Ayoola Ayobanji E, Tobaigy Mohsen S, Gadour Mohammed O, Ahmad Basher S, Hamza Margani K, Ageel Abdurahim M
Division of Gastroenterology, Department of Medicine, Ministry of Health, Jizan, Kingdom of Saudi Arabia.
Saudi Med J. 2003 Sep;24(9):991-5.
Hepatitis B virus (HBV) infection is endemic in the Kingdom of Saudi Arabia (KSA). The Jizan region in the South-Western area of the country was noted for a high prevalence of hepatitis B surface antigen (HbsAg) carrier rate. The study was carried out to determine the prevalence of HBsAg and other markers of HBV among residents of Jizan and evaluate the impact of the measures adopted in the last decade, to control HBV.
The study was carried out between 1995 and 1998. The subject were studied in 4 groups: Group A consisted of voluntary blood donors (n=14883) tested within the blood banking system during the time period June 1995 to June 1997, Group B were patients treated in the hospitals (n=4692) during the period June 1995 to June 1996, Group C consisted of volunteers recruited from the community (n=1172) and Group D children aged <10 years (n=229). Serum samples were obtained from the subjects tested for HBsAg, total antibody to hepatitis B core antigen, antibody to HBsAg and antibody to hepatitis C virus.
Hepatitis B surface antigen was positive in 5.4% of 14883 voluntary blood donors (Group A) and in 5.1% of 1172 persons recruited from the community (Group C) 40.2% were positive for at least one marker of HBV. The prevalence of HBsAg in-patients in Group B was 9.7% (456 of 4692). These prevalence rates are significantly lower than the prevalence of 12% and 32% reported in 1985 and 1986. Only 2 (0.9% of 229) children in Group D were positive for HBsAg, indicating a major decline from the rate of 8.8% observed in an earlier survey.
The low prevalence of HBsAg in children, provides evidence for the effectiveness and efficacy of the integration of hepatitis B vaccination into the extended program of immunization in KSA. The significant decline of HBV markers among unvaccinated Saudi adults indicated an indirect effect of other factors (for example health education and socio-economic progress) on the prevalence and transmission of HBV in Jizan. In areas of high endemicity, the epidemiological characteristics HBV are modified significantly by the combination of HBV vaccination and other complimentary control strategies.
乙型肝炎病毒（HBV）感染在沙特阿拉伯王国（KSA）呈地方性流行。该国西南部的吉赞地区以乙肝表面抗原（HbsAg）携带率高而闻名。开展本研究以确定吉赞居民中HBsAg及其他HBV标志物的流行情况，并评估过去十年为控制HBV所采取措施的影响。
研究于1995年至1998年进行。研究对象分为4组：A组为1995年6月至1997年6月期间在血库系统接受检测的自愿献血者（n = 14883）；B组为1995年6月至1996年期间在医院接受治疗的患者（n = 4692）；C组为由社区招募的志愿者（n = 1172）；D组为10岁以下儿童（n = 229）。采集受试者的血清样本检测HBsAg、乙肝核心抗原总抗体、抗-HBsAg及抗丙型肝炎病毒抗体。
在14883名自愿献血者（A组）中，5.4%的人HBsAg呈阳性；在从社区招募的1172人中（C组），5.1%的人HBsAg呈阳性。至少一种HBV标志物呈阳性的比例为40.2%。B组住院患者中HBsAg的流行率为9.7%（4692人中456人）。这些流行率显著低于1985年和1986年报告的12%和32%的流行率。D组中只有2名儿童（229名中的0.9%）HBsAg呈阳性，表明与早期调查中观察到的8.8%的比率相比有大幅下降。
儿童中HBsAg的低流行率证明了在沙特阿拉伯将乙肝疫苗接种纳入扩大免疫规划的有效性。未接种疫苗的沙特成年人中HBV标志物的显著下降表明其他因素（如健康教育和社会经济进步）对吉赞地区HBV流行率和传播的间接影响。在高流行地区，HBV疫苗接种与其他补充控制策略相结合可显著改变HBV的流行病学特征。
