Hepatitis B virus infection in general population in Madagascar: evidence for different epidemiological patterns in urban and in rural areas

Abstract

SUMMARYTo describe the features of hepatitis B virus (HBV) infection in Madagascar, a randomized sero-epidemiological survey was undertaken in the general population > 1 year old of two provinces which represents 45 % of the total population. In the 921 sera tested, the prevalence of HBV markers was 20-5 % for HBsAg, 38-2 % for anti-HBc and 6-9 % for HBeAg. HBsAg and anti-HBc prevalence rates were significantly higher in males. A large difference in HBsAg prevalence was observed between urban (5 3 %) and rural areas (26-0 %). The same contrast in prevalence was noticed for the other HBV markers. In rural areas, HBV infection was more frequently acquired early in infancy, which suggests predominantly perinatal or postnatal transmission. The presence of HBV markers was not significantly associated with a history of blood transfusion, surgery or parenteral injection. High infectivity carriers represented 5-3 % and the overall frequency of chronic carriers was 10 4 %. These results place Madagascar among areas of high endemicity.

Socio-demographic and behavioral determinants of hepatitis B vaccination and infection in pregnant women on Mayotte Island, Indian Ocean

“…In this study, HBV prevalence, defined as recent or past infection, was 35.5% among PW. The result is consistent with HBV epidemiology on Mayotte, the route of HBV transmission being mainly perinatal, from mother to child or from person to person in early childhood [13][14][15][16]20,21,24,25,27,28,[36][37][38][39][40][41][42][43][44].…”

“…Among PW of Mayotte Island, both qualification and birthplace were significantly associated with HBV vaccination. Birthplace is known to be an important demographic factor linked with the endemicity of HBV infection in these areas [1,3,18,20,21,24,25,27,28,[36][37][38][39][40][41][42][43]. Unemployment and education were other determinants of HBV vaccination, suggesting that education is important in successful HBV vaccination programs [1,2].…”

“…These strategies should target vulnerable populations from high endemic areas of HBV infection, such as Comoros and Madagascar [21,[36][37][38][39][40][41][42][43][44]. On Mayotte, they must be complemented by other approaches, such as those of Médecins du Monde, focusing on vulnerable and migrant populations [47,48].…”

Prevalence of hepatitis B virus serologic markers in pregnant patients in Antananarivo, Madagascar

“…The authors of a study conducted in rural settings reported a very high prevalence of hepatitis B, with 72.5 to 89.8% of the study population carrying at least 1 marker of the B virus, and with 18.9 to 30.5% of HBsAg carriers [7]. Boisier et al reported an overall Hepatitis B prevalence of 5% in urban areas and 25% in rural areas [8]. Little data was available on pregnant patients in Madagascar and published data was too old to allow comparing results.…”

Full genome analysis of hepatitis B virus genotype E strains from South‐Western Africa and madagascar reveals low genetic variability

“…The aim of this study, therefore, was to sequence and characterize the complete genome of genotype E isolates obtained from geographically distinct regions in Africa, namely, Namibia, Angola, and Madagascar. High HBV carrier rates have been recorded in all three countries: 15% in Namibia [Botha et al, 1984], 13% in Angola [Steele and Bos, 1996], and 26% in Madagascar [Boisier et al, 1996].…”