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Immunosurveillance and molecular detection of hepatitis B virus infection amongst vaccinated children in the West Gonja District in Savanna Region of Ghana.

ABSTRACT: Hepatitis B vaccination is the most effective preventive measure in reducing the incidence of chronic hepatitis B virus (HBV) infection and its consequences such as cirrhosis, hepatocellular carcinoma, liver failure and death. Ghana introduced the universal HBV vaccination in the national Expanded Programme on Immunization in 2002. The current study sought to determine the sero-protection rate and the prevalence of HBV infection among fully vaccinated children in the West Gonja District in the Savanna Region of Ghana. This cross-sectional study recruited three hundred and fifty (350) fully vaccinated children who visited West Gonja Catholic Hospital from September to December 2019 for healthcare. Structured questionnaires were administered to obtain information on the demographics. The clinical history of the participants was obtained from the hospital records. Sera were separated from 2-5ml of blood sample collected from each participant after informed consent had been sought from their parents/guardians. Sera were tested for HBsAg, anti-HBs and anti-HBc using ELISA. Samples positive for HBsAg or anti-HBc were tested for HBV DNA by Real-Time Polymerase Chain Reaction. The overall sero-protection rate (anti-HBs titers ≥ 10 mIU/mL) among the studied participants was 56% with anti-HBs geometric mean titer (GMT) of 95.7 mIU/mL (± 6.0; 95% CI) compared with GMT of 2.8 mIU/mL (± 0.2; 95% CI) among non-seroprotected participants. There was no statistically significant difference in sero-protection rate between males and females (p-value = 0.93) and in relation to age (p-value = 0.20). The prevalence of HBV infection among studied participants as determined by the HBV DNA/HBsAg positivity was 1.4% while anti-HBc sero-positivity was 2%. Even though the sero-protection rate and HBV infection rate reported in the current study compares with that of other international studies further studies need to be conducted to understand the factors related to sero-protection and HBV infection rate in the Savanna Region of Ghana.

SUBMITTER: Quaye T

PROVIDER: S-EPMC8448355 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundHBV infection affects about 257 million people globally and Sub-Saharan Africa has the highest burden. The disease still constitutes a major public health problem despite the advent of preventive measures like the HBV vaccine. This study was aimed at identifying factors that influence vaccine uptake and the efficacy of administered vaccines among people at high risk of HBV infection.MethodsThis was a cross-sectional study conducted between January 2016 and December 2017. A pretested semi-structured questionnaire was used to capture information on sociodemographic and vaccination status from healthcare workers, household and sexual contacts to HBV infected people. HBV serological panel as well as quantitative anti-HBs ELISA test was done for all participants. Additional information was obtained from the institutions that administered the vaccines.ResultsA total of 265 participants with a mean age of 32.1±8.7 were enrolled. Eighty (30.2%) of them had received at least 1 dose of the HBV vaccine while 185 (69.8%) were unvaccinated. Healthcare workers were the most vaccinated (37%). Ignorance, negligence, fear of injection and the cost of the vaccine all contributed to poor vaccine uptake in the study population. Natural immunity was seen in 9 (3.4%) of the participants. Only 64.9% of the vaccinated participants attained the desirable level of anti-HBs (?10mIU/ml) 1-2 months after ? 3 doses of the vaccine. Age, gender, obesity, alcohol and smoking were not significantly associated with poor immune responses. No standardized protocol was followed by the institutions administering the vaccine.ConclusionThis study revealed very poor vaccine uptake and poor immune responses to the HBV vaccine in the study population and this should urge the health sector in Cameroon to intensify their sensitization on HBV vaccine, standardize the protocol for storing and administering the vaccine, subsidize the cost of the vaccine especially amongst healthcare workers and encourage anti-HBs post vaccination testing.

