The prevalence of serological markers for hepatitis B virus infection in Australian Naval personnel

In order to determine the prevalence of hepatitis B virus infection in Royal Australian Navy personnel and to formulate policies for their education, screening and vaccination, a voluntary survey was undertaken. Seven hundred and forty-eight subjects completed a questionnaire that provided details of age, sex, rank, ethnic origin, service abroad, length of service, history of tattooing, liver disease and blood transfusions. Serum was assayed by radioimmunoassay for the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (antiHBs) and antibody to hepatitis B core antigen (antiHBc). The presence of markers of hepatitis B virus infection was correlated with "risk factors" by means of the chi 2 test of independence. Fourteen (74%) of 19 personnel from the Pacific Islands, Asia and Africa who were excluded from analysis showed one-or-more such markers. The prevalence of any marker of hepatitis B virus infection was 4.4% (95% confidence interval [CI], 2.9%-5.9%). The individual markers HBsAg, antiHBs and antiHBc were found in 0.4% (95% CI, 0.1%-1.2%), 3.6% (95% CI, 2.2%-4.9%) and 3.9% (95% CI, 2.5%-5.3%) of subjects, respectively. The annual attack rate was estimated to be less than 1%. Factors which had a significant correlation with an increased prevalence of markers of hepatitis B virus infection included tattooing (especially if this had been performed in Asia), age, the duration of service and service abroad. Based on these data, and given the reduced cost of hepatitis B vaccines, vaccination now is considered worth while. A policy of vaccinating all personnel who may be required for service at sea, and others at risk, now is in effect. Educational programmes that are aimed at minimizing the risk of exposure to hepatitis B and other viral infections have been instituted.     

Stochastic process of hepatitis A virus infection in urban and rural populations in Hebei, China

Aim To determine the epidemiological patterns of hepatitis A virus (HAV) infection in urban and rural populations. Methods Study populations were randomly selected by a twostage systematic cluster sampling method. Anti-HAV lgG was defected by enzyme immunoassay. A stochastic process methodtwo-state non-homogeneous Markov chain was used to analyse the seroprevalence of anti-HAV in urban and rural areas of Hebei, China. Two indexes, age-specific Markov risk rate(MRRt) and total Markov risk rate (Total MRR), were introduced. MRRt is a measure of infection risk, and varies as the product of the proportion susceptible at a given age t with the probability of becoming infected in two age/time steps, P^(2)01(t). Total MRR is the weighed sum of MRRts, which provides a reasonable estimate of the disease burden of the whole population. In this paper an ‘elaborated age-grouping method‘ was firstly raised. Results The total MRR in urban subjects was 109.56, much greater than that (41.16) in rural subjects. When grouping by 10 years of age, MRR1-9. MRR10-19 in urban subjects and MRR1-9 in rural subjects were greater than 20. Grouping by 5 years, the MRR, s of the first four age groups in urban subjects and the first two age groups in rural subjects were greater than 10. Grouping by 2 years, the absolute value of MRRts were big and with an alternative appearance of positive and negative values in urban samples,but the MRR, s above 10 were obviously centralized in 7-16 years of age. in rural subjects, the MRRts had an obvious tendency of decreasing following the increase of age and decreased to less than 10 in age 7-8 years‘ group. Conclusion The results showed that the disease burden was much heavier in urban populations than that in rural counterparts, and that HA prevention program or HA vaccination program is more eagerly needed in cities than in rural areas. The high risk population of HAV infection are these from 7 to 16 years of age in urban area and these less than 7 years in rural areas, respectively. Since there is antibody from the mothers of less than 1 year babies, the authors recommend people aged 1 to 6 years and 1 to 3years, respectively, as the proper population of HA vaccination in cities and in rural areas.     

Relationship between hepatitis B virus DNA in blood and serological markers of hepatitis B infection

The hepatitis B virus (HBV) DNA dot-hybridization assay has been introduced into clinical practice in Australia and its behaviour compared with that of the classic markers of HBV infection. A good correlation exists between the presence of HBV DNA and that of hepatitis B e antigen but the degree of dissociation between HBV DNA and the e:anti-e system was smaller than earlier studies would suggest. Patients who are seronegative for hepatitis B surface antigen (HBsAg), whether they possess anti-HBs, anti-HBc HBc (antibody to the core antigen), or neither antibody, gave uniformly negative results for the presence of HBV DNA. Theses results are different from those that were obtained from earlier studies of patients with chronic liver disease.     

