Shedain Purusotam Raj, Devkota Madhu Dixit, Banjara Megha Raj, Ling Huang, Dhital Subash
Department of Community Medicine and Public Health, Institute of Medicine/Ministry of Health, RamshahPath, Kathmandu, Nepal.
Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
BMC Infect Dis. 2017 Oct 10;17(1):667. doi: 10.1186/s12879-017-2763-4.
Hepatitis B Virus (HBV) infection is a worldwide public health problem. In Nepal, the prevalence of HBV is found to be low (0.9%), although high prevalence (≥8%) of HBV infection is depicted among subgroup/population in the mountain region by various studies. This study assessed the prevalence and the risk of HBV infection among mothers, as well as among the youngest child under 5 years old living with hepatitis B positive mothers in Dolpa, the most remote mountain district of Nepal.
The cross sectional study survey was conducted between June and July 2014. All mothers with their youngest child under 5 years old were invited to participate in the survey and tested for hepatitis B surface antigen (HBsAg). The HBsAg positive mothers were further tested by 5-panel HBV test card. Children living with HBsAg positive mothers were also tested for HBsAg.
One hundred fifty-one mothers, comprising 37% of the total study population in the selected Village Development Committees (VDCs), were surveyed in the mobile health camps. The seroprevalence of HBsAg among mothers and their youngest child under 5 years old living with HBsAg positive mothers were 17% (95% CI, 11.01-22.99%) and 48% (95%CI, 28.42-67.58%) respectively. The majority of HBV infected mothers were indigenous (84%) followed by Dalit (4%) and other castes (12%). Among HBV infected mothers, 40% were hepatitis B envelope antigen (HBeAg) positive. The prevalence of HBsAg was higher among children living with HBeAg positive mothers as compared to HBeAg negative (60% vs 40%) and male children compared to female (60% vs 33%). Thirty-six percent of children were vaccinated with a full course of the hepatitis B vaccine. Of these vaccinated children, 56% were HBsAg sero-positive.
The HBV infection rate is high among mothers and children living with HBsAg positive mothers in the indigenous population of the most remote mountain community of Nepal.
乙型肝炎病毒（HBV）感染是一个全球性的公共卫生问题。在尼泊尔，HBV的流行率较低（0.9%），尽管多项研究表明，在山区的亚组/人群中HBV感染的流行率较高（≥8%）。本研究评估了尼泊尔最偏远山区多尔帕县HBsAg阳性母亲及其5岁以下最小子女中HBV感染的流行率和风险。
于2014年6月至7月进行横断面研究调查。邀请所有携带5岁以下最小子女的母亲参与调查，并检测乙肝表面抗原（HBsAg）。HBsAg阳性母亲进一步通过五联HBV检测卡进行检测。与HBsAg阳性母亲生活在一起的儿童也进行了HBsAg检测。
在流动健康营中对151名母亲进行了调查，占选定村发展委员会（VDC）中总研究人群的37%。HBsAg阳性母亲及其5岁以下最小子女中HBsAg的血清流行率分别为17%（95%CI，11.01 - 22.99%）和48%（95%CI，28.42 - 67.58%）。大多数感染HBV的母亲是原住民（84%），其次是达利特人（4%）和其他种姓（12%）。在感染HBV的母亲中，40%的人乙肝e抗原（HBeAg）呈阳性。与HBeAg阴性母亲的子女相比，HBeAg阳性母亲的子女中HBsAg的流行率更高（60%对40%），男性儿童高于女性儿童（60%对33%）。36%的儿童接种了全程乙肝疫苗。在这些接种疫苗的儿童中，56%的人HBsAg血清呈阳性。
在尼泊尔最偏远山区社区的原住民中，HBsAg阳性母亲及其子女中的HBV感染率很高。
