The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu
The effectiveness of the infant hepatitis B immunisation program in Fiji, Kiribati, Tonga and Vanuatu
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DOI：
10.1016/s0264-410x(00)00080-3
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发表时间：
2000-07-01
期刊：
影响因子：
5.5
通讯作者：
Locarnini, S
中科院分区：
文献类型：
--
作者：
Wilson, N;Ruff, TA;Locarnini, S
该项目的目的是：(1) 确定婴儿乙型肝炎免疫接种在多大程度上预防生活在太平洋岛国样本中的儿童慢性乙型肝炎感染； (2) 确定与成功预防这些人群乙型肝炎感染相关的因素。 1995年开始向10个太平洋岛国提供乙型肝炎疫苗的区域乙型肝炎免疫项目。1998年初在斐济、基里巴斯、汤斯和瓦努阿图进行了血清流行病学调查。调查对象包括已免疫的学龄前儿童及其亲生母亲，以及历史对照组的未免疫学生。学生、母亲及其学龄前儿童人群中乙型肝炎表面抗原（HBsAg）的患病率分别为： 斐济：6.9%、6.6%、0.7%；基里巴斯：27.4、15.1、3.8%；汤加：11.1。 18.6, 3.8%;瓦努阿图：16.3、12.31 3.0%，所有四个国家：13.2、12.5、2.6%。与历史对照组学生相比，学龄前人群的 HBsAg 阳性概率要低得多（相对风险 [RR]=0.19 [95% CI: 0.12-0.31]）。所有国家的风险在统计上均存在显着差异：斐济：RR=0.10；基里巴斯：RR=0.14；汤加：RR=0.34；瓦努阿图：RR=0.19。这相当于减少慢性携带的整体计划有效性为 81%（95% CI：69-88%）。此外，对于暴露于 HBeAg 阳性和阴性携带者母亲的儿童中导致 HBsAg 阳性的乙型肝炎垂直传播的总体保护效果估计为 70%。到 6 个月大时，所有儿童都应接种三剂疫苗，完成免疫率范围为 22%（斐济）至 84%（瓦努阿图）。出生后 2 天内接种第一剂的覆盖率从基里巴斯的 43% 到汤加的 92% 不等。总之，这四个国家的婴儿乙型肝炎免疫对于预防慢性乙型肝炎感染具有显着的有益作用。尽管如此，进一步提高免疫接种的及时性仍有很大的空间。 (C) 2000 Elsevier Science Ltd. 保留所有权利。
The aims of this project were: (1) to determine the extent to which infant hepatitis B immunisation is preventing chronic hepatitis B infection in children living in a sample of Pacific Island countries; and (2) to identify factors associated with the successful prevention of hepatitis B infection in these populations. A regional hepatitis B immunisation project which supplied hepatitis B vaccine to 10 Pacific Island countries began in 1995. Seroepidemiological surveys were conducted in Fiji, Kiribati, Tongs and Vanuatu in early 1998. These included immunised pre-school children and their biological mothers, and a historical control group of unimmunised students. Prevalence rates for hepatitis B surface antigen (HBsAg) in the populations of students, mothers and their pre-school children were respectively: Fiji: 6.9, 6.6, 0.7%; Kiribati: 27.4, 15.1, 3.8%; Tonga: 11.1. 18.6, 3.8%; Vanuatu: 16.3, 12.31 3.0% and for all four countries: 13.2, 12.5, 2.6%. Compared to the historical control group of students, the pre-school population had a much lower probability of HBsAg positivity (relative risk [RR]=0.19 [95% CI: 0.12-0.31]). Statistically significant differences in risk were apparent for all the countries: Fiji: RR=0.10; Kiribati: RR=0.14; Tonga: RR=0.34; Vanuatu: RR=0.19. This is equivalent to an overall program effectiveness of 81% (95% CI: 69-88%) in reducing chronic carriage. Also, the overall protective effectiveness against vertical hepatitis B transmission resulting in HBsAg positivity among children exposed to HBeAg positive and negative carrier mothers, was estimated to be 70%. By age 6 months, when all children should have had three vaccine doses, completed immunisation rates ranged from 22 (Fiji) to 84% (Vanuatu). Coverage of the first dose being given within 2 days of birth varied from 43% in Kiribati to 92% in Tonga. In conclusion hepatitis B immunisation of infants in these four countries is having a substantial beneficial effect in preventing chronic hepatitis B infection. Nevertheless, there is significant scope for further improving the timeliness of immunisation. (C) 2000 Elsevier Science Ltd. All rights reserved.