The impact of a Hepatitis B birth dose vaccine on HBV immunogenicity and incidence in children in the DRC

乙型肝炎出生剂量疫苗对刚果民主共和国儿童乙型肝炎免疫原性和发病率的影响

• 批准号: 10455457
• 负责人: Samantha Tulenko
• 金额: $ 3.96万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10455457
• 关键词: AIDS/HIV problem; Adopted; Africa South of the Sahara; African; Age; Age-Months; Asia; Birth; Blood; Categories; Cause of Death; Cessation of life; Child; Childbirth; Childhood; Childhood Acute Lymphocytic Leukemia; Chronic Hepatitis; Communicable Diseases; Communities; Data; Data Analyses; Democratic Republic of the Congo; Development; Disease; Doctor of Philosophy; Dose; Effectiveness; Epidemiologic Methods; Epidemiology; Fellowship; Future; Government; Grant; HIV; Health; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Incidence; Hepatitis B Infection; Hepatitis B Prevalence; Hepatitis B Transmission; Hepatitis B Vaccines; Horizontal Disease Transmission; Hour; Household; Immunity; Immunology; Incidence; Infant; Infant Health; Infection; Infectious Disease Epidemiology; Intervention; Intervention Studies; Knowledge; Life; Malaria; Measures; Mentors; Modeling; Morbidity - disease rate; Mothers; Newborn Infant; North Carolina; Physicians; Policies; Postdoctoral Fellow; Province; Randomized; Research; Schedule; Scientist; Series; Spottings; Training; Tuberculosis; Universities; Vaccinated; Vaccines; Vertical Disease Transmission; Viral hepatitis; burden of illness; career; cohort; epidemiological model; global health; immunogenicity; infant infection; interest; intervention program; markov model; mathematical model; member; mortality; prevent; protective efficacy; secondary analysis; skills; translational study; vaccination schedule; vaccinology

PROJECT SUMMARY Over the past few decades, viral hepatitis has become a leading cause of death globally, causing more deaths each year than malaria, HIV/AIDS, or tuberculosis. When considering Hepatitis B (HBV), this large burden of disease is largely driven by childhood infections, as 90% of infants infected with HBV will develop chronic hepatitis with lifelong sequelae. Childhood HBV infection occurs through vertical transmission (from mothers to children during childbirth) and through horizontal transmission (between members of the same household or community). In sub-Saharan Africa (SSA), where HBV remains endemic, children are vaccinated against HBV at 6, 10, and 14 weeks of age. This schedule does not protect against vertical transmission, and an estimated 1% of newborns (367,250 infants) in SSA continue to be infected with HBV at birth each year. Administration of the monovalent HBV vaccine at birth has been shown to have up to 95% protective efficacy against vertical transmission in the WHO Western Pacific region. However, few studies have been conducted to characterize the potential impact of providing a birth dose of HBV vaccine in sub-Saharan African settings. Our partners for this project, the Ministry of Health in the Democratic Republic of the Congo (DRC) are particularly interested in understanding whether to adopt a national HBV birth dose intervention. This translational study will provide estimates of the effectiveness and impact of a 4-dose HBV vaccine series (including a birth dose) in the DRC. The proposed research will utilize previously collected data and dried blood spots from two trials in Kinshasa Province, DRC: the Birth Dose Immunogenicity Study and the Continuous Quality Improvement Study. Using advanced epidemiological methods and mathematical modeling, this proposal aims to 1) compare the proportion of infants who achieve protective immunity to HBV at 12 months of age by vaccine dose series and mothers' HBV and HIV status and 2) model the impact of adopting a national 4-dose HBV vaccine series, including the birth dose, on the incidence of HBV in children under 5 in the DRC. The results will provide valuable estimates of the immunogenicity and potential impact of an HBV birth dose that will inform vaccine policy in the DRC and greater sub-Saharan African region. Through the completion of these research aims, the trainee will gain a unique set of skills in advanced epidemiologic methods, mathematical modeling, and vaccine intervention research. Expert mentors in vaccinology, immunology, modeling, and epidemiology will support the trainee's successful completion of the proposed research, associated training plan, and MD/PhD degree at the University of North Carolina at Chapel Hill. This F30 fellowship will aid the applicant's development as a future interdisciplinary physician-scientist practicing at the intersection of infectious disease, infant health, and interventional epidemiology.

项目总结