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HEPATITIS DELTA VIRUS INFECTION IN MONGOLIA: ANALYSES OF GEOGRAPHIC DISTRIBUTION, RISK FACTORS, AND DISEASE SEVERITY

The prevalence and risk factors for hepatitis delta virus (HDV) infection among Mongolian school children were assessed by detecting the antibody against HDV and HDV RNA, and through structured interviews. The study subjects consisted of 181 children with the past or ongoing hepatitis B virus infection who were investigated during the nationwide serosurvey conducted in 2004. The prevalence of antibody to HDV was 6.1%, with the proportion of 13.6% among hepatitis B surface antigen (HBsAg)-positive subjects, all of whom had HDV RNA. Multivariate logistic regression analyses showed that injections (> 11 times) (odds ratio [OR] = 8.31, 95% confidence interval [CI] = 1.28–54.07) and blood sampling (> 3 times) (OR = 5.34, 95% CI = 1.12–25.53) in health care settings, hospitalization (> 3 times) (OR = 6.20, 95% CI = 1.18–32.71), and cohabitating with patients with chronic hepatitis (OR = 4.57, 95% CI = 1.26–16.55) predicted the seropositivity for antibody to HDV. These results suggest that parenteral exposures in health care settings and household transmission are the main routes of HDV transmission among Mongolian children.

Received January 26, 2006. Accepted for publication March 28, 2006.

Acknowledgments: We thank the study participants, field staffs, school teachers, nurses, and health sector personnel in each study area for cooperation and support.

Financial support: This study was supported by grants from the World Health Organization (grant no. WP/MOG/IVD/216/XC/04991.00), and Jichi Medical University, Japan.

^* Address correspondence to Dambadarjaa Davaalkham, Department of Public Health, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi 329-0498, Japan. E-mail: davaamon{at}jichi.ac.jp

Authors’ addresses: Dambadarjaa Davaalkham, Toshiyuki Ojima, Ritei Uehara, Makoto Watanabe, Izumi Oki, and Yosikazu Nakamura, Department of Public Health, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi 329-0498, Japan. Pagvajav Nymadawa, National Center for Communicable Diseases, Bayanzurkh District, Ulaanbaatar, Mongolia. Masaharu Takahashi, and Hiroaki Okamoto, Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi 329-0498, Japan.

Reprint requests: Dambadarjaa Davaalkham, Department of Public Health, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi 329-0498, Japan, Telephone: 81-285-58-7338, Fax: 81-285-44-7217, E-mail: davaamon{at}jichi.ac.jp.