Women Of Low Socioeconomic Class Research Articles

Determinants of Antenatal Healthcare Services Utilisation: A Case of Dodoma, Tanzania.

Antenatal Care (ANC) coverage is a key determinant of maternal and perinatal morbidity and mortality. Low utilization of ANC services and high Maternal Mortality Ratio (MMR) have been reported in the East African Region. Due to the paucity of information on the determinants of ANC utilization in this region, we conducted the study aiming at exploring factors influencing the utilization of ANC services. We further sought opinions that will aid the improvement of utilization of ANC services. A triangulation mixed-method study was conducted in August 2021 among forty-five women and ten healthcare providers in a selected health center located in Dodoma Urban District, Tanzania. Information was gathered using semi-structured questionnaires and in-depth interviews. Quantitative data were analysed using IBM SPSS Statistics. The relationship between the outcome variable and the predictor variables was assessed by either the Chi-square test or Fisher's exact test and a p value<.05 was considered statistically significant. Manual thematic analysis was used for qualitative data after thorough transcript and documentary reviews. Almost half (48.9%) of the interviewed women attended ANC services at least once during their last pregnancy. Women who reported having a low income and those who spent more than an hour reaching the health facility had poor ANC attendance (p value<.05). The main themed factors that negatively impacted ANC utilization included cultural practices and gender norms, poor communication between partners, and long waiting time at the ANC clinics. Utilization of ANC services was found to be low among women living in Dodoma Urban District. ANC attendance varied with the level of income and the time women spent reachingt the health facility. Cultural practices and gender norms, communication between spouses, and service waiting time were mentioned to influence ANC attendance. Public and private sectors should invest in maternal health, provide affordable services and formulate strategies to improve the accessibility of ANC services. Interventions should target women of low socio-economic class and those living in remote areas. Moreover, schemes to address the sociocultural barriers to ANC utilization need to be formulated.

Knowledge about Obstetrical Danger Signs among Pregnant Women of Low Socioeconomic Class

Background: In many developing countries including Pakistan maternal morbidity and mortality is still high. Knowledge of danger signs of Obstetrics during pregnancy is the first essential step for the timely referral. This study therefore, aims to fill this gap by assessing the current level of knowledge and associated factors of pregnant women living in low socioeconomic areas of Karachi Aim: The aim of the study is to assess the knowledge of pregnant women with low socio-economic status about the obstetric danger signs. Study Design: A cross-sectional study. Place and Duration: Community based medical centers of Gadap Town Karachi, from October 2020 to October 2021. Methods: A total of 300 pregnant women gave their consent and took part in the study. Data was collected in local language by interview and a pre-designed, tested questionnaire was used, which included the socio-demographic profile, number of births, prenatal care visits, and pregnant women knowledge of danger signs during pregnancy, and in the postpartum period. Socio-economic status was assessed in accordance with the modified international classification. Results: Knowledge of at least one danger sign varied from a total of 300 pregnant women consented and took part in this study. Most of them are in the age group of 21-34 years 138(46%) and over 92 (30.7%) were above thirty years, followed by the age group of 18-20 year 70(23.3%) and then &gt;35 years (27%). Most of the pregnant women (62.3%) have completed the primary Level education. The majority of the surveyed population is housewives and semiskilled workers. Conclusions: Our study has shown that there is little knowledge of the danger signs of pregnancy among pregnant women. Also, most subjects are unaware of obstetric danger signs. Based on this study, we suggest that planned strategies are needed to increase women's awareness of obstetric danger signs. Raising awareness of the key signs of danger, creating and promoting mechanisms of generating income should be carried out on a continuous basis in the health facility and in the environment, as it prepares women and their families to make appropriate, quick and effective decisions and actions in the event of symptoms of obstetric emergency. Keywords: Obstetric danger signs, pregnancy Antenatal and postpartum period

