Hepatitis B surface antigen seroprevalence among pre- and post-vaccine cohorts in Cambodia, 2017

Vichit Ork; Joseph Woodring; Md Shafiqul Hossain; Annemarie Wasley; Shintaro Nagashima; Chikako Yamamoto; Channarena Chuon; Aya Sugiyama; Masayuki Ohisa; Tomoyuki Akita; Ko Ko; Bunsoth Mao; Junko Tanaka

doi:10.1016/j.vaccine.2019.06.073

Hepatitis B surface antigen seroprevalence among pre- and post-vaccine cohorts in Cambodia, 2017

Vaccine. 2019 Aug 14;37(35):5059-5066. doi: 10.1016/j.vaccine.2019.06.073. Epub 2019 Jul 5.

Authors

Affiliations

¹ National Immunization Programme, Ministry of Health, 151-152 Kampuchea Krom Avenue, Phonm Penh, Cambodia. Electronic address: orkvichit@yahoo.com.
² Expanded Programme on Immunization, World Health Organization Regional Office for the Western Pacific, 1000 Manila, Philippines. Electronic address: woodringj@who.int.
³ Expanded Programme on Immunization, World Health Organization Country Office, Cambodia. Electronic address: hossains@who.int.
⁴ Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States. Electronic address: acw5@cdc.gov.
⁵ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: s-nagashima@hiroshima-u.ac.jp.
⁶ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: c-yamamoto@hiroshima-u.ac.jp.
⁷ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: chuonchannarena@rocketmail.com.
⁸ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: aya-sugiyama@hiroshima-u.ac.jp.
⁹ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: ohisam@hiroshima-u.ac.jp.
¹⁰ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: tomo-akita@hiroshima-u.ac.jp.
¹¹ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: d161800@hiroshima-u.ac.jp.
¹² University of Health Sciences, 73 Monivong Boulevard, Phnom Penh, Cambodia. Electronic address: maobunsoth@uhs.edu.kh.
¹³ Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: jun-tanaka@hiroshima-u.ac.jp.

Abstract

Background: Hepatitis B virus (HBV) infection is highly endemic in most low income countries including Cambodia. This nationwide serosurvey was conducted to assess the impact of hepatitis B vaccination and to determine whether Cambodia met the WHO regional 2017 target of hepatitis B surface antigen (HBsAg) seroprevalence less than 1% in five-year-old children.

Methods: A cross-sectional multi-stage cluster survey was conducted among children born during 2010-2012 and their mothers in Cambodia. HBsAg prevalence was estimated by rapid point-of-care testing, and demographic data, including vaccination history, was collected. Vaccine coverage in children and the prevalence of HBsAg among children and mothers was calculated taking into account the complex survey design. Factors associated with children's failure to receive timely (within 24 h) vaccination were analysed by multivariate logistic analysis.

Findings: A total of 2,520 children 5-7 years old and 2,028 mothers were recruited. In total, 78.4% of children received hepatitis B vaccination birth-dose (HepB-BD); of these, 58.7% were administered ≤ 24 h. Birth at home or "other" location were independent risk factors for children's failure to receive timely HepB-BD. Overall HBsAg seroprevalence was 4.39% (95%CI: 3.53%-5.45%) among mothers and 0.56% (95%CI: 0.32%-0.98%) among children. The prevalence among children without hepatitis B vaccination was 4.62% (95%CI: 1.31%-14.97%). Among children with a HBsAg-positive mother, prevalence was 10.11% (95%CI: 5.41%-18.11%).

Interpretation: Having achieved the 2017 target of less than 1% HBsAg prevalence among 5 years old children, Cambodia can now focus on eliminating mother-to-child transmission of HBV. Moreover, the high HBsAg prevalence among mothers suggests that routine screening with proper linkage to care and treatment is needed. Strengthening measures to improve vaccination coverage further and eliminate mother-to-child transmission by coordinated programming with other services offering additional HBV interventions will help move towards the global goal of hepatitis B elimination by 2030.

Funding: As per sources of funding.

Keywords: Cambodia; Hepatitis B virus; Seroprevalence; Vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cambodia / epidemiology
Child
Child, Preschool
Cohort Studies
Cost of Illness
Cross-Sectional Studies
Female
Hepatitis B / epidemiology*
Hepatitis B / immunology
Hepatitis B Antibodies / blood*
Hepatitis B Surface Antigens / immunology*
Hepatitis B Vaccines / administration & dosage
Hepatitis B Vaccines / immunology*
Hepatitis B virus
Humans
Infectious Disease Transmission, Vertical / prevention & control
Male
Middle Aged
Mothers / statistics & numerical data
Prevalence
Seroepidemiologic Studies
Surveys and Questionnaires
Vaccination Coverage / statistics & numerical data
Young Adult

Substances

Hepatitis B Antibodies
Hepatitis B Surface Antigens
Hepatitis B Vaccines

Grants and funding

001/WHO_/World Health Organization/International