© 1986 Oxford University Press
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Prevalence of Hepatitis B Virus Infection in Tonga: Identifying High Risk Groups for Immunization with Hepatitis B Vaccine
1Arctic Investigations Laboratory, Center for Infectious Diseases, Centers for Disease Control Anchorage, Alaska 99501, USA
2Alaska Area Native Health Service, Indian Health Service, Health Resources and Services Administrtion Anchorage, Alaska 99510, USA
3Department of Public Health Sciences and Preventive Medicine Residency Program, School of Public Health, University of Hawaii Honolulu, Hawaii 96822, USA
4Arctic Investigations Laboratory, Center for Infectious Diseases, Centers for Disease Control Anchorage, Alaska 99501
5Kaiser Hospital Alhambra, California 91801, USA
6Alaska Area Hepatitis B Program, Alaska Native Medical Center, Indian Health Service, Anchorage Alaska 99510, USA
7Ministry of Health Kingdom of Tonga, Nuku'alofa, Tonga, USA
8Formerly US Peace Corps Volunteer Nuku'alofa, Tonga
9Developmental Diagnostics Activity, Hepatitis Branch, Center for Infectious Diseases, Centers for Disease Control Atlanta, Georgia 30333, USA
Reprint requests to Dr Wainwright at Centers for Disease Control, 225 Eagle Street, Anchorage, Alaska 99501, USA.
A serological survey for evidence of hepatitis B virus (HBV) infection was conducted in the Kingdom of Tonga as the first step in developing a strategy for an immunization programme. There were 414 individuals from the general population plus 137 pregnant women included in the survey. HBsAg was found in 20% of the general population and 88% had one or more serologic markers of HBV infection. In the 5–9 year age group, 80% of the children had one or more markers of HBV, and in the 10–19 year age group, the prevalence was 96.4%, indicating that most transmission of HBV in the Tongans studied occurs in the young. Of the pregnant women studied, 15% were positive for HBsAg, and 57% of those positive for HBsAg were also positive for HBeAg. Evidence of delta virus infection was not found in any of 82 HBsAg positive sera tested. Surveillance data suggested that significant serious sequelae to HBV infection (cirrhosis and primary hepatocellular carcinoma) also occur in Tonga. Immunization of infants and children is the most effective strategy for reducing or eliminating HBV infection and its sequelae in developing countries like Tonga.
Received 1 February 1986
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