Morgan Camille E, Powers Kimberley A, Edwards Jess K, Devkota Upasana, Biju Stane, Lin Feng-Chang, Schmitz John L, Cloherty Gavin, Muwonga Jérémie, Mboyo Aimée, Tshiamala Pascal, Kashamuka Melchior M, Tshefu Antoinette, Emch Michael, Yotebieng Marcel, Becker-Dreps Sylvia, Parr Jonathan B, Thompson Peyton
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 111 Mason Farm Rd, Chapel Hill, NC27599, United States of America (USA).
Infectious Disease Epidemiology and Ecology Lab, University of North Carolina, Chapel Hill, USA.
Bull World Health Organ. 2025 Jun 1;103(6):354-365. doi: 10.2471/BLT.24.292013. Epub 2025 Apr 8.
To characterize childhood hepatitis B virus (HBV) epidemiology to inform elimination efforts in the Democratic Republic of the Congo, one of the most populous African countries.
Using the most recent (2013-2014) nationally representative Demographic and Health Survey, we analysed hepatitis B surface antigen (HBsAg) on dried blood spots and associated survey data from children aged 6-59 months. We estimated HBsAg-positivity prevalence nationally, regionally and by potential correlates of infection. We evaluated spatial variation in HBsAg-positivity prevalence overall, and by age, sex and vaccination status.
Using data representing 5773 children, we observed a national HBsAg-positivity prevalence of 1.3% (73/5773; 95% confidence interval, CI: 0.9 to 1.7), ranging from 0.0% in Kinshasa to 5.6% in Sud-Ubangi. Prevalence among boys (1.8%; 95% CI: 1.2 to 2.7) was double that among girls (0.7%; 95% CI: 0.4 to 1.3). Testing negative for tetanus antibodies, rural residence and poorer household were associated with higher HBsAg-positivity prevalence. We observed no difference in prevalence by age. Children had higher HBsAg-positivity odds if living with one or more HBsAg-positive adult household member (odds ratio, OR: 2.3; 95% CI: 0.7 to 7.8), particularly an HBsAg-positive mother (OR: 7.2; 95% CI: 1.6 to 32.3). Notably, nearly two thirds (36/51) of HBsAg-positive children had a HBsAg-negative mother.
Our investigation highlights the importance of subnational prevalence estimates in large countries such as the Democratic Republic of the Congo, and we have identified regions that may benefit from improved childhood vaccination delivery strategies and community HBV prevention efforts.
描述儿童乙型肝炎病毒（HBV）流行病学特征，为非洲人口最多的国家之一刚果民主共和国的消除工作提供信息。
利用最新的（2013 - 2014年）具有全国代表性的人口与健康调查，我们分析了6至59个月儿童干血斑上的乙型肝炎表面抗原（HBsAg）及相关调查数据。我们估计了全国、区域以及按感染潜在相关因素划分的HBsAg阳性率。我们评估了总体HBsAg阳性率以及按年龄、性别和疫苗接种状况划分的空间变异。
利用代表5773名儿童的数据，我们观察到全国HBsAg阳性率为1.3%（73/5773；95%置信区间，CI：0.9至1.7），从金沙萨的0.0%到上韦莱省的5.6%不等。男孩的阳性率（1.8%；95%CI：1.2至2.7）是女孩（0.7%；95%CI：0.4至1.3）的两倍。破伤风抗体检测呈阴性、农村居住和家庭贫困与较高的HBsAg阳性率相关。我们未观察到年龄方面的阳性率差异。如果儿童与一名或多名HBsAg阳性的成年家庭成员同住，其HBsAg阳性几率更高（优势比，OR：2.3；95%CI：0.7至7.8），尤其是HBsAg阳性母亲（OR：7.2；95%CI：1.6至32.3）。值得注意的是，近三分之二（36/51）的HBsAg阳性儿童其母亲HBsAg呈阴性。
我们的调查突出了在刚果民主共和国这样的大国进行次国家级患病率估计的重要性，并且我们已经确定了可能从改进儿童疫苗接种策略和社区HBV预防工作中受益的地区。
