Serum level of anti-hepatitis B surface antigen 6-8 years after hepatitis B vaccination at birth.

The duration of protection after hepatitis B vaccination in children is unknown. We determined the serum level of antibody to hepatitis B surface antigen (anti-HBsAg) in 273 randomly selected 7-9-year-old schoolchildren from Zanjan City, Islamic Republic of Iran, who had been fully vaccinated against hepatitis B starting at birth. Titres < or = 10 mlU/mL were considered unprotective. Just over half of the children (52%) had titres < or = 10 mlU/mL with no difference between the sexes, while 81 (29.7%) had no anti-HBsAg (0 mlU/mL). Three of the children had antibodies to hepatitis B core protein. More studies are needed to determine the necessity for or timing of booster doses.

Breast-feeding patterns and factors determining exclusive breast-feeding.

INTRODUCTION: Breast-feeding is a major determinant of infants' health and survival. The aim of this study was to examine breast-feeding patterns and the role of some factors on exclusive breast-feeding. METHODS: The study was done at the Health Centre of Community Oriented Medical Education of Zanjan City, Iran. Mothers of 650 infants younger than one year of age were interviewed directly by healthcare providers. The necessary information was recorded on pre-structured questionnaires, and the feeding patterns of all infants were determined. RESULTS: The rate of breast-feeding was greater than 92 percent during the first year of life. Exclusive breast-feeding rate in the first five days of life was 82 percent, but it declined to 44 percent at the first month. The chance of exclusive breast-feeding was higher in infants who were on demand feeding (odds ratio [OR] 2.6), breastfed more than eight times per day (OR 2.23), and their birth weight ranged from 2.5 to 4 kg (OR 2.16). This chance was less among infants exposed to pacifiers (OR 2.62) and with the numbers of deliveries equal to or more than three (OR 2.25). CONCLUSION: The rates of breast-feeding initiation and its duration at six and 12 months were higher than the national goal. The rate of exclusive breast-feeding was nearly 44 percent. It seems necessary to elucidate the role of other factors, such as socioeconomic status, on exclusive breast-feeding.

Evaluation of neonatal indirect hyperbilirubinaemia at Zanjan Province of Iran in 2001-2003: prevalence of glucose-6-phosphate dehydrogenase deficiency.

INTRODUCTION: Neonatal hyperbilirubinaemia, defined as a total serum bilirubin level above 5 mg/dL, is a frequent problem. This condition accounts for up to 75 percent of hospital readmissions in the first week of life. The purpose of this study was to evaluate the aetiology of indirect hyperbilirubinaemia and the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in newborns who were admitted to Vali-e-Asr Hospital in Zanjan City during the period 2001-2003. METHODS: Medical records of 376 newborns who had been admitted for management of indirect hyperbilirubinaemia were reviewed. All necessary information, including the results of G6PD activity test (expressed as unit per gramme haemoglobin), were recorded on standardised questionnaires. RESULTS: The subject group included 159 (42.3 percent) boys and 217 (57.7 percent) girls. The prevalence of sepsis, ABO incompatibility, Rhesus incompatibility, and cephalhaematoma, G6PD deficiency was 15.7 percent (59 neonates), 3.7 percent (14 neonates), 2.1 percent (eight neonates), 0.5 percent (two neonates), and 2.1 percent (eight neonates), respectively. The median (interquartile range) of the highest total bilirubin level was 18 (15.8-20) mg/dL and 18.4 (16.3-19.5) mg/dL in normal G6PD and G6PD-deficient newborns, respectively (p-value equals 0.7). CONCLUSION: We recommend performing G6PD testing in all Iranian and Mediterranean newborns with indirect hyperbilirubinaemia, unless other investigators ascertain and document that this is unnecessary as a routine test.

Serum level of anti-hepatitis B surface antigen 6-8 years after hepatitis B vaccination at birth

The duration of protection after hepatitis B vaccination in children is unknown. We determined the serum level of antibody to hepatitis B surface antigen [anti-HBsAg] in 273 randomly selected 7-9-year-old schoolchildren from Zanjan City, Islamic Republic of Iran, who had been fully vaccinated against hepatitis B starting at birth. Titres </= 10 mIU/mL were considered unprotective. Just over half of the children [52%] had titres </= 10 mIU/mL with no difference between the sexes, while 81 [29.7%] had no anti-HBsAg [0 mIU/mL]. Three of the children had antibodies to hepatitis B core protein. More studies are needed to determine the necessity for or timing of booster doses