Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control

Abebe, A; Nokes, DJ; Dejene, A; Enquselassie, F; Messele, T; Cutts, FT; (2003) Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control. Epidemiology and infection, 131 (1). pp. 757-770. ISSN 0950-2688 DOI:

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A community-based seroepidemiological survey of Addis Ababa, Ethiopia was conducted in 1994 to inform on the transmission dynamics and control of hepatitis B virus (HBV) infection. Venous blood from 4736 individuals under 50 years of age from 1262 households, selected using stratified cluster-sampling, was screened for HBV markers using commercial ELISAs. HBsAg prevalence was 7% (95% CI 6-8). higher in males (9%; 7-10) than females (5%; 4-6). HBeAg prevalence in HBsAg positives was 23% (18-29), and less than 1% of women of childbearing age were HBeAg positive. Overall HBV seroprevalence (any marker), rose steadily with age to over 70% in 40-49 year olds, indicating significant childhood and adult transmission. Estimated instantaneous incidence was 3-4/100 susceptibles/year, higher in males than females in 0-4 year olds, and peaking in early childhood and young adults. The age at which 50% had evidence of infection was around 20 years, and the herd immunity threshold is approximated at 63-77%. Addis Ababa is of intermediate-high HBV endemicity, with negligible perinatal transmission. Our main findings are the identification of a significant difference between males and females in the age- acquisition of HBV infection, and marked differences between age groups in HBV incidence rates. These results should target future research studies of underlying risk factors. Furthermore, we generate a crude estimate of the level of coverage of HBV vaccine that would be required to eliminate the virus from the study population.

Item Type: Article
Keywords: Chronic liver-disease, highly endemic areas, viral-hepatitis, carrier state, blood-donors, immunization programs, mathematical-model, urban-population, infection, epidemiology, Adolescent, Adult, Age Factors, Child, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Ethiopia, epidemiology, Female, Hepatitis B, epidemiology, transmission, Hepatitis B Vaccines, administration & dosage, immunology, Hepatitis B Virus, immunology, pathogenicity, Human, Infant, Infant, Newborn, Male, Middle Age, Seroepidemiologic Studies, Sex Factors, Support, Non-U.S. Gov't, Urban Population
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Vaccine Centre
PubMed ID: 12948377
Web of Science ID: 185006100023


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