Using data to guide policy: Next steps for preventing perinatal hepatitis B virus transmission in Cambodia

Soeung, Sann Chan; Thiep, Chanthan; Duncan, Richard; Patel, Minal; Hennessey, Karen

doi:10.1016/j.vaccine.2012.10.079

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…This assessment along with several others found that providers cite false contraindications as a reason for not vaccinating a newborn [10, 13, 14], and HepB-BD coverage can be increased by ensuring good understanding of appropriate contraindications to HepB-BD vaccination. Vaccine shortages were commonly identified during this evaluation and resulted in newborns missing HepB-BD vaccination which has also been seen in several other countries [10, 14]. In 2012, the Philippines’ national EPI, which is not donor-supported and procures its own vaccine, had a vaccine shortage of monovalent hepatitis B vaccine from January to April and from June to December.…”

Section: Discussionmentioning

confidence: 97%

“…The HepB-BD must be given by staff in inpatient maternity/neonatal units as well as at outpatient health facilities through outreach visits for newborns born at home. Furthermore, location of birth can impact administration of HepB-BD; infants born in a health facility are more likely to get a HepB-BD within 24 hours of birth than infants born at home, as they already have access to the health care system [8–10]. In the Philippines, only 44% of infants are born in health facilities; an additional 18% are born at home in the presence of a skilled birth attendant (SBA), and 38% are born at home without any SBA present [11].…”

Section: Introductionmentioning

confidence: 99%

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Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: Opportunities to engage the private sector

Patel

Capeding

Ducusin

et al. 2014

Vaccine

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Background Hepatitis B vaccination in the Philippines was introduced in 1992 to reduce the high burden of chronic hepatitis B virus (HBV) infection in the population; in 2007, a birth dose (HepB-BD) was introduced to decrease perinatal HBV transmission. Timely HepB-BD coverage, defined as doses given within 24 hours of birth, was 40% nationally in 2011. A first step in improving timely HepB-BD coverage is to ensure that all newborns born in health facilities are vaccinated. Methods In order to assess ways of improving the Philippines’ HepB-BD program, we evaluated knowledge, attitudes, and practices surrounding HepB-BD administration in health facilities. Teams visited selected government clinics, government hospitals, and private hospitals in regions with low reported HepB-BD coverage and interviewed immunization and maternity staff. HepB-BD coverage was calculated in each facility for a 3 month period in 2011. Results Of the 142 health facilities visited, 12 (8%) did not provide HepB-BD; seven were private hospitals and five were government hospitals. Median timely HepB-BD coverage was 90% (IQR 80%–100%) among government clinics, 87% (IQR 50%–97%) among government hospitals, and 50% (IQR 0%–90%) among private hospitals (p=0.02). The private hospitals were least likely to receive supervision (53% versus 6%–31%, p=0.0005) and to report vaccination data to the national Expanded Programme on Immunization (36% vs. 96%–100%, p<0.0001). Conclusions Private sector hospitals in the Philippines, which deliver 18% of newborns, had the lowest timely HepB-BD coverage. Multiple avenues exist to engage the private sector in hepatitis B prevention including through existing laws, newborn health initiatives, hospital accreditation processes, and raising awareness of the government’s free vaccine program.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: Opportunities to engage the private sector

Patel

Capeding

Ducusin

et al. 2014

Vaccine

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“…The correct timing of the vaccine birth dose is crucial to reduce the infection risk, as it has been proven that efficacy is reduced if delayed beyond 24 h after birth [ 27 , 28 ]. Delayed 3-dose series vaccinations were not only observed in low-income, but also in high-income countries [ 29 , 30 , 31 , 32 ]. Indeed, the late vaccinations we observed in 7.7% of our cases at >24 h from birth (6.8% within 24–36 h, 0.9% > 36 h) might lead to perinatal HBV infection.…”

Section: Discussionmentioning

confidence: 99%

Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy

et al. 2021

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Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given vaccine and hepatitis B immunoglobulin, within 12–24 post-delivery hours. A single center retrospective analysis of policies and practices to prevent mother-to-child transmission of HBV was carried out, to evaluate their adherence to HBV care guidelines. Paired maternal-infant medical records for consecutive live births, between January 2015 and December 2019, were reviewed at the AOU Città della Salute e Scienza di Torino, where a total of 235/35,506 babies (0.7%) were born to HBsAg positive mothers. Markers of active viral replication, i.e., HBV DNA level and/or HBeAg, were reported in only 66/235 (28%) of the mothers’ medical records. All newborns had immunoprophylaxis at birth: 61% at <12 h, 31% between 12 and 24 h, 7% between 24 and 36 h and 1% at >36 h. In 2019, two cases of vertical HBV transmission occurred, despite timely immunoprophylaxis, as their mothers’ viral load was detected too late for antiviral prophylaxis. Missed early identification of pregnant women with high viremia levels or late vaccinations may contribute to perinatal HBV infection. Immunoprophylaxis should be given to babies born to HBsAg positive mothers at the latest within 12 h. In Italy, policies aimed at achieving the WHO 2030 goal of eliminating viral hepatitis should be further implemented.

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Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978–2021: A scoping review to map measurement and methodological gaps

Wariri

Okomo

Kwarshak

et al. 2022

PLOS Glob Public Health

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Empiric studies exploring the timeliness of routine vaccination in low-and middle-income countries (LMICs) have gained momentum in the last decade. Nevertheless, there is emerging evidence suggesting that these studies have key measurement and methodological gaps that limit their comparability and utility. Hence, there is a need to identify, and document these gaps which could inform the design, conduct, and reporting of future research on the timeliness of vaccination. We synthesised the literature to determine the methodological and measurement gaps in the assessment of vaccination timeliness in LMICs. We searched five electronic databases for peer-reviewed articles in English and French that evaluated vaccination timeliness in LMICs, and were published between 01 January 1978, and 01 July 2021. Two reviewers independently screened titles and abstracts and reviewed full texts of relevant articles, following the guidance framework for scoping reviews by the Joanna Briggs Institute. From the 4263 titles identified, we included 224 articles from 103 countries. China (40), India (27), and Kenya (23) had the highest number of publications respectively. Of the three domains of timeliness, the most studied domain was ‘delayed vaccination’ [99.5% (223/224)], followed by ‘early vaccination’ [21.9% (49/224)], and ‘untimely interval vaccination’ [9% (20/224)]. Definitions for early (seven different definitions), untimely interval (four different definitions), and delayed vaccination (19 different definitions) varied across the studies. Most studies [72.3% (166/224)] operationalised vaccination timeliness as a categorical variable, compared to only 9.8% (22/224) of studies that operationalised timeliness as continuous variables. A large proportion of studies [47.8% (107/224)] excluded the data of children with no written vaccination records irrespective of caregivers’ recall of their vaccination status. Our findings show that studies on vaccination timeliness in LMICs has measurement and methodological gaps. We recommend the development and implement of guidelines for measuring and reporting vaccination timeliness to bridge these gaps.

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Using data to guide policy: Next steps for preventing perinatal hepatitis B virus transmission in Cambodia

Cited by 4 publications

References 9 publications

Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: Opportunities to engage the private sector

Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: Opportunities to engage the private sector

Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy

Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978–2021: A scoping review to map measurement and methodological gaps

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