The risk for hepatitis A, B, and C at two institutions for children in Somalia with different socioeconomic conditions

The prevalence of serologic markers for hepatitis A B and C was investigated in children from 2 residential institutions in Somalia. Among 596 individuals at 1 residence (Shebeli) the prevalences were 96% for antibody to hepatitis A virus (anti-HAV) 75% for total hepatitis B virus (HBV) markers 16% for hepatitis B surface antigen (HBsAg) and 1.5% for antibody to hepatitis C virus (anti-HCV). Corresponding figures for the 76 individuals at a smaller residence (Societe Organisation Sociale SOS) were 59% 20% 3.9% and 0% respectively. At Shebeli the HBsAg carrier rates in the 1-10 year old age group was 28% for boys and 16% for girls. these rates were significantly higher than in the older children (16% and 7.4% for boys and girls respectively). 58% of the HBsAg carriers were positive for hepatitis B e antigen. Total HBV markers were significantly more frequent in girls from Shebeli when their duration of residence was longer than 5 years (89% vs. 63%). The duration of stay did not influence the prevalences of HBsAg HAV or HCV antibodies. A followup study of children initially seronegative for HBV markers was carried out after 2 years. For children at Shebeli 1-10 years old the annual seroconversion rates to HBV markers (95% confidence interval) was 60.5% (42.7-77.0%). The corresponding rate for children at SOS was 10.2% (5.2-17.5%). The differences between the 2 institutions in the prevalence of serologic markers for hepatitis A and B and in the annual seroconversion rate to HBV markers reflected different rates of horizontal transmission. This was presumed to be due to differences in socioeconomic conditions and size between the 2 institutions and the disparity in the number of infectious HBV carriers. (authors)