Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis ...Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis B vaccine(HepB)series and hepatitis B immunoglobulin.Post-vaccination serological testing(PVST)is utilized to determine an infant's outcome after HBV exposure and completion of HepB series.We aim to determine the frequency of compliance with a PVST testing cascade for HBV infected mothers and analyze factors associated with infant lost to follow up(LTFU).Methods:We conducted a retrospeaive cohort review of previously collected data in Fujian,Jiangxi,Zhejiang and Chongqing provinces in China from 1 June 2016-31 December 2017.The study population included all HBV-exposed infants and their mothers.SAS software was used for statistical analyses.Bivariate and multivariate regression analyses(presented in odds ratio[OR]with 95%confidence intervals[CI])were used to compare the proportional differences of factors associated with PVST not being completed.Results:Among enrolled 8474 target infants,40%of them transferred out of the study provinces without further information and 4988 were eligible for PVST.We found 20%(994)of infants were not compliant with the testing cascade:55%of LTFU occurred because parents refused venous blood sample collection or failure of sample collection in the field,16%transferred out after 6 months of age,and 10%of families chose to have independent,confidential PVST completed without reporting results.High PVST noncompliance rates were more likely to be from Fujian(aOR=17.0,95%CI:9.7-29.9),Zhejiang(aOR=5.7,95%Cl:3.2-10.1)and Jiangxi(aOR=1.9,95%CI:1.0-3.4),and from HBV e antigen positive mother(aOR=1.2,95%CI:1.1-1.4).Conclusions:This study found that the LTFU rate reached 20%in PVST program,which was a significant problem.We recommend implementing a national elearonic information system for tracking HBV at risk mother-infant pairs;encourage further research in developing a less invasive means of completing PVST,and take effective measures nationally to reduce HBV stigma.Without reducing the loss to follow up rate among infants eligible for PVST,elimination of vertical HBV transmission will be impossible.展开更多
Objective: The objective of this study was to evaluate the post-vaccination seroconversion of small ruminants after the 2022-2023 vaccination campaign against peste des petits ruminants, as part of the national PPR co...Objective: The objective of this study was to evaluate the post-vaccination seroconversion of small ruminants after the 2022-2023 vaccination campaign against peste des petits ruminants, as part of the national PPR control and eradication strategy. Methodology and Results: The study was conducted in the study area comprising the provinces of Chari-Baguirmi, N’Djamena, Bahr Elgazale, Kanem and Lac. It involved the collection of 1687 samples of sera from small ruminants, which were analysed in the laboratory using the Eliza competition diagnostic method. Statistical analyses of the data obtained were carried out using the R Studio 4.1.2 software. The data analyses made it possible to assess post-vaccination seroconversion at the level of the study area, regions and municipalities, as well as to see the effect of sex, marking and the “vaccinated and unvaccinated animal” aspect on PPR seroconversion. At the level of the study area, an overall seroconversion of 73.56% (higher than the rate set by the national strategy) was obtained, but it was distributed differently between provinces and municipalities. Conclusion and Application of Results: Provinces such as Bahr Elgazal (69.84%) and Lac (68.78%) experienced a seroconversion to decaf of the rate set by the national strategy for the control and eradication of PPR. The municipalities with low seroconversion rates were the 1st district of the city of N’Djamena (54.29%) and Amsileb (49.02%). Thus, it would be suggested that the General Directorate of Veterinary Services, through its Animal Health Directorate, intensify its efforts in municipalities with a low seroconversion rate and maintain the gains made in those with high rates. In this context, it is important to ensure that vaccines are administered appropriately and that the cold chain is functioning properly to achieve the objective of the national strategy for the control and eradication of peste des petits ruminants in Chad.展开更多
