■世界卫生组织非洲地区的乙型肝炎病毒(HBV)流行率很高,和证据表明更频繁的水平HBV传播比其他地区。需要针对特定环境的流行病学研究来告知额外的HBV预防措施。
■在乙型肝炎(HOVER-HBV)研究的横截面水平和垂直传播中,我们引入了HBV表面抗原(HBsAg)筛查与现有的HIV筛查作为常规产前护理的一部分,在金沙萨的高容量产科诊所,刚果民主共和国。我们招募了孕妇的家庭(“指数母亲”)谁是HBsAg阳性和HBsAg阴性,将家庭定义为指数积极和指数消极,分别。家庭成员接受了HBsAg检测和流行病学调查。我们评估了HBsAg患病率和潜在的传播相关因素。
■我们招募了来自200个家庭的1006名参与者(100个指数阳性,100指数为阴性),整个金沙萨。HBsAg阳性患病率是指数阳性家庭的两倍以上(5.0%[95%置信区间{CI},2.8%-7.1%])与指数阴性家庭一样(1.9%[95%CI,.6%-3.2%])。HBsAg阳性患病率为3.3(95%CI,.9-11.8)倍,在指数阳性与指数阴性家庭的直接后代中。与HBsAg阳性相关的因素包括年龄较大,婚姻,在指数母亲中有多个最近的伴侣或任何新的性伴侣;和年龄较大,较低的家庭财富,分享指甲钳,并在指数阳性家庭的后代中使用街头沙龙。
■在金沙萨,家庭内的HBV垂直和水平传播正在进行。与感染相关的因素揭示了HBV预防努力的机会,包括围产期预防,性接触期间的保护,和共享个人物品的卫生。
UNASSIGNED: The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence, and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures.
UNASSIGNED: In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women (\"index mothers\") who were HBsAg-positive and HBsAg-negative, defining households as index-positive and index-negative, respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates.
UNASSIGNED: We enrolled 1006 participants from 200 households (100 index-positive, 100 index-negative) across Kinshasa. HBsAg-positivity prevalence was more than twice as high in index-positive households (5.0% [95% confidence interval {CI}, 2.8%-7.1%]) as in index-negative households (1.9% [95% CI, .6%-3.2%]). HBsAg-positivity prevalence was 3.3 (95% CI, .9-11.8) times as high among direct offspring in index-positive versus index-negative households. Factors associated with HBsAg positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index-positive households.
UNASSIGNED: Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.