Cp.203 Seroprevalence Of Hbsag In Bangladeshi Children

A. Mamun, R. Salimur
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Bangladesh is a small developing country in South Asia with a population density of 834 per sq. km. Viral hepatitis is also a commonly encountered liver disease in Bangladesh occurring sporadically round the year. Hepatitis B virus (HBV) is quite prevalent here. Patients with acute viral B hepatitis, chronic viral B hepatitis, hepatitis B virus related cirrhosis of liver and its complications and hepatocellular carcinoma due to HBV are frequently encountered in our clinical practice. It has been estimated that HBV is responsible for 10.0 to 35.0% cases of acute viral hepatitis, 35.7% cases of acute liver failure, 33.3 to 40.5% cases of chronic hepatitis and 46.8% cases of hepatocellular carcinoma in Bangladesh. Approximately 6-8% population of the country is HBsAg positive. We tested blood samples of 94 children in an orphanage in Dhaka for HBsAg by ELISA. These children are from the low-income group. They came from all over the country to this orphanage and were representative of our general population. Blood samples of another 58 children were tested at a private hospital in Dhaka. This second group of children, belonging to the mid and high-income groups, came to the hospital for HBV vaccination. They were also representative of our population as their families settled in Dhaka from different districts of the country.
of this study show that 6.38% children (6 out of 94) from low socio-economic group tested positive for HBsAg, while in the mid and high-income group, 3.45% children (2 out of 58) were seropositive for HBsAg. The risk of developing chronic hepatitis B is 98% in children, opposed to only 10% in adults. Many of these chronic hepatitis patients eventually go on to develop cirrhosis of liver and hepatocellular carcinoma, both of which are frequently encountered in this country. This study reveals the magnitude of the threat that HBV continues to pose to this very populous, developing country. The Bangladesh Government has recently integrated HBV vaccination into the existing Expanded Programme for Immunization (EPI) program. In this programme, the 1st dose of HBV vaccine is given with the 1st dose of DPT vaccine at six weeks (DPT-1), the 2nd dose with DPT-2 at ten weeks and finally the 3rd dose with DPT-3 at 14 weeks respectively.