Background: Health care workers (HCWs) are particularly at risk of hepatitis B virus (HBV) infections due to contact with infectious material like contaminated blood and body fluids or contact with HBV contaminated fo...Background: Health care workers (HCWs) are particularly at risk of hepatitis B virus (HBV) infections due to contact with infectious material like contaminated blood and body fluids or contact with HBV contaminated fomites. HBV vaccine is efficient in preventing infection though 5% - 10% of individuals are non-responders. HBV vaccine was introduced into Nigerian childhood immunization services in year 2004. However, routine vaccination of HCWs is often not implemented due to cost in resource limited settings like ours. Therapeutic options are also not affordable and available options do not guarantee complete cure. This study aimed at determining the burden of HBV infection among HCWs in Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Nigeria, in order to institute prompt treatment as a way of curbing HBV spread and disease progression. Materials and Method: This cross-sectional study was conducted between October and December, 2016. Staff from various cadres in EKSUTH, who accepted to participate, was recruited into the study. Following informed consent, 5 mls of blood collected from each participant was screened for HBV markers using HBV serologic combo test kit. Demography and Information on risk factors were collected with questionnaire. Results: A total of 965 participants, of which 323 (33.5%) were males and 642 (66.5%) were females, were recruited. Majority (72.6%) were married. History of unprotected sexual contact and multiple sexual partners was found in 62.3% and 54% of participants, respectively. In this study, 43 (4.5%) were HBsAg positive, out of which 40 (93%) had HBV infection (HBcAb positive). Prevalence of HBV infection was significantly higher among males than females (p value 0.004). Majority (60.5%) of infected individuals were 30 to 49 years of age. All infected participants had no previous vaccination, but no serologic evidence of previous vaccination was seen among vaccinated individuals. Conclusion and Recommendation: We concluded that Hepatitis B virus infection is still high among HCWs and significantly higher among males than females. Vaccinated individuals were found to be HBsAg negative, but had no detectable protective immunoglobulin against HBV. We recommend pre-employment screening and free vaccination of all staff in our health institutions, post vaccination immunization status assessment and provision of standard and affordable treatment for infected individual in order to achieve vision 2030 of HBV eradication.展开更多
To evaluate maternal hepatitis B virus (HBV) DNA as risk for perinatal HBV infection among infants of HBV-infected women in California. METHODSRetrospective analysis among infants born to hepatitis B surface antigen (...To evaluate maternal hepatitis B virus (HBV) DNA as risk for perinatal HBV infection among infants of HBV-infected women in California. METHODSRetrospective analysis among infants born to hepatitis B surface antigen (HBsAg)-positive mothers who received post vaccination serologic testing (PVST) between 2005 and 2011 in California. Demographic information was collected from the California Department of Public Health Perinatal Hepatitis B Program databaseand matched to birth certificate records. HBV DNA level and hepatitis B e antigen (HBeAg) status were obtained from three large commercial laboratories in California and provider records if available and matched to mother infant pairs. Univariate analysis compared infected and uninfected infants. Multivariate analysis was restricted to infected infants and controls with complete maternal HBV DNA results using a predefined high HBV DNA level of > 2 × 10<sup>7</sup> IU/mL, a 5:1 ratio of cases to controls and a two-sided confidence level of 95%. RESULTSA total of 17687 infants were born to HBsAg positive mothers in California between Jan 1 2005 and Dec 31, 2011. Among 11473 infants with PVST, only 125 (1.1%) were found to be HBV infected. Among these infected infants, lapses in Advisory Committee on Immunization Practices recommended post exposure prophylaxis (PEP) occurred in only 9 infants. However, PEP errors were not significantly different between infected and uninfected infants. Among the 347 uninfected and infected infants who had maternal HBeAg and HBV DNA level, case-control analysis found HBeAg positivity (70.4% vs 28.9%, OR = 46.76, 95%CI: 6.05-361.32, P < 0.001) and a maternal HBV DNA level ≥ 2 × 10<sup>7</sup> IU/mL (92.6% vs 18.5%, OR = 54.5, 95%CI: 12.22-247.55, P < 0.001) were associated with perinatal HBV infection. In multivariate logistic regression, maternal HBV DNA level ≥ 2 × 10<sup>7</sup> IU/mL was the only significant independent predictor of perinatal HBV infection. CONCLUSIONIn California, transmission is low and most infected infants receive appropriate PEP and vaccination. Maternal HBV DNA ≥ 2 × 10<sup>7</sup> IU/mL is associated with high risk of perinatal infection.展开更多
