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Impact of universal preadolescent vaccination against hepatitis B on antenatal seroprevalence of hepatitis B markers in British Columbia women.

ABSTRACT: Countries with a low risk of hepatitis B (HB) lack data on the effectiveness of universal HB vaccination programs for children. British Columbia began a program in 1992, offering HB vaccination to 11 year olds. We conducted an anonymous, unlinked serologic survey 7 years later, analyzing a random sample of specimens (n = 1215) from women aged 15-44 years who had undergone antenatal rubella testing. Among those aged 15-19 years inclusive there was no evidence of chronic HB (HB surface antigen), the proportion with evidence of acute HB (anti-HB core antibody) was only 0.6% (compared with 6.5% for the entire sample), and evidence of protective immunity was strong: the prevalence of anti-HB surface antibody (anti-HBs) was 79.1% (compared with 41.4% for the entire sample) and the geometric mean titre was 34.9 IU/mL (compared with 0.6-0.8 IU/mL for the older groups [p < 0.001]).

SUBMITTER: Dawar M

PROVIDER: S-EPMC154915 | biostudies-literature | 2003 Mar

REPOSITORIES: biostudies-literature

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Impact of universal preadolescent vaccination against hepatitis B on antenatal seroprevalence of hepatitis B markers in British Columbia women.

Dawar Meenakshi M Patrick David M DM Bigham Mark M Cook Darrel D Krajden Mel M Ng Helen H

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20030301 6

Countries with a low risk of hepatitis B (HB) lack data on the effectiveness of universal HB vaccination programs for children. British Columbia began a program in 1992, offering HB vaccination to 11 year olds. We conducted an anonymous, unlinked serologic survey 7 years later, analyzing a random sample of specimens (n = 1215) from women aged 15-44 years who had undergone antenatal rubella testing. Among those aged 15-19 years inclusive there was no evidence of chronic HB (HB surface antigen), t ...[more]

PMID: 12642425

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Project description:BackgroundWomen living with hepatitis C virus (HCV) are rarely addressed in research and may be overrepresented within key populations requiring additional support to access HCV care and treatment. We constructed the HCV care cascade among people diagnosed with HCV in British Columbia, Canada, as of 2019 to compare progress in care and treatment and to assess sex/gender gaps in HCV treatment access.MethodsThe BC Hepatitis Testers Cohort includes 1.7 million people who tested for HCV, HIV, reported cases of hepatitis B, and active tuberculosis in BC from 2000 to 2019. Test results were linked to medical visits, hospitalizations, cancers, prescription drugs, and mortality data. Six HCV care cascade stages were identified: (1) antibody diagnosed; (2) RNA tested; (3) RNA positive; (4) genotyped; (5) initiated treatment; and (6) achieved sustained virologic response (SVR). HCV care cascade results were assessed for women, and an 'inverse' cascade was created to assess gaps, including not being RNA tested, genotyped, or treatment initiated, stratified by sex.ResultsIn 2019, 52,638 people with known sex were anti-HCV positive in BC; 37% (19,522) were women. Confirmatory RNA tests were received by 86% (16,797/19,522) of anti-HCV positive women and 83% (27,353/33,116) of men. Among people who had been genotyped, 68% (6756/10,008) of women and 67% (12,640/18,828) of men initiated treatment, with 94% (5023/5364) of women and 92% (9147/9897) of men achieving SVR. Among the 3252 women and 6188 men not yet treated, higher proportions of women compared to men were born after 1975 (30% vs. 21%), had a mental health diagnosis (42% vs. 34%) and had used injection drugs (50% vs. 45%). Among 1619 women and 2780 men who had used injection drugs and were not yet treated, higher proportions of women than men used stimulants (64% vs. 57%), and opiates (67% vs. 60%).ConclusionsWomen and men appear to be equally engaged into the HCV care cascade; however, women with concurrent social and health conditions are being left behind. Treatment access may be improved with approaches that meet the needs of younger women, those with mental health diagnoses, and women who use drugs.

