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2.
MMWR Morb Mortal Wkly Rep ; 69(5): 136-139, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027629

RESUMO

On December 21, 2018 the Food and Drug Administration (FDA) licensed a hexavalent combined diphtheria and tetanus toxoids and acellular pertussis (DTaP) adsorbed, inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib) conjugate (meningococcal protein conjugate) and hepatitis B (HepB) (recombinant) vaccine, DTaP-IPV-Hib-HepB (Vaxelis; MCM Vaccine Company),* for use as a 3-dose series in infants at ages 2, 4, and 6 months (1). On June 26, 2019, after reviewing data on safety and immunogenicity, the Advisory Committee on Immunization Practices (ACIP)† voted to include DTaP-IPV-Hib-HepB in the federal Vaccines for Children (VFC) program.§ This report summarizes the indications for DTaP-IPV-Hib-HepB and provides guidance for its use.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Vacina Antipólio de Vírus Inativado/administração & dosagem , Pré-Escolar , Humanos , Esquemas de Imunização , Lactente , Licenciamento , Estados Unidos , Vacinas Combinadas/administração & dosagem , Vacinas Conjugadas/administração & dosagem
3.
Pan Afr Med J ; 33: 218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692718

RESUMO

Introduction: Hepatitis B is a major health concern in Ghana, where prevalence of the virus remains high and most chronic patients are infected during childhood or at birth. This study aimed to determine the prevalence and main factors associated with mother-to-child transmission of hepatitis B in the context of Ghana. Methods: In this cross-sectional pilot study, we tested infants born to hepatitis B positive mothers at a hospital in the Eastern Region of Ghana to determine the prevalence of mother-to-child transmission. A questionnaire was completed by hepatitis B positive mothers to investigate the association between factors surrounding the birth of the child and whether transmission had occurred. These factors were analyzed independently using Fisher's exact test. To investigate the relationship between mother's age at the time of delivery and viral transmission, a univariate logistic regression analysis was performed. Results: The prevalence of mother-to-child transmission was 5.9%, with 51 hepatitis B positive mothers included in the study and three infants testing positive. A majority of infants received the standard hepatitis B vaccination schedule (96.1%) while two-thirds received the birth dose. There was no significant association observed between the clinical interventions reported in the study and mother-to-child transmission. No significant association was observed between the age of the mother at the time of delivery and viral transmission (OR: 1.077, 95% CI: 0.828 - 1.403, p = 0.58). Viral marker testing during pregnancy was absent in the population and could not be reliably assessed. Conclusion: There was a low prevalence of HBV mother-to-child transmission observed despite a clear absence of viral marker and viral load testing. It is recommended that viral profile analysis is performed for hepatitis B positive pregnancies to identify high risk cases.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/virologia , Adulto , Estudos Transversais , Feminino , Gana , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Idade Materna , Projetos Piloto , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Carga Viral , Adulto Jovem
4.
BMC Health Serv Res ; 19(1): 796, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690313

RESUMO

BACKGROUND: Hepatitis B virus (HBV) infection is a global public health problem. The burden of the disease is high in low and middle income countries like Ethiopia. However, for highly vulnerable groups such as health professionals, vaccination coverage is a major issue in the developing countries where health professionals are expected to pay for vaccination. Therefore, the objective of this study was to assess health professionals' acceptance and willingness to pay (WTP) and associated factors for vaccination against HBV. METHODS: Cross-sectional study was conducted from March to April, 2017 in Gondar city administration governmental health institutions among 423 health professionals. Simple random sampling method was employed to select the study participants. Data were collected using self- administered questionnaire. Tobit model was used to analyze the determinants of WTP and the maximum amount of money the individuals might pay for HBV vaccination. P-value < 0.05 was considered statistically significant. RESULT: A total of 423 health professionals (physicians, nurses, midwives, laboratory technicians/technologists, and others) participated in the study with a response rate of 100, and 62.4% of them were willing to pay for HBV vaccination. The mean amount of money the participants might pay for HBV vaccination was 325.83 ± 283.46 ETB (US$ 14.39 ± 12.52). The study indicated that the WTP for HBV vaccination of health professionals from health centers was 179.41 ETB less compared to health professionals from hospital. The WTP for HBV vaccination of the participants who had no experience of seeing previous patients with HBV was 157.87 ETB less compared to participants who had experience of seeing previous patients with HBV. As monthly income of the study participants increased by one ETB, the WTP was increased by 0.027 ETB. CONCLUSION: The study revealed that the mean amount of money the participants might pay for HBV vaccination was much less than the market price for HBV vaccination. Type of workplace and experience of seeing/observing patients with HBV, and income were the predictors of WTP for HBV vaccination. Availing the vaccine with affordable cost in governmental health institutions may increase WTP of health professionals for HBV vaccination.