文摘Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis B vaccine(HepB)series and hepatitis B immunoglobulin.Post-vaccination serological testing(PVST)is utilized to determine an infant's outcome after HBV exposure and completion of HepB series.We aim to determine the frequency of compliance with a PVST testing cascade for HBV infected mothers and analyze factors associated with infant lost to follow up(LTFU).Methods:We conducted a retrospeaive cohort review of previously collected data in Fujian,Jiangxi,Zhejiang and Chongqing provinces in China from 1 June 2016-31 December 2017.The study population included all HBV-exposed infants and their mothers.SAS software was used for statistical analyses.Bivariate and multivariate regression analyses(presented in odds ratio[OR]with 95%confidence intervals[CI])were used to compare the proportional differences of factors associated with PVST not being completed.Results:Among enrolled 8474 target infants,40%of them transferred out of the study provinces without further information and 4988 were eligible for PVST.We found 20%(994)of infants were not compliant with the testing cascade:55%of LTFU occurred because parents refused venous blood sample collection or failure of sample collection in the field,16%transferred out after 6 months of age,and 10%of families chose to have independent,confidential PVST completed without reporting results.High PVST noncompliance rates were more likely to be from Fujian(aOR=17.0,95%CI:9.7-29.9),Zhejiang(aOR=5.7,95%Cl:3.2-10.1)and Jiangxi(aOR=1.9,95%CI:1.0-3.4),and from HBV e antigen positive mother(aOR=1.2,95%CI:1.1-1.4).Conclusions:This study found that the LTFU rate reached 20%in PVST program,which was a significant problem.We recommend implementing a national elearonic information system for tracking HBV at risk mother-infant pairs;encourage further research in developing a less invasive means of completing PVST,and take effective measures nationally to reduce HBV stigma.Without reducing the loss to follow up rate among infants eligible for PVST,elimination of vertical HBV transmission will be impossible.
文摘Objective: The objective of this study was to evaluate the post-vaccination seroconversion of small ruminants after the 2022-2023 vaccination campaign against peste des petits ruminants, as part of the national PPR control and eradication strategy. Methodology and Results: The study was conducted in the study area comprising the provinces of Chari-Baguirmi, N’Djamena, Bahr Elgazale, Kanem and Lac. It involved the collection of 1687 samples of sera from small ruminants, which were analysed in the laboratory using the Eliza competition diagnostic method. Statistical analyses of the data obtained were carried out using the R Studio 4.1.2 software. The data analyses made it possible to assess post-vaccination seroconversion at the level of the study area, regions and municipalities, as well as to see the effect of sex, marking and the “vaccinated and unvaccinated animal” aspect on PPR seroconversion. At the level of the study area, an overall seroconversion of 73.56% (higher than the rate set by the national strategy) was obtained, but it was distributed differently between provinces and municipalities. Conclusion and Application of Results: Provinces such as Bahr Elgazal (69.84%) and Lac (68.78%) experienced a seroconversion to decaf of the rate set by the national strategy for the control and eradication of PPR. The municipalities with low seroconversion rates were the 1st district of the city of N’Djamena (54.29%) and Amsileb (49.02%). Thus, it would be suggested that the General Directorate of Veterinary Services, through its Animal Health Directorate, intensify its efforts in municipalities with a low seroconversion rate and maintain the gains made in those with high rates. In this context, it is important to ensure that vaccines are administered appropriately and that the cold chain is functioning properly to achieve the objective of the national strategy for the control and eradication of peste des petits ruminants in Chad.
