| The ability to determine population-specific risk factors and associated intervention strategies is essential in areas with limited resources. The Republic of Palau, an island nation in the Pacific, was the site for a 10% equal probability clustered household sampling, which included every member of the household. The uniform weighting scheme simplified the analysis, as there was no need to control for stratification or sampling probabilities within the household.; Demographic data collected were compared with identical variables from the 1990 U.S. Census report. There was no significant difference between the survey results and census report for the variables measured.; The data set collected was evaluated for level of correlation within households and then analyzed by three different statistical methods: the traditional method of analysis based on the assumption of simple random sampling, and two methods, GEE and SUDAAN, which control for clustering in the analysis. It was found that although correlation within households was minimal, point estimates and standard errors differed among methods. Thus, it was necessary to control for clustering in spite of the low level of intraclass correlation.; Seroprevalence rates of hepatitis B surface antigen and anti-hepatitis B core antibody were found to be 18.8% and 68.1%, respectively. These markers for hepatitis B virus infection were statistically significantly associated only with increasing age, which suggests that the disease is endemic in the general population, rather than being confined to specific high risk groups. The high prevalence in the very young confirms the suspicion that perinatal transmission is a major factor in transmission of hepatitis B in this population, and thus strongly supports the essential role of a national hepatitis B immunization both prenatally and for young children.; The true anti-hepatitis C antibody seroprevalence rate in Palau was 0.6%, and was found to be significantly associated with intravenous drug usage and history of transfusion. Although intravenous drug usage is not currently a major problem in the population, it was found to be very high in prevalence in the prison population. This suggests a danger, therefore, that the disease could be spread from this drug-using group to the general population. |