Assuntos
Pessoal de Saúde/psicologia , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/economia , Adulto , Estudos Transversais , Etiópia , Feminino , Instalações de Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Hepatite B/prevenção & controle , Hospitais Públicos/estatística & dados numéricos , Humanos , Governo Local , Masculino , Inquéritos e Questionários
5.
Arq Gastroenterol ; 56(4): 440-446, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721974

RESUMO

BACKGROUND: Although liver transplantation is considered to be a high-risk procedure, it is well-established as a treatment option for the cure and quality of life enhancement for individuals who suffer from diseases. Preventing an infection by hepatitis B virus through immunization schedules has been the most effective way to reduce complications, since it decreases the number of people who suffer from chronic hepatitis caused by the hepatitis B virus and eradicates its transmission. OBJECTIVE: 1. Analyzing evidence in the literature on various schedules employed for immunization against hepatitis B in patients who have received a liver transplantation. 2. Suggesting potential immunization schedules against hepatitis B in patients who suffer from liver cirrhosis, without previous verifying documentation, using the Child-Turcotte Pugh score, according to evidences found in the literature. METHODS: Systematic review of the literature, conducted on the data bases MedLine, PubMed, and Lilacs, between September, 2017 and January, 2018, by using the following keywords: "Liver Transplantation, "Immunization Schedule", "Hepatitis B Vaccines". In order to analyze the articles, a summary figure was especially designed and both the results and discussion were presented in a descriptive way. RESULTS: We included 24 studies; among them, eight had accelerated immunization schedules, 13 followed the conventional schedules, and three had super accelerated schedules. Regarding immunization, 21 studies were conducted with patients in the pre-transplant period, one with a transplanted patient, one with a pre-transplant group, and one with a post-transplant group. Found articles suggest that, disregarding the chosen immunization schedule, seroconversion rates tended to be lower as the liver disease advanced, compared to the healthy population. CONCLUSION: The studies did not find seroconversion superiority between the different immunization schedules (conventional and unconventional). However, since candidates to liver transplantation are usually very vulnerable, results show that super accelerated immunization schedules are possibly recommended for such group of patients; serologic test results will be higher when the immunization schedule is completed in the pre-transplant period.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Esquemas de Imunização , Transplante de Fígado , Vacinas contra Hepatite B/imunologia , Humanos
6.
BMC Infect Dis ; 19(1): 985, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752732

RESUMO

BACKGROUND: Vaccine escape mutants (VEMs) are one of the causes of breakthrough infections in the mother-to-child transmission of hepatitis B virus (HBV). We hypothesized that VEMs existing as minor populations in the maternal blood are associated with breakthrough infections in children. We sought to determine whether VEMs exist as minor populations in the preserved umbilical cords of children with breakthrough infections. CASE PRESENTATION: Two families (Family 1: three children, Family 2: two children) were enrolled. Despite immunoprophylaxis, a breakthrough infection occurred in two Family 1 children and two Family 2 children. Preserved umbilical cords, serum, and nails were used for the HBV DNA analysis. To detect VEMs, we performed direct and deep sequencing of hepatitis B surface antigen gene. The direct sequencing showed that there were no VEMs in the serum of the children or mother of Family 1 and family 2, but it identified a G145A mutant in the nails of the mother of Family 2. In Family 1, deep sequencing detected a T143S mutant as a minor population (1.7-2.0%) in the umbilical cords and serum of all three children and in the serum of the mother. A T126A mutant was also detected in the umbilical cord (9.2%) and serum (7.0%) of the first-born child of Family 1. In Family 2, the deep sequencing showed no VEMs in the umbilical cords, but it detected D144A (2.5%) and G145A (11.2%) mutants in the serum of the 2nd-born child. CONCLUSIONS: VEMs were present as minor populations in the preserved umbilical cords of children with breakthrough infections. The VEMs did not become major populations after the breakthrough infections. The evolution of VEMs from a minor form to a major form might not be a prerequisite for breakthrough infections in mother-to-child transmission.


Assuntos
Antígenos de Superfície da Hepatite B/genética , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Cordão Umbilical/virologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Hepatite B/prevenção & controle , Hepatite B/virologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/isolamento & purificação , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imunização , Masculino
7.
Orv Hetil ; 160(41): 1607-1616, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31587575

RESUMO

More than 200 million HBV surface antigen (HBsAg) positive, hepatitis B virus (HBV) carriers live worldwide. Health-care personnel have increasing risk for aquiring the HBV infection. An effective vaccine is available against the infection, however, a certain proportion of the vaccinated patients do not respond to the vaccine depending on certain factors. Therefore, vaccine-induced immunity (anti-HBs) should be tested at health-care workers. For nonresponders, there are other vaccination strategies to try to achieve protection. This recommendation also provides a guidance for postexposure prophylaxis following occupational exposures against HBV infection. This is the first Hungarian recommendation about this topic. Orv Hetil. 2019; 160(41): 1607-1616.


