PREVALENCE OF HEPATITIS-B VIRUS AMONG HEALTH-CARE WORKERS IN BELIZE, CENTRAL-AMERICA

A seroprevalence survey of hepatitis B virus (HBV) markers was conduct ed among health care workers in Belize to help determine the epidemiol ogy of hepatitis B and to determine if screening before immunization m ight lower vaccine costs. Of the 330 workers tested, 94 (29%) were pos itive for antibody to HBV core antigen (anti-HBc) and three (1%) had H BV surface antigen. The presence of anti-HBc increased significantly w ith age from 12% in those 18-24 years old to 52% in those greater than or equal to 50 years old. The rate was 17% of 48 men compared with 30 % of 282 women (P = 0.05). Rates increased with years of medical servi ce and were higher among nurses (69 of 228; 30%) and nonprofessional s taff (15 of 44; 34%) than among physicians (0 of 20). The presence of anti-HBc also differed significantly among ethnic groups: Mestizo, 4%; Creole, 33% and Garifuna, 57%. Rates differed by district ranging fro m 3% in a northern district (mostly Mestizo) to 67% in a southern dist rict (mostly Garifuna). Parenteral exposure to hepatitis B through nee dle stick injuries and blood transfusions was not associated with anti -HBc. Multiple logistic regression analysis confirmed ethnicity, distr ict of residence, and age as the best predictors of anti-HBc in health care workers. Cost analysis suggests that because of regional differe nces in exposure, testing of health care workers for anti-HBc in the B elize and Stann Creek districts in southern Belize before hepatitis B immunization would result in vaccine program cost savings.