title: Epidemiological Differentials of Hepatitis B Carrier State in the Army : A Community Based Sero-epidemiological Study.
abstract: BACKGROUND
  Most available studies on seroprevalence of Hepatitis B in the Armed Forces and also at the national level are based on hospital patients and blood donors. Hence, there was a perceived need to undertake a seroepidemiological study on an adequately large and representative random sample of the general cross section of Army personnel, with a view to obtain the exact picture of the frequency and distribution of HBV in the Army.
  
  
  METHODS
  A community based cross sectional study with random samples from four groups were drawn, viz recruits from the Army Medical Corps (AMC) and other Arms and Services; AMC personnel and personnel from other Arms and Services who had served for more than 10 years. A structured pretested questionnaire was administered to all participants and blood samples were drawn aseptically subsequently, with separation of serum and testing by ELISA technique for HBsAg. Multivariate analysis using multiple logistic regression procedure was done after appropriate data entry.
  
  
  RESULTS
  The overall seroprevalence was 7.9% (95%CI = 6.5% to 9.26%). The differential seroprevalence in the four groups being 7.72%, 7.92%, 8.28% and 7.75% respectively. There was statistically no significant difference as regards the seroprevalence levels [p > 0.05]. As regards serving medical personnel, the seroprevalence was observed to be higher among personnel involved in direct nursing care. On multiple logistic regression analysis, two risk factors emerged as independent and significant predictors of hepatitis B positivity. These were history of sexual exposure with commercial sex workers (CSWs) (OR = 3.06, p < 0.01) and history of having taken injections from civil sources (OR = 1.92, p < 0.001).
  
  
  CONCLUSIONS
  The relatively high level of seroprevalence among recruits has led to certain recommendations on testing and further studies in specific groups, based on the findings of the study.
authors.affiliation: DADH, HQ 8 Mtn Division (Med), C/o 56 APO.
authors.forename: M P
authors.initials: MP
authors.lastname: Cariappa
authors.affiliation: ADH & Senior Advisor (PSM & Epidemiology), HQ 16 Corps (Med), C/o 56 APO.
authors.forename: J
authors.initials: J
authors.lastname: Jayaram
authors.affiliation: ADH & Senior Advisor (PSM & Epidemiology), HQ 16 Corps (Med), C/o 56 APO.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Bhalwar
authors.affiliation: Senior Advisor (Pathology & Microbiology), 151 Base Hospital, C/o 99 APO.
authors.forename: A K
authors.initials: AK
authors.lastname: Praharaj
authors.affiliation: ADH, HQ 4 Corps (Med), C/o 99 APO.
authors.forename: V K
authors.initials: VK
authors.lastname: Mehta
authors.affiliation: Classified Specialist (PSM), Army Medical Corps (Centre & School), Lucknow.
authors.forename: L K
authors.initials: LK
authors.lastname: Kapur
keywords: Health care workers; Hepatitis B - seroprevalence; Military personnel; Multivariate analysis; Risk factors