Dataset Information

Prevalence and Clinical Significance of Occult Hepatitis B Infection in The Gambia, West Africa.

ABSTRACT:

Background

Prevalence and clinical outcomes of occult hepatitis B infection (OBI) have been poorly studied in Africa.

Methods

Using the PROLIFICA cohort, we compared the prevalence of OBI between hepatitis B surface antigen (HBsAg)-negative healthy adults screened from the general population (controls) and HBsAg-negative patients with advanced liver disease (cases), and estimated the population attributable fraction for the effect of OBI on advanced liver disease.

Results

OBI prevalence was significantly higher among cases (15/82, 18.3%) than controls (31/330, 9.4%, P = .03). After adjusting for age, sex, and anti-hepatitis C virus (HCV) serology, OBI was significantly associated with advanced liver disease (odds ratio, 2.8; 95% confidence interval [CI], 1.3-6.0; P = .006). In HBsAg-negative people, the proportions of advanced liver disease cases attributable to OBI and HCV were estimated at 12.9% (95% CI, 7.5%-18.1%) and 16.9% (95% CI, 15.2%-18.6%), respectively.

Conclusions

OBI is endemic and an independent risk factor for advanced liver disease in The Gambia, West Africa. This implies that HBsAg-negative people with liver disease should be systematically screened for OBI. Moreover, the impact of infant hepatitis B immunization to prevent end-stage liver disease might be higher than previous estimates based solely on HBsAg positivity.

SUBMITTER: Ndow G

PROVIDER: S-EPMC9470103 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Prevalence and Clinical Significance of Occult Hepatitis B Infection in The Gambia, West Africa.

Ndow Gibril G Cessay Amie A Cohen Damien D Shimakawa Yusuke Y Gore Mindy L ML Tamba Saydiba S Ghosh Sumantra S Sanneh Bakary B Baldeh Ignatius I Njie Ramou R D'Alessandro Umberto U Mendy Maimuna M Thursz Mark M Chemin Isabelle I Lemoine Maud M

The Journal of infectious diseases 20220901 5

<h4>Background</h4>Prevalence and clinical outcomes of occult hepatitis B infection (OBI) have been poorly studied in Africa.<h4>Methods</h4>Using the PROLIFICA cohort, we compared the prevalence of OBI between hepatitis B surface antigen (HBsAg)-negative healthy adults screened from the general population (controls) and HBsAg-negative patients with advanced liver disease (cases), and estimated the population attributable fraction for the effect of OBI on advanced liver disease.<h4>Results</h4>O ...[more]

PMID: 34160616

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Project description:BackgroundThe limited availability of microbiology services in sub-Saharan Africa impedes accurate diagnosis of bacterial pathogens and understanding of trends in prevalence and antibiotic sensitivities. We aimed to characterize bacteremia among hospitalized children in The Gambia and to identify factors associated with bacteremia and mortality.MethodsWe prospectively studied children presenting with suspected severe infection to 2 urban hospitals in The Gambia, between January 2013 and September 2015. Demographic and anthropometric data, clinical features, management, and blood culture results were documented. Urine screens for antibiotic activity were performed in a subset of participants.ResultsOf 411 children enrolled (median age, 29 months; interquartile range, 11-82), 79.5% (325 of 409) reported prehospital antibiotic use. Antimicrobial activity by urinary screen for antibiotic activity was detected in 70.8% (n = 80 of 113). Sixty-six bacterial pathogens were identified in 65 (15.8%) participants and Staphylococcus aureus predominated. Gram-positive organisms were more commonly identified than Gram-negative (P < .01). Antibiotic resistance against first-line antimicrobials (ampicillin and gentamicin) was common among Gram-negative bacteria (39%; range, 25%-100%). Factors significantly associated with bacteremia included the following: gender, hydration status, musculoskeletal examination findings, admission to the Medical Research Council The Gambia at London School of Hygiene & Tropical Medicine hospital, and meeting sepsis criteria. Those associated with increased mortality were presence of a comorbidity, clinical pallor, tachypnea, and altered consciousness. Tachycardia was associated with reduced mortality.ConclusionsThe bacteremia rate in children with suspected childhood life-threatening infectious diseases in The Gambia is high. The pattern of pathogen prevalence and antimicrobial resistance has changed over time compared with previous studies illustrating the importance of robust bacterial surveillance programs in resource-limited settings.

Dataset Information

Prevalence and Clinical Significance of Occult Hepatitis B Infection in The Gambia, West Africa.

Background

Methods

Results

Conclusions

Publications

Prevalence and Clinical Significance of Occult Hepatitis B Infection in The Gambia, West Africa.

Similar Datasets

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