埃努古市儿童乙肝病毒感染的血清流行率及相关危险因素
Seroprevalence and Associated Risk Factors of Hepatitis B Virus Infection Among Children in Enugu Metropolis.
作者信息
Ezeilo Maryann Chinenye, Engwa Godwill Azeh, Iroha Romanus Ifeanyi, Odimegwu Damian Chukwu
机构信息
Department of Microbiology, Godfrey Okoye University, Enugu, Nigeria.
Department of Chemical Sciences, Godfrey Okoye University, Enugu, Nigeria.
出版信息
Virology (Auckl). 2018 Aug 22;9:1178122X18792859. doi: 10.1177/1178122X18792859. eCollection 2018.
BACKGROUND
Though measures are being put in place for the management of Hepatitis B virus (HBV) infection in Nigeria, children remain the most vulnerable to develop chronic hepatitis. Routine screening in children is therefore necessary for effective control. However, the performance of the commonly used immunochromatographic test (ICT) strips has been challenging. Also, identifying the risk factors of transmission in this age group is of importance for the implementation of preventive measures. Hence, the goal of this study was to assess the test performance of the routinely used ICT strip and identify the associated clinical manifestations and risk factors of HBV.
METHODS
A cross sectional study involving 270 children below six years of age was conducted at ESUTH and Favor Child Pediatrics Hospital in Enugu, Nigeria. The subjects were screened for HBV by ICT and ELISA assays and a structured questionnaire was used to obtain participants data including demographic, socioeconomic, signs and symptoms, risk factors and vaccination.
RESULTS
BBased on ELISA, 31 out of 270 children were positive for HBV with an infection rate of 11.5%. ICT kit showed a low sensitivity of 51.6% in diagnosing HBV but was highly specific (100%) and accurate (94.4%). HBV infection was not associated with sex (χ2: 0.209; = 0.401). The prevalence of HBV infection was similar in all the age group and HBV infection was not associated (χ2: 2.099; = 0.914) with age group. All the clinical manifestations were not associated ( > 0.05) with HBV infection. Blood transfusion, shared items, tattoo marks and history of surgery associated significantly ( < 0.05) with HBV infections having odd ratios of 4.247, 4.224, 3.134 and 3.195 respectively. The vaccination rate was 55.2% (159/270) and only 3 (1.1%) out of 159 vaccinated subjected contracted the infection (OR: 0.068, < 0.0001).
CONCLUSIONS
HBV was prevalent (11.5%) in children below six years old in Enugu metropolis. Moreover, the routinely used ICT test was less reliable than ELISA in diagnosis HBV infection. More so, shared items, blood transfusion, tattooing and history of surgery were potential risk factors while vaccination served as a protective factor against the infection.
背景
尽管尼日利亚正在采取措施管理乙型肝炎病毒（HBV）感染，但儿童仍然是最易发展为慢性肝炎的群体。因此，对儿童进行常规筛查对于有效控制感染至关重要。然而，常用的免疫层析试验（ICT）试纸的检测性能一直存在挑战。此外，确定该年龄组的传播风险因素对于实施预防措施也很重要。因此，本研究的目的是评估常规使用的ICT试纸的检测性能，并确定HBV相关的临床表现和风险因素。
方法
在尼日利亚埃努古的ESUTH和Favor儿童儿科医院对270名6岁以下儿童进行了一项横断面研究。通过ICT和ELISA检测对受试者进行HBV筛查，并使用结构化问卷获取参与者的数据，包括人口统计学、社会经济状况、体征和症状、风险因素以及疫苗接种情况。
结果
基于ELISA检测，270名儿童中有31名HBV呈阳性，感染率为11.5%。ICT试剂盒在诊断HBV时灵敏度较低，为51.6%，但特异性高（100%），准确性高（94.4%）。HBV感染与性别无关（χ2：0.209；P = 0.401）。所有年龄组的HBV感染患病率相似，HBV感染与年龄组无关（χ2：2.099；P = 0.914）。所有临床表现与HBV感染均无关联（P>0.05）。输血、共用物品、纹身和手术史与HBV感染显著相关（P<0.05），比值比分别为4.247、4.224、3.134和3.195。疫苗接种率为55.2%（159/270），159名接种疫苗的受试者中只有3名（1.1%）感染了该病毒（比值比：0.068，P<0.0001）。
结论
在埃努古市，6岁以下儿童中HBV感染流行率为11.5%。此外，常规使用的ICT检测在诊断HBV感染方面不如ELISA可靠。更重要的是，共用物品、输血、纹身和手术史是潜在的风险因素，而疫苗接种是预防感染的保护因素。
Zotero 插件