乙型肝炎病毒血清标志物组合模式的探讨

目的探讨不同的乙肝病毒血清标志物的组合模式。方法对住院患者共8 151份血清标本,采用化学发光法(CMIA)进行乙肝病毒血清标志物检测,分析结果并探讨多种不同组合模式。结果乙肝病毒血清标志物组合模式共有18种,其中最常见的4种模式,即模式1(全阴性)、模式2(抗-HBs+)、模式3(抗-HBs+、抗-HBc+)、模式4(抗-HBs+、抗-HBe+、抗-HBc+)所占比例,分别为24.6%、23.0%、20.3%和12.9%,同时也发现了一些少见模式,且HBs Ag阳性的病毒携带者比例较高(11.3%)。结论住院患者的乙肝病毒血清标志物组合模式较为复杂,且病毒携带者比例较高,分析HBV各种血清学模式可以获得有价值的临床诊疗信息,各种组合模式的探讨对HBV感染的预防、治疗、预后判断意义重大。     

The prevalence of markers of infection with hepatitis B virus in a mixed-race Australian community

A seroepidemiological study of markers of infection with hepatitis B virus was conducted in Brewarrina, a mixed-race township in north-western New South Wales. Six hundred and forty-three subjects, who represented 41.5% of the town's population, were screened for a range of serological markers of hepatitis B virus infection. Of the Aboriginal subjects, 72% had markers which indicated previous infection with hepatitis B virus, with 19.2% of subjects being identified as hepatitis B surface antigen (HBsAg)-seropositive. In the non-Aboriginal subjects, the prevalence of infection with markers of hepatitis B virus was 13.1%, with 2.2% of subjects being HBsAg-seropositive. The marker prevalences for Aboriginal and non-Aboriginal subjects in the 15- to 19-year-old age-group were 86.7% and 28%, respectively. The prevalence of hepatitis B virus infection in the total non-Aboriginal sample was higher than it is in the general Australian blood-donor population. The extent to which hepatitis B virus infection may result from cross-infection between coexisting "high-risk" and "low-risk" population groups is speculative. Furthermore, the risk of infection to non-Aborigines is unlikely to be spread evenly across the non-Aboriginal community. The cost of vaccine remains high, and until further data become available, mass vaccination of the population probably is not warranted. Initially, control measures should concentrate on the reduction of hepatitis B virus infection in the Aboriginal population and in non-Aboriginal households which contain a HBsAg-seropositive member.     

Urban-rural comparison of HBV and HCV infection prevalence in eastern China

The present study was initiated to make and urban-rural comparison of the prevalence of cases positive to hepatitis B and C virus(HBV and HCV,respectively)infection markers in densely populated eastern half of China.For this purpose.10 survey sites were selected,i.e.,six sites in urban areas(the city group;Beijing,shangahi and four provincial capitals)and four sites in rural areas(the village group;one village each in Jilin and Shandong provinces,and two villages in Shaanxi Province),About 50 adult women per site volunteered to participate,from whom 494 valid bllod samples were collected.Positivities to HBsAg(HBsAg^ ),anti-HBs(anti-HBs^ )and antiHBc(anti-HBc^ )were examined by RIA methods.and that to anti-HCV(anti-HCV^ )by either EIA or RIA.Those positive to any one of the three HBV infection markers were taken as HBV infection-positive(HBV^ ).The prevalence of HBsAg^ ,HBV^ and anti-HBc^ was 8%,70%and 2.7% in the city group,and 8%,65% and 2.0%in the village group,and no significant difference was found between the two groups.The overall prevalence was 8% for HBsAg^ ,68% for HBV^ ,and 2.4% for anti-HVC^ ,The results were discussed in reference to some 20 papers each on HBV^ and anti-HCV^ prevalence in China published since(1991),The reviewing of these papers of anti-HCV was low(well below 5%),and that no substantial difference was found between the rural and urban populations.     

The prevalence,intensity and ecological determinants of helminth infection among children in an urban and rural community in Southern Malawi

Rapid urbanisation and poor town planning in Malawi has been associated with poor environmental hygiene and sanitation. The aim of the present study was to investigate the prevalence, intensity and some potential risk factors of intestinal helminth infections among children aged 3 – 14 years in an urban and rural community in Southern Malawi. A randomised cross-sectional survey was conducted in July, 1998. Data were collected through questionnaire interview regarding socio-demographic and environmental conditions from households in both areas. Stool samples were collected from 273 children in the urban community and 280 in the rural. There was a significant difference (p<0.001) in the prevalence of helminth infections between the urban and rural communities, 16.5% and 3.6% respectively. Most of the infections were light (93.2% for Ascaris lumbricodes, 85.7% for hookworm). Large variance to mean ratios of egg intensity within age groups and the total study population suggested a high degree of aggregation of the parasites in the communities. Multiple logistic regression analysis showed that certain groups of children in the urban community were much more likely to develop helminth infection. They included children who had pools of water/sewage around houses (OR = 3.0, 95% CI = 1.4 ñ 6.5), did not wear shoes (OR a 7.1, 95% CI = 2.7 – 19.2), did not attend school (OR = 2.8, 95% CI = 1.2 ñ 6.5), had mothers who had 4 to 8 years of education (OR = 5.2, 95% CI = 2.0 – 14.0), had mothers below 35 years of age (OR = 4.09, 95% CI = 1.39 – 16.28) and living in an urban community (OR = 5.3, 95% CI = 2.6 – 12.1). Efforts to reduce helminth infections should focus on reducing exposures.     

