Abstract:
It is a well-known fact that a higher prevalence of hepatitis B infection is seen among cancer
patients under going multiple invasive investigations and therapeutic procedures. Once
infected there is a higher chance of them going in to chronicity as their immune systems are
compromised. This is even more so when the index case is a child due to the immaturity of
the immune system. Hence, horizontal transmission of the virus is easier to occur in such an
instance. It had been noticed by the clinicians of the Cancer Hospital, Maharagama that
there had been an increase of hepatitis B infection among patients. Therefore, it was
important to identify the asymptomatic HBsAg carrier patients and the extent of horizontal
transmission, in order to prevent further spread of hepatitis B infection in the household
contacts of carrier patients.To determine the prevalence of HBV markers in paediatric
cancer patients at Cancer Institute, Maharagama.To determine the prevalence o HBV
markers in household contacts of HBsAg The study was carried out at Cancer Institute,
Maharagama (CIM) from July to October 2003. 103 blood samples were collected from
asymptomatic paediatric patients who were chosen - randomly from wards and clinics and
the sera were tested for HBsAg, anti-HBs, anti-HBc (total) using reverse passive haemeagglutination, - passive haeme- agglutination anQiEtISA respectively. 110 household
contacts of the 34 patients who were positive for HBsAg were identified and their sera were
tested for the same hepatitis B viral markers using the same tests. Doubtful results were retested with the same test. The prevalence of hepatitis B viral markers in asypmtomatic
paediatric patients at CIM is as follows, HBsAg-33 percent , anti-HBs 5.8 percent , antiHBc 41.7 percent . The prevalence of hepatitis B viral markers in the household contacts of
the HBsAg positive patients is as follows, HBsAg 2.73 percent , anti-HBs 33.6 percent ,
anti-HBc 52.7 percent According to the results obtained, hepatitis B sero-prevalence was
found to be higher in paediatric patient population of CIM than that of the normal
population in Sri Lanka. Most of the patients who had acquired the infection were
asymptomatic posing a higher risk of transmission. Majority (79 percent) of the infected
patients developed carrier state due to impaired immunity. There was a higher prevalence of
HBV infection among household contacis of HBsAg carriers. Most (43 percent ) of them
were siblings of the index case. Development of persistent infection in this group was
comparable to that of the normal population. on a patient with past three abdominal
delivaries; Post partum haemorrhage managed with s come, including preinstall morbidity
and mortality. Of the goals of ante natal care, this is one of the most important continuum to
remain. Measurement of the symphysio fundal height (SFH), the distance from the upper
level of the symphysis pubis to the highest point of the uterine fundus, has traditionally been
advocated, and is commonly used in ante natal clinics (ANC) in Sri Lanka as a screening
tool. The chart currently used in Lankan ANC is provided by the Family Health Bureau
(FHB) and it is included in the mother's record