MOTHER-CHILD TRANSMISSION OF HEPATITIS-B VIRUS IN THE TUNISIAN SAHEL

In order to assess the importance of mother-child transmission of the hepatitis B virus (HBV) in the Tunisian Sahel, 81 HBsAg-positive mothe rs have been selected at delivery in a representative sample of 1940 w ho delivered in maternities of this region. Each HBsAg-positive mother was matched for age and parity particularly with two HBsAg-negative m others. Children born to these 66 HBsAg + and 120 HBsAg- mothers were traced at 28 months and tested by ELISA for Hsv serologic markers (HBs Ag, anti-HBs and anti-HBc). The distribution of these markers was sign ificantly different according to the maternal status for HBsAg. The ov erall prevalence rate of HBV markers was higher in children born to HB sAg + mothers as compared to children born to HBsAg - mothers (33.3% v s 13.3%, OR = 2.5, 95% CI:1.4-4.2). For HBsAg, the figures were 27.3% and 9.2% respectively (OR = 2.9, 95% CI:1.5-5.9). Given the prevalence rate of HBsAg in mothers (4.2%), the role of mother-child transmissio n in the spread of HBV infection and the intensity and precocity of ho rizontal transmission, systemic vaccination against HBV at birth shoul d be recommanded in the Tunisian Sahel in the context of the EPI. Howe ver this decision should take into account, in terms of cost/efficacy ratio, the other public health problems concerning this area.