IMPACT OF SOCIODEMOGRAPHIC FACTORS ON VAGINAL DISCHARGE

Introduction:- Vaginal discharge is one of the most common complaint in women attending obstetrics and Gynecology outpatient department. It increases the morbidity in women. AIM : The study is aimed at identifying the impact of the social and demographic variables associated with the complaint of vaginal discharge. Method :This is a hospital based prospective observational study conducted in the obstetries and gynecology outpatient department of Jawaharlal Nehru Medical college , Bhagalpur , Bihar. Pretested questionnaire was done on women with Vaginal discharge . Results : The total number of cases mere 60. The results were vaginal discharge common among 26-35 yr of age . 15.6% among lower socio economic class women , 33.6% among women living with their husband , 27.6% has vaginal discharge who got married before 18 yrs of age. 44% women perceived no specic symptoms. Conclusion : Awarness regarding personal and menstrual hygiene is mandatory among women to lower the incidence of vaginal discharge

Midwife-woman interaction as a critical component of antenatal care: ethical implications and lessons to be learned

Pregnancy and childbirth are important rites of passage for women and their families, with deep personal and cultural significance, bringing joy along with great physical and emotional vulnerability. The purpose of the study under review was to explore pregnant women’s experiences of midwife-woman interaction and the extent to which it conforms to respectful ethical care. A qualitative case study design was applied. The setting was randomly selected primary health care facilities that form a first point of contact for pregnant women for antenatal care in Gauteng, South Africa. The population of the study was pregnant women of low socio-economic class receiving free antenatal care service at public primary health care facilities. Women waiting for their routine antenatal care were conveniently selected to be part of the focus group discussions (FGDs). The data was analysed thematically. Whilst a few positive aspects regarding midwife-woman interaction were shared, the participants expressed a desire for personal care; a shorter waiting time; continuity of care; enhanced communication with midwives; a greater opportunity for asking questions and receiving comprehensive answers; and a greater attention to their needs and fears. Recommendations were provided based on the study findings to enhance respectful practice by midwives.

Persisting high magnitude of anaemia in Women of Reproductive age

Background: Despite several steps taken by governments, anaemia remains a major cause of ill health in women globally, maybe it is increasing. Objectives: Study was done to know magnitude of anaemia in women of reproductive age (WRA, 15-49 yrs) with mission of services. Materials and Methods: It was institution based prospective study for knowing magnitude of anaemia in WRA. Study was carried out over 9 months in Obstetrics &amp; Gynaecology, after approval of ethics committee of institute. Study subjects were non-pregnant women of 15-49 years of age who reported to hospital with various disorders, but did not have any disorder which could have been responsible for anaemia. Patients’ friends, relatives who volunteered to be part of study were also included. Women with known bleeding disorders, or obvious causes for anaemia like menorrhagia, piles, chronic diseases were not included. Pretested tool was used. As per inclusion criteria women from regular counter of obstetrics gynaecology outpatient. were directed to research assistant. Results: Adolescents had maximum burden of anaemia, 76.15%, followed by 69.45% among women of 20-34 yrs, 65.21% in women of 35-49 yrs age. Severely anaemic were 2.02% among adolescents, 0.44% of 20-34 years ,0.27% among of 35-49 yrs. As expected, highest numbers were amongst women of low socio-economic class and illiterate. Conclusion: Around seventy percent women of reproductive age with no obvious cause were anaemic, more of adolescents. It is essential that in depth studies are done about available food, eating habits, as anaemia continues to kill many mothers during pregnancy, birth, postbirth and affects baby too. Keywords: Anaemia; Reproductive Age Women; No Obvious Cause

Multidrug Resistant Uropathogens among Egyptian Pregnant Women

Urinary Tract Infections (UTIs) in pregnancy is a common medical problem associated with significant increase in the risk of fetal morbidity and mortality. The effective appropriate antimicrobial agent is a major concern as many effective antimicrobial groups cannot be used due to their potential toxicity to the fetus as well as the increasing rates of Multidrug-Resistant (MDR) strain isolation. This cross- sectional study was conducted on women attending the antenatal care of Zagazig University. This study aimed to estimate prevalence of various uropathogens in UTI among the pregnant women and determine their antimicrobial resistance patterns. Clean catch mid-stream urine samples were obtained, complete microbiological examination and antibiotic susceptibility testing were carried out. More than half of culture positive samples was obtained from asymptomatic pregnant women. Asymptomatic bacteriuria was more common among primigravida, women of low socioeconomic class and with history of previous Cesarean section. Gram negative bacterial isolates were the most prevalent (71%). The most frequently isolated pathogens were: E. coli 34%, K. pneumoniae 26% and S. saprophyticus 23%, among the total Gram negative isolates, 95.0% were MDR. Meropenem was the antibiotic with the highest susceptibility rate (96%) on E coli isolates, followed by nitrofurantoin (74%) and tobramycin (72%). Recommendations: Urine culture and sensitivity must be the role as MDR pathogens are increasing, rationalization of antibiotic administration is a must.

