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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 two residential institutions in Somalia. Among 596 individuals at one 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). Fifty-eight percent 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 five years (89% versus 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 two 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 two 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 two institutions, and the disparity in the number of infectious HBV carriers.