An intervention study was done over two years in seven Gambian village
s to determine the contribution of bedbugs to hepatitis B transmission
. In addition, fortnightly questionnaires were completed for each chil
d to assess other possible routes of transmission. The intervention, i
nsecticide spraying of the child's dwelling, was highly effective in r
educing exposure to bedbugs but there was no effect on hepatitis B inf
ection. No other risk factor for transmission was identified despite a
consistent village-to-village variation in the rate of childhood infe
ction. The major mode of transmission of hepatitis B in childhood rema
ins unknown.