Study of Serum FT3, FT4 and TSH Levels in Pregnant Women

Thyroid disease have a strong predominance in woman of childbearing age. Pregnancy may be associated with thyroid dysfunction. Our objective was to assess the serum FT3, FT4 and TSH levels in pregnant women. This cross-sectional analytical study was done in the Department of Physiology of Dhaka Medical College from July 2006- June 2007. Total 50 apparently healthy women of low socioeconomic class, age ranged from 18- 40 years were selected from the Outpatient Department of urban primary health care project at Mirpur, Dhaka. Out of them 30 pregnant women of different trimester were taken as study group and 20 age matched non pregnant women were taken as control. Serum FT3, FT4 and TSH levels were parameters in both groups. Statistical analysis was done by the SPSS 12.0 programme. The means ( SD) of serum FT3 levels were 6.36 1.16 p mol/L and 6.38 1.38 p mol/L, FT4 levels were 20.25 4.77 pmol/L and 19.39 8.17 pmol/L and TSH levels were 0.96 0.96 mIu/L and 1.27 0.86 mIu/L in group A (Study) and group B (control) respectively. The difference of means ( SD) of serum FT3 , FT4 and TSH levels were not significant (p&gt;0.05) between group A and B. From the statistical analysis of the results obtained in the present study and their comparison with those of published reports, it may be concluded that there is no change of serum FT3, FT4 and TSH levels in pregnancy.Medicine Today 2015 Vol.27(2): 1-4

Sexually transmitted infections other than HIV/AIDS among women of low socio-economic class attending antenatal clinics in Khartoum, Sudan.

Sexually transmitted infections (STIs) are major health threats affecting people globally; however, the burden of STIs is greatest in low-income countries. Since they are physiologically more vulnerable, women are mostly affected. The risk is increased dramatically during pregnancy leading to serious health complications that may affect the newborn. Underprivileged pregnant women attending antenatal clinics for routine checkups in displaced camps, a women's prison and several peripheral health centres were clinically and laboratory screened for trichomoniasis, chlamydial infections, gonorrhea and syphilis. A total of 426 women with an age range of 14-45 years were included. Clinical data, blood, cervical and vaginal swabs were collected. Conventional bacteriological and serological methods were applied. All attendees were HIV1/2-negative. The prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum infections was found to be 7.8%, 4.9%, 0% and 5%, respectively. Although vaginal discharge, among other symptoms, is known to be the most significant indicator for STIs, our identified positive predictive value was only 14.1%. We conclude that use of syndromic approach for diagnosing and treating attendees of antenatal settings is of low clinical value and many easily curable STIs will be overlooked. Consequently, trichomoniasis, chlamydial infection and syphilis prevailed widely among this population.

Study of serum FT3, FT4 and TSH in pregnant women

Background: Thyroid diseases have a strong predominance in woman of childbearing age. Pregnancy may be associated with thyroid dysfunction. The aim of the present study was to assess the serum FT3, FT4 and TSH levels in pregnant women. Methods: This cross-sectional analytical study was done in the Department of Physiology of Dhaka Medical College, Dhaka, from July 2006 to June 2007. Total 50 apparently healthy women of low socioeconomic class, age ranged from 18-40 years were selected from the Outpatient Department of Urban Primary Health Care Project (UPHCP) at Mirpur, Dhaka. Out of them 30 pregnant women of different trimester were taken as study group (group A) and 20 age matched non pregnant women were taken as control (group B). Serum FT3, FT4 and TSH levels were parameters in both groups. Statistical analysis was done by the SPSS version 12.0. Results: The mean serum FT3 levels were 6.36±1.16 pmol/L and 6.381.36 pmol/L in group A (Study) and group B (control) respectively. The mean serum FT4 levels were 20.25±4.77 pmol/L and 19.39±8.17 pmol/L in group A (Study) and group B (control) respectively. The mean serum TSH levels were 0.96±0.96 mIu/L and 1.27±0.86 mIu/L in group A (Study) and group B (control) respectively. The difference was not significant (p&gt;0.05) between group A and B. Conclusion: From the results obtained in the present study, it may be concluded that there is no change of serum FT3, FT4 and TSH level in pregnancy. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22697 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 68-72

