SEROPREVALENCE OF HEPATITIS-B VIRUS AMONG SCHOOL-AGE-CHILDREN IN THE STANN CREEK DISTRICT OF BELIZE, CENTRAL-AMERICA

Adults in the Stann Creek District of Belize have a high prevalence of hepatitis B virus (HBV) infection, but the age of onset of these infe ctions is unclear. We conducted a seroprevalence study of hepatitis B markers among Stann Creek school-age children to provide information f or planning a hepatitis B vaccine program. The overall prevalence in 5 87 students was high for antibody to hepatitis B core antigen (anti-HB c) (43.3%) and hepatitis B surface antigen (HBsAg) (7.7%). There was m arked Variation of anti-HBc by school and by the predominant ethnic gr oups attending these schools. Maya had the highest prevalence (76%), f ollowed by Mestizo (50%), Garifuna (37%), and Creole (25%). Children l ess than nine years of age attending the rural primary schools (mostly Mayan and Mestizo) had significantly higher prevalence of anti-HBc th an did children attending the urban primary school (mostly Garifuna an d Creole) (P < 0.05). Anti-HBc was found in 42% and 36% of students at the two high schools. Of the five schools tested, only at the urban p rimary school did anti-HBc positivity increase with age. Based on an a nalysis of the cost of serologic screening before immunization compare d with mass vaccination, preimmunization serologic screening resulted in vaccine program cost savings in four of the five schools. Because m ost children in the rural areas contract hepatitis B before entering s chool, immunization against HBV should be integrated into the routine infant immunization program.