Project description:BackgroundChildhood immunization is one of the most cost effective health interventions but its rate has been declining recently in Ghana. Information on immunization coverage and determinants is needed to improve immunization programmes. The objective of this study was to determine the prevalence and factors associated with incomplete immunization of children (12-23 months) in Kwabre East District, Ghana.MethodsA cross-sectional, community-based survey involving 322 children and their mothers was carried out. Data were collected on socio-demographic characteristics of mothers, childhood immunization history and mothers' knowledge and practices of immunization using a structured questionnaire. Children were classified as incompletely immunized if they failed to receive at least one of 8 vaccine doses: - one dose of Bacillus Calmette-Guérin (BCG), 3 doses each of pentavalent, 3 doses of polio and one dose of measles per WHO/UNICEF definition. Chi-square and logistic regression analyses were used to identify the factors associated with incomplete immunisation.ResultsThe prevalence of incomplete immunization was low (15.5%) suggesting high immunisation coverage but the coverage of the second measles dose, taken at 18 months of age, was the lowest (23.9%). Most of the mothers knew the importance of immunisation (95.7%) and at least one vaccine-preventable disease or symptom (84.9%). Two factors associated with incomplete immunisation in bivariate analyses (community of residence, and mother's knowledge of number of oral polio vaccines given to children) were no longer significant in a logistic regression model. Compared to children in Aboaso, children in Gyamfi Wonoo (AOR = 1.81, 95% CI = 0.80-4.08), Mamponteng (Bonwunu) (AOR = 0.59, 95% CI = 0.24-1.48) and Mamponteng (Town) (AOR = 0.63, 95% CI = 0.26-1.55) had similar odds of incomplete immunisation. Similarly, mother's lack of knowledge of the number of doses of polio vaccine given to children had no effect on the odds of incomplete immunisation (AOR = 0.53, 95% CI = 0.22-1.26).ConclusionsImmunization coverage is high in the Kwabre East district but very few children received the second measles dose. None of the maternal and child factors assessed is associated with immunisation coverage. Further research is needed to identify the determinants of immunisation coverage and the reasons for the low uptake of second measles dose in the study area.

Project description:There is limited knowledge on cost of treating malaria in children under-five years in northern Ghana which poses a challenge in determining whether interventions such as the National Health Insurance Scheme (NHIS) and Community-based Health Planning and Services (CHPS) have reduced the economic burden of malaria to households or not. This study examined the malaria care seeking and cost of treatment in children under-five years in the Upper West Region of Ghana.The study used a cross-sectional, quantitative design and data were collected between July and August 2016 in three districts in the Upper West Region of Ghana. A total of 574 women who had under-five children were interviewed. Socio-demographic characteristics of respondents, malaria seeking patterns for under-five children with malaria as well as direct medical and non-medical costs associated with treating under-five children with malaria were collected from the patient perspective. Analysis was performed using STATA 12.Out of 574 women visited, about 63% (360) had children who had malaria and sought treatment. Most treatment was done at formal health facilities such as the health centres (37%) and the CHPS (35%) while 3% had self-treatment at home. The main reason for choice of place of treatment outside home was nearness to home (53%). The average direct medical and non-medical costs associated with treating an under-five child with malaria were US$4.13 and US$3.04 respectively. The average cost on transportation alone was US$2.64. Overall, the average direct medical and non-medical cost associated with treating an under-five child with malaria was US$4.91(range: minimum = US$0.13 -maximum = US$46.75). Children who were enrolled into the NHIS paid an average amount of US$4.76 compared with US$5.88 for those not enrolled, though the difference was not statistically significant (p-value = 0.15).The average cost to households in treating an under-five child with malaria was US$4.91. This amount is considerably high given the poverty level in the area. Children not insured paid a little over one US dollar for malaria treatment compared to those insured. Efforts to improve enrolment into the NHIS may be needed to reduce the cost of malaria treatment to households. Construction of more health facilities near to community members and at hard to reach areas will improve access to health care and reduce direct non-medical cost such as transportation costs.

Project description:IntroductionHepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana.MethodsWe administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention.ResultsThe students had moderate median scores for knowledge (12.00; IQR = 10-13) and attitude (6.00; IQR = 5.00-7.00) but a poor median score (5.00; IQR = 4.00-6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention.ConclusionThe KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students.

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Immunosurveillance and molecular detection of hepatitis B virus infection amongst vaccinated children in the West Gonja District in Savanna Region of Ghana.

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