Iron status in women using oral contraceptives

Objectives: To assess the iron status of women using oral contraceptive pill (OCP) and compare this status with that of women of non-OCP users. Methods: This prospective cross-sectional comparative study was done in Dhaka Medical College from January 2006 to December 2006. Total 61 apparently healthy women of low socioeconomic class, age ranged 20-40 years were selected from different areas of Dhaka city. Of them 41 women were OCP users (Study group) and 20 women were non-OCP users (for comparison). OCP users again subdivided into subgroups according to duration of OCP use. Serum ferritin and haemoglobin level were taken as parameters of iron status in both groups. Statistical analysis was done by the SPSS 12.0 programme. Results: The mean (±SD) of serum ferritin level were 59.45±24.79ng/ml and 77.36±35.16 ng/ml in non-OCP &amp; OCP users respectively. The difference of mean (±SD) of serum ferritin levels were significant (p:&lt;0.05) between two groups. The mean (±SD) of haemoglobin levels were 11.54±0.76gm/dl and 12.04±0.79gm/dl in non-OCP user and OCP users respectively. The difference of mean (±SD) were significant (p:&lt;0.05) between two groups. Levels of serum ferritin &amp; haemoglobin were 19ng/ml and 10.95gm/dl respectively in women using OCP for 1 year. But their levels became 144 ng/ml and 13.95gm/dl respectively in women using OCP for 12 years. Conclusion: This study suggests that OCP use raises serum ferritin and haemoglobin levels and thus has beneficial effects on iron status of the body. http://dx.doi.org/10.3329/bjpp.v26i1-2.19963 Bangladesh J Physiol Pharmacol 2010; 26(1&amp;2) : 25-29

Study of Depression and Its Associated Factors among Women Living with HIV/AIDS in Coastal South India

Background. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals. Women with HIV are about four times more likely to be depressed than those who are not infected. Aims. To assess the sociodemographic and clinical correlates of depression among women living with HIV/AIDS. Setting and Design. One public and one private hospital in Mangalore, Coastal South India, and cross-sectional design. Methods and Materials. Study constituted of 137 HIV-positive women, depression was assessed using BDI (Beck Depression Inventory), and social support was assessed using Lubben Social Network Scale. Statistical Analysis. All analysis was conducted using SPSS version 11.5. Chi-square test with P value less than 0.05 was taken as statistically significant. Results. Among 137 HIV-positive women, 51.1% were depressed. Around 16% were having moderate to high risk for isolation. Depression was statistically significant in rural women, widowed women, and lower socioeconomic class women. Conclusion. Depression is highly prevalent among women living with HIV which is still underdiagnosed and undertreated, and there is a need to incorporate mental health services as an integral component of HIV care.

Study of depression and its associated factors among women living with HIV AIDS in coastal South India

Background. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals. Women with HIV are about four times more likely to be depressed than those who are not infected. Aims. To assess the sociodemographic and clinical correlates of depression among women living with HIV/AIDS. Setting and Design. One public and one private hospital in Mangalore, Coastal South India, and cross-sectional design. Methods and Materials. Study constituted of 137 HIV-positive women, depression was assessed using BDI (Beck Depression Inventory), and social support was assessed using Lubben Social Network Scale. Statistical Analysis. All analysis was conducted using SPSS version 11.5. Chi-square test with P value less than 0.05 was taken as statistically significant. Results. Among 137 HIV-positive women, 51.1% were depressed. Around 16% were having moderate to high risk for isolation. Depression was statistically significant in rural women, widowed women, and lower socioeconomic class women. Conclusion. Depression is highly prevalent among women living with HIV which is still underdiagnosed and undertreated, and there is a need to incorporate mental health services as an integral component of HIV care.

