Tswana S, Chetsanga C, Nyström L, Moyo S, Nzara M, Chieza L
Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe.
S Afr Med J. 1996 Jan;86(1):72-5.
To estimate the prevalence of hepatitis B viral markers.
A sero-epidemiological community-based cross-sectional study.
All nine provinces of Zimbabwe.
From April 1989 to December 1991 serum samples were collected from 1,461 males and 1,933 females in the age group 10-61 years, the majority in the younger age groups.
Sera were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), antibody to HBs-Ag (anti-HBs), antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B e antigen (anti-HBe). All sera were tested for HBsAg, anti-HBs and anti-HBc but for the detection of HBeAg and anti-HBe, only samples positive for HBsAg were examined.
The male-to-female ratio in rural and urban settings was 0.82 and 0.66 respectively. The median age for males and females in rural areas was 21 and 22 years and 28 and 26 years respectively in urban areas. The overall prevalence of HBsAg was 15.4% (males 16.8%, females 14.3%). The difference between sexes was consistent in all age groups and statistically significant (P < 0.05). The prevalences in urban and rural areas were almost identical (15.7% v. 15.3%). However, the prevalence was significantly higher among males in the age group 40-49 years in urban areas compared with rural areas (P < 0.0001). Using the case-referent approach, with HbsAg-positive patients as cases and HBsAg-negative ones as referents, the crude odds ratio for rural areas compared with urban areas was 0,97. However, standardisation for year of data collection and province resulted in a relative risk of 2.0, i.e. the risk of being HBsAg-positive in rural areas is twice as high as in urban areas. Similarly, the crude odds ratio for females compared with males was 0.83, and was reduced significantly to 0.7 when standardised for year of data collection and province. The prevalences of HBeAg, anti-HBe, anti-HBs and anti-HBc were 25%, 25%, 45% and 36% respectively. The prevalences of anti-HBs and anti-HBc increased continuously with age and were about 70% higher in the age group 50 years and above compared with those under 20 years. The prevalence of any of the HBV markers-HBsAg, or anti-HBc -was 66% in males and 61% in females.
The results indicate that hepatitis B is hyperendemic in both rural and urban areas of Zimbabwe.
评估乙肝病毒标志物的流行率。
一项基于社区的血清流行病学横断面研究。
津巴布韦的所有九个省份。
1989年4月至1991年12月，收集了年龄在10 - 61岁之间的1461名男性和1933名女性的血清样本，大多数为年轻年龄组。
检测血清中的乙肝表面抗原（HBsAg）、乙肝e抗原（HBeAg）、乙肝表面抗原抗体（抗-HBs）、乙肝核心抗原抗体（抗-HBc）和乙肝e抗原抗体（抗-HBe）。所有血清均检测HBsAg、抗-HBs和抗-HBc，但对于HBeAg和抗-HBe的检测，仅检测HBsAg阳性的样本。
农村和城市地区的男女比例分别为0.82和0.66。农村地区男性和女性的年龄中位数分别为21岁和22岁，城市地区分别为28岁和26岁。HBsAg的总体流行率为15.4%（男性16.8%，女性14.3%）。各年龄组中性别差异一致且具有统计学意义（P < 0.05）。城市和农村地区的流行率几乎相同（15.7%对15.3%）。然而，城市地区40 - 49岁年龄组的男性流行率显著高于农村地区（P < 0.0001）。采用病例对照方法，以HBsAg阳性患者为病例，HBsAg阴性患者为对照，农村地区与城市地区的粗比值比为0.97。然而，对数据收集年份和省份进行标准化后，相对风险为2.0，即农村地区HBsAg阳性的风险是城市地区的两倍。同样，女性与男性的粗比值比为0.83，在对数据收集年份和省份进行标准化后显著降至0.7。HBeAg、抗-HBe、抗-HBs和抗-HBc的流行率分别为25%、25%、45%和36%。抗-HBs和抗-HBc的流行率随年龄持续上升，5０岁及以上年龄组比20岁以下年龄组高约70%。任何一种乙肝病毒标志物（HBsAg或抗-HBc）的流行率男性为66%，女性为61%。
结果表明乙肝在津巴布韦的农村和城市地区均为高度地方性流行。
