Markers of hepatitis B in nurses and domestic staff in an area of high endemicity.
Results obtained in two sero-epidemiologic surveys of hospital personnel in Durban were collated to yield information on 423 nurses and 141 domestic staff. The prevalence of antibodies to HBV was 14.9 per cent in 101 white nurses, 52.5 per cent in 322 African nurses and 51.8 per cent in 141 African domestics. This represents a greater than eight times increase for white nurses and a 50 per cent increase for African nurses and domestics over that seen in the equivalent blood donor groups (P less than 0.001 in each case). Antibody prevalence increased with age for all three staff groups, as did the number of individuals exhibiting a marker pattern (HBcAb greater than HBsAb) suggestive of persisting infection. No white nurses but 14 (4.3 per cent) African nurses and 17 (12.1 per cent) African domestics were HBsAg positive, the antigenaemia in domestics representing a significant increase (P less than 0.001) over the 4.0 per cent seen in female African blood donors. Six of the nurses and two of the domestics were also HBeAg positive. African nurses in adult medical wards showed greatest exposure (57 per cent) closely followed by nurses working in outpatient departments (54 per cent) and as theatre staff (52 per cent). Lower exposure rates (40 per cent) were seen in paediatric and renal unit nurses. This contrasts with results obtained for doctors in the two surveys which indicated that while Indian and white doctors are at significantly higher risk in the African hospital, African doctors are not, and that doctors working in surgical and renal departments are at higher risk than doctors on adult medical wards.(ABSTRACT TRUNCATED AT 250 WORDS)