An audit of Maternal Deaths from a referral University Teaching Hospital in Nigeria: The Emergence of HIV/AIDS as a leading cause

To analyse the characteristics and causes of maternal death in a referral tertiary health facility in Southern Nigeria. This is a facility- based review of 184 maternal deaths that occurred from January 2005 to June 2009. Primary causes of death and factors that contributed to maternal death including delay in accessing health care were identified. During the study period, the Maternal Mortality Ratio (MMR) was 2230/100,000 live births. There was a progressive reduction in the annual MMR from 2901/100,000 live birth in 2005 to 1459/100,000 live birth in 2009. More than four fifth (84.9%) of the maternal deaths occurred among women of low socio-economic class (IV and V). The leading causes of direct maternal deaths (64.1%) were Puerperal sepsis (17.8%), Pre-eclampsia/Eclampsia (15.8%) and complications of unsafe abortion (11.4%). HIV/AIDS was the third commonest overall cause of maternal death (15.2%). Half of the women experienced Type 1 delay (50%), Type 2 and 3 delay occurred in 7.6% and 18.5% of maternal deaths respectively. About two thirds of the women (58.2%) experienced more than one form of delay. Although direct obstetric deaths remain the leading cause of maternal mortality, HIV/AIDS is becoming an important primary cause of maternal mortality in our environment. Organization of health service delivery with an effective referral system and the provision of optimal care for HIV infected women are recommended.

Bone Status of Women Over 40 Years of Age from Two Socioeconomic Strata

Background. Literature reports examining the association of bone mineral density (BMD) and socioeconomic status suggest of an inconclusive relation. Methods. We studied 58 and 54 women (mean age 49.5 ± 7.2 years) from upper socioeconomic class (USC) and lower socioeconomic class (LSC), respectively, for their BMD at lumber spine and total femur by Lunar DPX-PRO dual-energy X-ray absorptiometry. Socioeconomic, lifestyle and biochemical data were collected. Results. Percent prevalence of osteoporosis in USC women was 12% and 0% at lumber spine and total femur, respectively, while it was 33% and 11%, respectively, in LSC women. When the mean BMD values were adjusted for the effect of body mass index, protein and calcium intake, physical activity, and sunlight exposure, only the total femoral BMD of USC premenopausal women was significantly greater. Conclusion. Our data suggest that bone health of our LSC women was poor possibly due to the influence of socioeconomic and lifestyle factors.

Clandestine Abortion in Port Harcourt: Providers\' Motivations and Experiences:

Abortion is illegal in Nigeria. It is a crime to perform or obtain an abortion except to save a woman's life. In spite of this, several medical practitioners working in profit-oriented private clinics still provide abortion services on demand and on a fee for service basis. This study is to find out the motivations and experiences of these practitioners. The study was carried out in 15 clinics in Port Harcourt that were known to provide abortion services, using a descriptive, cross-sectional study design. Data were collected using a semi-structured, self-administered questionnaire, followed a few days later by in-depth interview to further explore responses in the questionnaire. A total of 34 doctors, 29 males and 5 females that routinely provide abortion services in the clinics were interviewed. Most of them (79.42%) were below the age of 40 years, married (76.47%), non-specialist doctors (55.88%), and had practiced for less than fifteen years (88.24%). All the owners/Medical Directors of the clinics were actively engaged in providing abortion services, and most of the clinics (86.67%) had less than ten in-patient beds. All the providers were Christians, but most (85.29%) provided abortion services mainly for the financial benefit. Expertise for the abortion procedures were acquired in private clinics, but most of the providers (61.76%) restricted themselves to terminating pregnancies in which they felt were firmly within their level of competence. All the respondents used manual vacuum aspiration for the termination of pregnancies less than 12 weeks and charge an average of five thousand naira (N5,000.00) for an 8-week pregnancy Most abortion providers in Nigeria are lured by the large market and the huge fees collected for the services. Abortion should be formally legalized in Nigeria to at least force down the service charge, and hence make safe abortion accessible to women of low socio-economic class.

