Madzime S, Adem M, Mahomed K, Woelk G B, Mudzamiri S, Williams M A
Department of Obstetrics and Gynaecology, University of Zimbabwe Medical School, Avondale, Harare, Zimbabwe.
Cent Afr J Med. 1999 Aug;45(8):195-8. doi: 10.4314/cajm.v45i8.8414.
To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among pregnant women delivering at Harare Maternity Hospital.
A serological survey study of pregnant women admitted for labour and delivery.
Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June 1997.
A random sample of 1,000 women, delivering at the hospital during the study period agreed to participate in the study. Serum samples were available for 984 women.
HBV carriage status was determined by the presence of hepatitis B surface antigen (HBsAg) by enzyme immunoassay (EIA). Maternal HBV infectivity status was determined by testing all HBsAg positive women for the presence of hepatitis e surface antigen (HBeAg) using EIA.
Overall 246 (25%) women were identified as carriers of HBV (95% confidence interval 22 to 28%). The frequency of HBV carriers did not vary with maternal age, parity or marital status. Only a positive prior history of spontaneous abortion was associated with an increased prevalence of HBV carriage status. Eight of the 246 (3.3%) women identified as HBV carriers tested positive for HBeAg. Hence, 0.8% of the entire study population was found to be at high risk of transmitting HBV to their newborns.
Our results demonstrate a high prevalence of HBV carriage among women giving birth at Harare Maternity Hospital. None of the demographic variables studied were important predictors of HBV carriage status. The high carriage rate and low infectivity rates suggest that HBV infection is likely to be acquired by horizontal, rather than by vertical means of transmission. Given the scarcity of financial resources, routine testing of mothers for HBsAg may not be feasible. Our results suggest, however, that mass vaccination of all infants, irrespective of maternal HBV carriage status, may be the most effective approach to HBV prevention and control in Zimbabwe.
确定在哈拉雷妇产医院分娩的孕妇中乙型肝炎病毒（HBV）携带者的患病率及感染状况。
对入院待产及分娩的孕妇进行血清学调查研究。
1996年6月至1997年6月期间，津巴布韦哈拉雷的哈拉雷妇产医院。
在研究期间于该医院分娩的1000名妇女的随机样本同意参与研究。984名妇女有血清样本。
采用酶免疫测定法（EIA）通过检测乙型肝炎表面抗原（HBsAg）来确定HBV携带状态。通过对所有HBsAg阳性妇女采用EIA检测乙型肝炎e抗原（HBeAg）的存在来确定母亲的HBV感染状况。
总体上，246名（25%）妇女被确定为HBV携带者（95%置信区间为22%至28%）。HBV携带者的频率与母亲年龄、产次或婚姻状况无关。只有既往自然流产史阳性与HBV携带状态患病率增加有关。在246名被确定为HBV携带者的妇女中，有8名（3.3%）HBeAg检测呈阳性。因此，发现整个研究人群中有0.8%的人将HBV传播给新生儿的风险很高。
我们的结果表明，在哈拉雷妇产医院分娩的妇女中HBV携带率很高。所研究的人口统计学变量均不是HBV携带状态的重要预测因素。高携带率和低感染率表明，HBV感染可能是通过水平传播而非垂直传播获得的。鉴于财政资源稀缺，对母亲进行常规HBsAg检测可能不可行。然而，我们的结果表明，对所有婴儿进行大规模疫苗接种，无论母亲的HBV携带状态如何，可能是津巴布韦预防和控制HBV最有效的方法。