Project description:BackgroundThere are growing concerns that antenatal corticosteroid administration may harm children's neurodevelopment. We investigated the safety of antenatal corticosteroid administration practices for children's overall developmental health (skills and behaviors) at early school age.Methods and findingsWe linked population health and education databases from British Columbia (BC), Canada to identify a cohort of births admitted to hospital between 31 weeks, 0 days gestation (31+0 weeks), and 36+6 weeks, 2000 to 2013, with routine early school age child development testing. We used a regression discontinuity design to compare outcomes of infants admitted just before and just after the clinical threshold for corticosteroid administration of 34+0 weeks. We estimated the median difference in the overall Early Development Instrument (EDI) score and EDI subdomain scores, as well as risk differences (RDs) for special needs designation and developmental vulnerability (<10th percentile on 2 or more subdomains). The cohort included 5,562 births admitted between 31+0 and 36+6 weeks, with a median EDI score of 40/50. We found no evidence that antenatal corticosteroid administration practices were linked with altered child development at early school age: median EDI score difference of -0.5 [95% CI: -2.2 to 1.7] (p = 0.65), RD per 100 births for special needs designation -0.5 [-4.2 to 3.1] (p = 0.96) and for developmental vulnerability of 3.9 [95% CI:-2.2 to 10.0] (p = 0.24). A limitation of our study is that the regression discontinuity design estimates the effect of antenatal corticosteroid administration at the gestational age of the discontinuity, 34 + 0 weeks, so our results may become less generalisable as gestational age moves further away from this point.ConclusionsOur study did not find that that antenatal corticosteroid administration practices were associated with child development at early school age. Our findings may be useful for supporting clinical counseling about antenatal corticosteroids administration at late preterm gestation, when the balance of harms and benefits is less clear.

Project description:BackgroundViral hepatitis is an emerging global health problem. A pregnant mother infected with the hepatitis B virus has a high rate of vertical transmission, causing adverse fetal and neonatal outcomes. Understanding the magnitude of the problem and associated factors has paramount importance to avert such adverse fetal and neonatal outcomes. Therefore, the main aim of this study was to assess the seroprevalence of hepatitis B virus and associated factors among pregnant women attending antenatal care clinics at public health facilities in Nekemte town.MethodsAn institutional-based cross-sectional study was conducted among 277 pregnant women attending antenatal care at public health facilities in Nekemte town from June 1 to July 30, 2020. All public health institutions in Nekemte town (two hospitals and one health center) were recruited, and study participants were selected by using a systematic sampling method. The data were collected using pretested and structured questionnaires using a face-to-face interview, and a blood sample was collected to test for hepatitis B surface antigen. Logistic regression analysis was employed to identify factors significantly associated with hepatitis B virus infection. Variables with a p value < 0.05 were considered statistically significant predictors of the outcome variable.ResultThe overall seroprevalence of hepatitis B virus infection was 16 (5.8%) [95% CI: 3.2-8.7], which indicates intermediate endemicity. History of abortion (AOR =6.155; 95% CI: 1.780, 21.291), history of contact with hepatitis patient (AOR =7.178; 95% CI: 1.702, 30.279), and having multiple sexual partners (AOR =6.788; 95% CI: 1.701, 27.086) had a statistically significant association with hepatitis B surface antigen seropositivity.ConclusionHepatitis B virus seroprevalence among pregnant women in this study shows intermediate endemicity. Therefore, health professionals should provide health information on the risk of having multiple sexual partners, risk factors of unprotected contact with hepatitis patients, and abortion for pregnant women during their antenatal care visits.

Dataset Information

Impact of universal preadolescent vaccination against hepatitis B on antenatal seroprevalence of hepatitis B markers in British Columbia women.

Publications

Impact of universal preadolescent vaccination against hepatitis B on antenatal seroprevalence of hepatitis B markers in British Columbia women.

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