文摘Background: Health care workers (HCWs) are particularly at risk of hepatitis B virus (HBV) infections due to contact with infectious material like contaminated blood and body fluids or contact with HBV contaminated fomites. HBV vaccine is efficient in preventing infection though 5% - 10% of individuals are non-responders. HBV vaccine was introduced into Nigerian childhood immunization services in year 2004. However, routine vaccination of HCWs is often not implemented due to cost in resource limited settings like ours. Therapeutic options are also not affordable and available options do not guarantee complete cure. This study aimed at determining the burden of HBV infection among HCWs in Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Nigeria, in order to institute prompt treatment as a way of curbing HBV spread and disease progression. Materials and Method: This cross-sectional study was conducted between October and December, 2016. Staff from various cadres in EKSUTH, who accepted to participate, was recruited into the study. Following informed consent, 5 mls of blood collected from each participant was screened for HBV markers using HBV serologic combo test kit. Demography and Information on risk factors were collected with questionnaire. Results: A total of 965 participants, of which 323 (33.5%) were males and 642 (66.5%) were females, were recruited. Majority (72.6%) were married. History of unprotected sexual contact and multiple sexual partners was found in 62.3% and 54% of participants, respectively. In this study, 43 (4.5%) were HBsAg positive, out of which 40 (93%) had HBV infection (HBcAb positive). Prevalence of HBV infection was significantly higher among males than females (p value 0.004). Majority (60.5%) of infected individuals were 30 to 49 years of age. All infected participants had no previous vaccination, but no serologic evidence of previous vaccination was seen among vaccinated individuals. Conclusion and Recommendation: We concluded that Hepatitis B virus infection is still high among HCWs and significantly higher among males than females. Vaccinated individuals were found to be HBsAg negative, but had no detectable protective immunoglobulin against HBV. We recommend pre-employment screening and free vaccination of all staff in our health institutions, post vaccination immunization status assessment and provision of standard and affordable treatment for infected individual in order to achieve vision 2030 of HBV eradication.
文摘To evaluate maternal hepatitis B virus (HBV) DNA as risk for perinatal HBV infection among infants of HBV-infected women in California. METHODSRetrospective analysis among infants born to hepatitis B surface antigen (HBsAg)-positive mothers who received post vaccination serologic testing (PVST) between 2005 and 2011 in California. Demographic information was collected from the California Department of Public Health Perinatal Hepatitis B Program databaseand matched to birth certificate records. HBV DNA level and hepatitis B e antigen (HBeAg) status were obtained from three large commercial laboratories in California and provider records if available and matched to mother infant pairs. Univariate analysis compared infected and uninfected infants. Multivariate analysis was restricted to infected infants and controls with complete maternal HBV DNA results using a predefined high HBV DNA level of > 2 × 10<sup>7</sup> IU/mL, a 5:1 ratio of cases to controls and a two-sided confidence level of 95%. RESULTSA total of 17687 infants were born to HBsAg positive mothers in California between Jan 1 2005 and Dec 31, 2011. Among 11473 infants with PVST, only 125 (1.1%) were found to be HBV infected. Among these infected infants, lapses in Advisory Committee on Immunization Practices recommended post exposure prophylaxis (PEP) occurred in only 9 infants. However, PEP errors were not significantly different between infected and uninfected infants. Among the 347 uninfected and infected infants who had maternal HBeAg and HBV DNA level, case-control analysis found HBeAg positivity (70.4% vs 28.9%, OR = 46.76, 95%CI: 6.05-361.32, P < 0.001) and a maternal HBV DNA level ≥ 2 × 10<sup>7</sup> IU/mL (92.6% vs 18.5%, OR = 54.5, 95%CI: 12.22-247.55, P < 0.001) were associated with perinatal HBV infection. In multivariate logistic regression, maternal HBV DNA level ≥ 2 × 10<sup>7</sup> IU/mL was the only significant independent predictor of perinatal HBV infection. CONCLUSIONIn California, transmission is low and most infected infants receive appropriate PEP and vaccination. Maternal HBV DNA ≥ 2 × 10<sup>7</sup> IU/mL is associated with high risk of perinatal infection.