Prevalence of serological markers of chronic hepatitis B virus infection in diabetics in the Lagos University Teaching Hospital,Lagos

Hepatitis B virus (HBV) infection, a major world health problem, is hyper endemic in South-East Asia and sub-Saharan Africa including Nigeria. Being a major cause of morbidity and mortality, prophylaxis using the highly efficacious hepatitis B vaccine is recommended for those at risk. The prevalence of serological markers of chronic HBV infection was determined in a population of 100 outpatient diabetics and 80 non-diabetic controls at the Medical Outpatient Department of the Lagos University Teaching Hospital Idi-Araba between January and July 1992. Twenty diabetic patients [20%] and 14 controls [17.5%] had serological markers (HbsAg and antiHBc) indicating ongoing chronic HBV infection. The difference between diabetics and non-diabetic controls was not statistically significant (P>.05). None of the HbsAg and antiHBc positive diabetics [45%] and 8 control patients [57%] were HbeAg positive. The presence of serological markers was not related to the duration, type of diabetic treatment and degree of diabetic control. Our findings suggest that diabetics in Lagos appear not to be more predisposed to chronic HBV infection than the rest of the population, and therefore would require no special antiHBV prophylaxis.     

Prevalence of Helicobacter pylori in Indigenous Western Australians: comparison between urban and remote rural populations

OBJECTIVES: To determine and compare the prevalence of Helicobacter pylori in an urban and a remote rural Western Australian Indigenous community. DESIGN: Cross-sectional study of Helicobacter pylori status determined by urea breath tests between mid-January 2003 and the end of June 2004. PARTICIPANTS: 520 self-selected fasting participants, comprising 270 members of the Martu community at Jigalong, Punmu and Parnngurr in the East Pilbara region (129 men, 141 women; age range, 2-90 years) and 250 people from the Perth Indigenous community (96 men, 154 women; age range, 3-75 years. RESULTS: The overall prevalence of H. pylori was 76%, but the prevalence in the remote rural community was 91%, compared with 60% in the urban community. The odds of having H. pylori were six times greater for rural than for urban participants (odds ratio [OR], 6.34; 95% CI, 3.89-10.33). Further, the overall odds of H. pylori infection in males (rural and urban combined) were greater than for females (OR, 1.61; 95% CI, 1.02-2.54). In both communities, the prevalence of infection remained relatively constant after the age of 10. CONCLUSIONS: The prevalence of H. pylori in the two Indigenous communities was two to three times higher than that in the non-Indigenous Australian population and higher than that shown in previous studies in Indigenous Australians.     

献血人群隐匿性乙型肝炎病毒感染的流行病学和血清学研究

目的了解广州地区献血人群隐匿性乙型肝炎病毒感染(OBI)的流行病学和血清学情况。方法对广州地区199631例无偿献血者标本同时用ELISA法检测HBsAg、紫外-乳酸脱氢酶法检测ALT、核酸扩增技术(NAT)联合检测HBV/HCV/HIV及HBV单项鉴别试验,对HBsAg阴性HBV DNA阳性者进行随访,用荧光定量PCR检测病毒载量,用ELISA法检测乙肝两对半。结果 199631例标本中共检出104例HBsAg阴性HBV DNA阳性者,经随访有54例为OBI,OBI检出率为0.027%,年龄以46～55岁组检出率最高(P<0.01),外地身份证的献血者检出率高于广州市身份证者(P<0.01),OBI检出率与性别和献血次数无关(P>0.05)。104例HBsAg阴性HBV DNA阳性的标本ALT均正常,病毒载量均<1000IU/ml,平均值为162IU/ml。随访标本中,除6例ALT异常外其余均正常,54例OBI标本病毒载量均<1000IU/ml,平均值为122IU/ml,乙肝两对半中抗-HBc阳性率明显高于其他项目(P<0.01)。结论 HBsAg阴性献血者中存在OBI,有必要在献血者中开展核酸检测。     

Prevalence and risk factors for falls in urban and rural older adults in Ekiti State,Nigeria

