Hepatitis B virus, human immunodeficiency virus type-1, and syphilis among women attending prenatal clinics in Belize, Central America
Scott-Wright, A.; Hakre, S.; Bryan, J.P.; Jaramillo, R.; Reyes, L.G.; Cruess, D.; Macarthy, P.O.; Gaydos, J.C.
American Journal of Tropical Medicine and Hygiene 56(3): 285-290
1997
ISSN/ISBN: 0002-9637 PMID: 9129530 Document Number: 482120
A cross-sectional study of 543 pregnant women attending prenatal clinics in Belize's 6 districts in a 6-week period in 1993 detected highly variable prevalences of hepatitis B virus (HBV) markers. 81 sera specimens (14.9%) were positive for anti-hepatitis B core antigen (anti-HBc); one woman had asymptomatic hepatitis B surface antigenemia. No HBV markers were detected in the sera of the 1 woman with human immunodeficiency virus (HIV)-1 infection. 15 women (2.8%) had reactive syphilis serologies. Serologic evidence of exposure to HBV was significantly associated with the following sociodemographic factors: single status, age 30-34 years, household size exceeding 8, 5 or more lifetime sexual partners, geographic location (residence in the Stann Creek or Toledo districts), and ethnicity (Garifuna, Creole, and Mayan). In the multivariate analysis, ethnicity and a reactive syphilis result were the only independent predictors of anti-HBc seroprevalence. Anti-HBc seroprevalence varied by district from 3.1-43.5%, with the highest rate in Stann Creek, and by ethnicity from 0 to 40.9%, with the highest rate among the Garifuna. Prevalences were substantially lower among Mestizo-Spanish from the northern and western districts of Orange Walk, Corozal, and Cayo. The overall low prevalence of HBsAg does not support a nationwide prenatal screening program, especially given limited public health care resources. However, this study's findings suggest the feasibility of HBV screening of pregnant women among the Garifuna, Creole, Mayan, and immigrant populations of Belize's Stann Creek and Toledo districts.