International Journal of Epidemiology, Vol 28, 782-786, Copyright © 1999 by International Epidemiological Association
YJ Hutin, R Harpaz, J Drobeniuc, A Melnic, C Ray, M Favorov, P Iarovoi, CN Shapiro and BA Woodruff
BACKGROUND: Reported rates of acute hepatitis B are high in many former
Soviet Union republics and modes of transmission are not well defined.
METHODS: Two case-control studies were undertaken in Moldova to identify
risk factors for acute hepatitis B in people aged 2-15 years (children) and
> or =15 years (adults). Serologically confirmed acute hepatitis B cases
occurring between 1 January 1994 and 30 August 30 1995, were matched on
age, sex, and district of residence to three potential controls who were
tested for hepatitis B markers to exclude the immune. Stratified odds
ratios (SOR) were calculated using bivariate and multivariate methods.
RESULTS: In multivariate analysis, compared with the 175 controls, the 70
adult cases (mean age 25 years, 66% male) were more likely to report
receiving injections in the 6 months before illness during a dental visit
(SOR = 21; 95% CI: 3.7- 120), a hospital visit (SOR = 35; 95% CI: 7.2-170),
or a visit to the polyclinic (SOR = 13; 95% CI: 2.4-74). Among children,
receiving injections during a hospital visit (SOR = 5.2; 95% CI: 1.2-23)
was the only exposure reported significantly more often by the 19 cases
(mean age 8 years, 68% male) compared with the 81 controls. CONCLUSION:
These results, along with reported unsafe injection practices in Moldova,
suggest that injections are a major source of hepatitis B virus
transmission and highlight the importance of proper infection-control
procedures in preventing transmission of blood-borne infections.
ARTICLES
Injections given in healthcare settings as a major source of acute hepatitis B in Moldova
Hepatitis Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. yah5@cdc.gov
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