ObjectivesThis study assessed and compared the risk factors for falls among older adults in rural and urban communities.DesignA comparative cross-sectional approach was used.SettingThe study was conducted among community-living older adults in the rural and urban communities of the most populated Local Government Area (Ado-Ekiti LGA) in Ekiti State.ParticipantsThe study population consisted of 624 persons aged 65 years and above recruited into rural and urban groups using multi-stage random sampling.Main outcome measuresData collected using validated tools and physical measurements were subjected to binary logistic regression to determine the odds of falls with relevant predictor variables among older adults in both groups.ResultsA significantly higher proportion of participants in the urban than the rural group had experienced a fall , and the associated risks include low visual acuity, increasing age, arthritis, hearing impairment, hyperglycaemia and high BMI. Physical activity was a protective factor.ConclusionThis study revealed a high risk of falls among older adults in the urban community. Early diagnosis and management of chronic conditions that increase fall risk and promote physical activity, especially among urban-dwelling older adults, are vital measures to be considered in fall prevention programmes.FundingSelf-funded research     

北京市城乡限定人群低视力与盲的患病率及其病因的调查

目的 研究北京市城乡≥40岁特定人群低视力、盲的患病率和病因。方法 对北京大兴区榆垡镇与城区北部5个干休所社区,用限定人群逐户上门登记的方法进行最佳矫正视力的检查。符合条件的人群进行系统的眼科检查。系统的眼科检查包括视功能检查和眼形态学检查。低视力和盲以WHO的标准进行统计。结果 5324人入选,实查4451人,农村应答率：79.37%,城市应答率：87.15%。低视力和盲的患病率分别为0.99%（95%CI：0.70-1.28)和0.39%(95%CI:0.21-0.57)。低视力的患病率女性（1.45%)是男性（0.65%)的2.23倍（OR：1.97,95%CI:1.00-3.95),农村（1.76%)是城市（0.61%)的2.89倍（OR：2.93,95%CI:1.43-6.11)。盲的患病率女性为0.64%,男性为0.37%(OR:1.55,95%CI:0.63-3.96),农村（1.06%)是城市（0.52%)的2.04倍（OR：3.77,95%CI:1.41-10.62)。导致盲的主要原因是白内障（37.50%)、青光眼（29.17%)、高度近视眼底病变（8.33%)、角膜病（8.33%)和其他眼底病变（16.67%)。各种病因的患病率农村明显高于城市。特别是白内障的患病率,农村（8/9,88.89%)明显高于城市（1/9,11.11%),24例盲中,农村女性占66.67%。结论 低视力和盲的患病率随年龄增长患病率增高。农村地区的低视力和盲的患病率高于城市。白内障、青光眼是致盲的主要原因。低视力和盲受年龄、地区、医疗保健水平、文化程度、经济状况、环境因素和性别的影响。     

血清学阴性的乙型肝炎病毒相关性肾炎的临床病理分析及治疗

目的  探讨血清学阴性的乙型肝炎病毒相关性肾炎（HBV-GN）的临床病理特征及治疗方案,评估他克莫司联合激素治疗的安全性及有效性。方法  选取2009年1月-2012年9月该院其经肾活检诊断为HBV-GN的患者,根据血清学特点选出HBV血清学阴性组患者20例,分析其临床及病理特点;将确诊为肾病综合征的17例患者分为两组,拉米夫定联合激素组（B组）和他克莫司联合激素组（A组）,比较两种治疗方案的疗效,并定期监测HBV血清学指标及肝、肾功能等评价治疗的安全性。结果  ①20例血清学阴性HBV-GN患者,男女比为1.86∶1.00,17例（85%）表现为肾病综合征,3例（15%）表现为肾炎综合征;血清HBsAg、HBeAg、HBsAb、HBeAb、HBcAb阴性,HBV-DNA阴性。②HBV-GN病理特点。a.光镜100%表现为不典型膜性肾病（MN）;免疫组织化学法检查肾组织HBsAg、HBcAg和HBsAg+HBcAg阳性率分别为90%（18/20）、40%（8/20）和30%（6/20）。免疫荧光多种免疫复合物多部位、高强度沉积。b.电镜下电子致密物多部位沉积。③A组总有效率为100.0%,高于B组（12.5%）（P <0.05）;A组血清白蛋白（ALB）水平高于B组（P <0.05）,而A组24 h尿蛋白定量（UPRO）低于对照组（P <0.05）。④两组治疗过程中无明显不良反应。结论  ①血清学阴性HBV-GN以男性多见,病理类型表现为不典型膜性肾病。血清学阴性HBV-GN患者拉米夫定+激素治疗无效;FK506+激素治疗所有患者均有效,并且不引起HBV活动及肝肾功能异常。②建议对乙肝病毒血清学阴性的肾病综合征或慢性肾炎综合征患者,尤其病理表现为非典型膜性肾病的患者,肾活检时应常规行肾组织病理乙肝抗原检测,以免漏诊HBV-GN。③他克莫司联合激素是治疗血清学阴性HBV-GN的安全、有效方法之一。