and aim: Hepatitis B virus (HBV) infections have been consistently reported over the last few years from the two wards of Thrikkaruva, Kollam district, Kerala, southern India. This study was conducted to determine the risk factors associated with HBV transmission in Thrikkaruva. Methods: This was a community based, case-control study, enrolling HBsAg positive cases diagnosed since January 2010. Controls were age (+5years) and sex matched neighbourhood individuals. Data was collected using a

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... tionnaire and all subjects were investigated for HBsAg, anti-HBs and anti-HBc. Local healthcare institutions serving the community were surveyed for infection control practices. Statistical analysis for HBV associated factors was carried out. Results: A total of 49 cases and 49 controls were included in the final analysis. Logistic regression revealed close personal contact with of a case of hepatitis B (adjusted OR: 3.09, 95% CI: 1.13-9.40) as a significant risk factor in the community. Qualitative examination of infection control practices at private clinics, barber shops and dental clinics revealed conditions conducive for HBV transmission in the community. Conclusions: Our study reveals active horizontal person-to-person HBV transmission in the village. Comprehensive action including vaccination of all susceptible contacts, promotion of infection control at health care institutions, and raising public awareness are recommended in this region.