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

Vaccine. 2012 Dec 17;31(1):149-53. doi: 10.1016/j.vaccine.2012.10.079. Epub 2012 Nov 3.

Abstract

Background: Cambodia is highly endemic for hepatitis B virus (HBV) infection. Preventing perinatal HBV transmission should be prioritized in health facilities by providing hepatitis B vaccination to all infants within 24 h of birth (timely birth dose coverage).

Methods: Teams assessed birth dose policy, practices and coverage in hospitals and health facilities in 10 provinces in Cambodia.

Results: Fifty-one sites were assessed. Median (interquartile range) timely birth dose coverage was 66% (48-92%); coverage was 88% (range=60-96%) in facilities vaccinating on-site and 48% (range=20-52%) in those referring off-site (p<0.0001). Overall, 5 (29%) of 16 hospitals that referred vaccination off-site did not tell mothers vaccination should take place within 24 h of birth, and 6 (35%) discharged mothers when no vaccination services were available for infants to receive the birth dose.

Conclusions: Newborns can miss a time-sensitive opportunity to be protected against perinatal HBV infection when they are referred for vaccination off-site rather than being vaccinated in the delivery facility. These data support the case to strengthen policies and practices to provide hepatitis B birth dose vaccination in the delivery facility.

MeSH terms

  • Cambodia / epidemiology
  • Female
  • Hepatitis B / epidemiology
  • Hepatitis B / immunology*
  • Hepatitis B / prevention & control
  • Hepatitis B / transmission*
  • Hepatitis B virus / pathogenicity*
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / prevention & control