Results of longterm hospital based cytological screening in asymptomatic women

Routine cytological screening has been carried out in 27,062 asymptomatic women attending Gynaec and Family Planning O.P.D. of Queen Mary's Hospital, Lucknow, India (April 1971-December 2004). Incidence of squamous intraepithelial lesion (SIL) was found to be 5.9% in the series, while cervical malignancy was seen in 0.6% of cases. The study highlighted the immense utility of cytological screening in minimizing the incidence of carcinoma cervix in the segment of the urban population screened, as the incidence dropped down to 0.5% in the second half from 1.1% noticed in the first half of the screening period. The study also emphasized the utility of clinically downstaging the cervical cancer as 7,316 women showing clinical lesions of cervix were found to harbor SIL in 15.3% and carcinoma cervix in 1.3% of cases as against the incidence of 2.5% for SIL and 0.6% for frank cancer in women with normal cervix. The investigation into different risk factors involved in cervical carcinogenesis revealed that the incidence of SIL and cancer cervix showed a rise with increasing age and parity and prolonged sexual period. The incidences of both cervical cytopathologies were also higher in women of low socio-economic status while religion was found to have no bearing on the occurrence of the disease. Among the four sexually transmitted diseases (STDs) diagnosed in the cervical smears, Trichomonas vaginalis was found to be more prevalent (2.6%), while human papillomavirus (HPV) and Herpes simplex was seen in 0.4 and 0.2% of cases, respectively Herpes simplex was found to have strong affinity with both SIL and carcinoma cervix, while only SIL incidence was high with HPV infection. The study emphasizes need of proper education to women of low socio-economic class for creating awareness regarding hazards and risk factors of cervical cancer as well as management and cure of the disease.

Vertical transmission of HTLV-I/II: a review.

The vertical transmission of the human T-cell lymphotropic virus type I (HTLV-I) occurs predominantly through breast-feeding. Since some bottle-fed children born to carrier mothers still remain seropositive with a frequency that varies from 3.3% to 12.8%, an alternative pathway of vertical transmission must be considered. The prevalence rate of vertical transmission observed in Japan varied from 15% to 25% in different surveys. In Brazil there is no evaluation of this form of transmission until now. However, it is known that in Salvador, Bahia, 0.7% to 0.88% of pregnant women of low socio-economic class are HTLV-I carriers. Furthermore the occurrence of many cases of adult T-cell leukemia/lymphoma and of four cases of infective dermatitis in Salvador, diseases directly linked to the vertical transmission of HTLV-I, indicates the importance of this route of infection among us. Through prenatal screening for HTLV-I and the refraining from breast-feeding a reduction of approximately 80% of vertical transmission has been observed in Japan. We suggest that in Brazil serologic screening for HTLV-I infection must be done for selected groups in the prenatal care: pregnant women from endemic areas, Japanese immigrants or Japanese descendents, intravenous drug users (IDU) or women whose partners are IDU, Human immunodeficiency virus carriers, pregnant women with promiscuous sexual behavior and pregnant women that have received blood transfusions in areas where blood donors screening is not performed. There are in the literature few reports demonstrating the vertical transmission of HTLV-II.

Women and Poverty

No abstract available for this article.

Effectiveness of Breast Self-examination Teaching to Women of Low Socioeconomic Class

To assess the effect of a breast self-examination (BSE) teaching program on retention of BSE knowledge and accuracy of BSE performance among women of low socioeconomic class, a pretest-posttest control group design with random assignment to groups was given to women at a Southeastern urban clinic. One hundred eighty women were pretested, after which the experimental group (N = 89) received one-to-one BSE instruction. Seventy of the subjects were given a posttest approximately two months later. All subjects were then asked to demonstrate BSE on themselves. The experimental group subjects showed a significantly greater increase in BSE knowledge from pretest to posttest and performed BSE with greater accuracy than the control group.

Hepatitis B serology in Greek prostitutes: significance of the different serum markers.

One hundred and ninety-eight prostitutes (mean age 41.8 years) and 117 control women of low socio-economic class (mean age 43.8 years) were tested by solid-phase radioimmunoassay for hepatitis B surface antigen (HBsAg), its antibody (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc). The prevalence of HBsAg was higher among prostitutes (11% v. 4%, P approximately 0.06). This difference was accounted for by the higher infection rate of prostitutes to hepatitis B virus (HBV) 97% v. 45%, P less than 10(-6)), since the proportion of HBsAg carriers among those infected was practically the same between the two groups (11% v. 9%). Among the previously infected prostitutes who did not become carriers the majority (75%) were positive for both anti-HBc and anti-HBs, whereas among control women about half (52%) were positive only for anti-HBc.