venous blood from 4736 individuals under 50 years of age from 1262 households, selected using stratified cluster-sampling, was screened for HBV markers using commercial ELISAs. HBsAg prevalence was 7% (95 % CI 6-8), higher in males (9%; 7-10) than females (5%; 4-6). HBeAg prevalence in HBsAg positives was 23% (18-29), and less than 1% of women of childbearing age were HBeAg positive. Overall HBV seroprevalence (any marker), rose steadily with age to over 70% in 40-49 year olds, indicating significant childhood and adult transmission. Estimated instantaneous incidence was 3-4/100 susceptibles/year, higher in males than females in 0-4 year olds, and peaking in early childhood and young adults. The age at which 50% had evidence of infection was around 20 years, and the herd immunity threshold is approximated at 63-77%. Addis Ababa is of intermediate-high HBV endemicity, with negligible perinatal transmission. Our main findings are the identification of a significant difference between males and females in the age-acquisition of HBV infection, and marked differences between age groups in HBV incidence rates. These results should target future research studies of underlying risk factors. Furthermore, we generate a crude estimate of the level of coverage of HBV vaccine that would be required to eliminate the virus from the study population.
Abebe
A
A
Virology and Rickettsiology Research Team, Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, PO Box 1242, Ethiopia.
Nokes
D J
DJ
Dejene
A
A
Enquselassie
F
F
Messele
T
T
Cutts
F T
FT
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology / Q000472:pathogenicity*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D014505:Urban Population
D017325:Hepatitis B Vaccines