Assuntos
Pessoal de Saúde , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Vacinação , Comitês Consultivos , Hepatite B/transmissão , Humanos , Hungria , Imunização , Profilaxia Pós-Exposição , Guias de Prática Clínica como Assunto , Profilaxia Pré-Exposição
8.
J Med Microbiol ; 68(11): 1686-1693, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31592765

RESUMO

Introduction. Tunisia is an intermediate hepatitis B virus (HBV) endemic country. The vaccination against hepatitis B was introduced in 1995 including four doses with a first dose administrated at birth. Decreasing the level of antibodies against hepatitis B surface antigen (anti-HBs) over time can be alarming. This study was conducted to explore the anti-HBV immune response among children under 6 years old, vaccinated according to the national vaccination schedule, by evaluating the immunological response to primary vaccination and by exploring the anamnestic immune response to a booster dose.Methods. We conducted a cross-sectional prospective study from June 2016 to June 2017 (n=180), based on voluntary participation. Children were recruited from the public pediatric ward sectors in Sahloul University Hospital of Sousse in Central Tunisia. An anti-HB titre was determined based on electro-chemiluminescence micro-particle immunoassay (ECLIA), using Elecsys Anti-HBs II kit, Roche.Results. Mean age at the time of enrollment in the study was 33±14.8 months. The seroprotection rate was 77.2 %. The anti-HB titre differed significantly between the different age groups (P=0.002). The predicting variable for having no seroprotective antibody level was older age. Children with anti-HB levels <10 IU l- 1 were offered an additional dose of HBV vaccine. Anamnestic response 1 month after the challenge dose was observed in 100 % of subjects. The probability of developing a high antibody response, following the booster dose increased in conjunction with an increased pre-booster antibody level.Conclusion. The response to a booster dose suggests the persistence of immune memory in almost all vaccinated individuals. Although a booster dose increases substantially anti-HB titre, the clinical relevance of such an increase remains unknown.


Assuntos
Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/imunologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/administração & dosagem , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Memória Imunológica , Lactente , Masculino , Estudos Prospectivos , Tunísia , Vacinação
9.
Artigo em Inglês | MEDLINE | ID: mdl-31505743

RESUMO

Hepatitis B Virus (HBV) is a significant public health challenge. Around 250 million people live with chronic HBV infection. With a global approach to this issue, we focus on new perspective in diagnosis, management and prevention of HBV chronic infection. Precise diagnosis of HBV status is crucial to guide patient management. Although available drugs reduce the risk of liver disease progression, they are not able to definitely eradicate HBV, and new therapeutic options are urgently needed. Thus, prevention of HBV infection is still the most effective strategy to achieve the control of the disease. Key aspects of prevention programs include surveillance of viral hepatitis, screening programs and immunization strategies. In spite of the high success rate of licensed HBV vaccines, a need for improved vaccine persists, especially in order to provide coverage of current non-responders.


Assuntos
Hepatite B Crônica , Antivirais/uso terapêutico , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/prevenção & controle , Humanos , Imunização , Imunocompetência
10.
BMC Public Health ; 19(1): 1263, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510967

RESUMO

BACKGROUND: Although hepatitis B vaccinations have been integrated in the Universal Immunization Program (UIP) in India over a decade, only half of the children are immunized against hepatitis B. The national average in hepatitis B vaccination conceals large variations across states, districts and socio-economic groups. In this context, the aim of this paper is to examine the spatial heterogeneity and contextual determinants of hepatitis B vaccination across the districts of India. METHODS: Using data of 199,899 children aged 12-59 months from the National Family Health Survey-4 (NFHS-4), 2015-16 we have examined the district level spatial distribution and clustering of hepatitis B vaccination with the help of Moran's I and Local Indicator of Spatial Autocorrelation (LISA) measures. We investigated the low coverage of HBV vaccination using spatial autoregressive models (SAR) at the meso scale. And we applied multivariate binary logistic regression analysis to understand the micro-level predictors of hepatitis B vaccination. RESULTS: In 2015-16, 45% of the children aged 12-59 months were not vaccinated against hepatitis B in India. The coverage of hepatitis B vaccine across the districts of India showed a highly significant spatial dependence (Moran's I = 0.580). Bivariate Moran's I confirmed the spatial clustering of hepatitis B vaccination with mother's education, full antenatal care (ANC) utilization, post natal care (PNC) utilization, institutional births and registration of births at the district level. Districts with a very low coverage of HBV vaccine are clustered in the western, north-eastern regions and in some parts of central India. At the unit (child) level, children's hepatitis B immunization status is mostly determined by the socio-economic and demographic characteristics like their mother's educational status, caste, religion, household's wealth condition, birth order, year of birth and the region they belong to. CONCLUSIONS: District level variation in hepatitis B vaccination is spatially heterogeneous and clustered in India with a strong neighbourhood effect. Uptake of hepatitis B vaccine among Indian children is predominantly dependent upon their socio-economic and demographic characteristics.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Programas de Imunização/organização & administração , Índia , Lactente , Masculino , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Análise Espacial
11.
Public Health Rep ; 134(6): 651-659, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31539482

RESUMO

OBJECTIVES: Despite recommendations for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) for all adults at increased risk of infection, several US states have reported increases in HAV and HBV infections among persons who inject drugs. We investigated hepatitis A and hepatitis B vaccination coverage among a sample of persons who reported injecting drugs and had evidence of hepatitis C virus (HCV) infection. METHODS: We searched the Wisconsin Immunization Registry for the vaccination records of persons who underwent HCV testing at syringe services programs from January 1 through August 31, 2018, and were reported to the Wisconsin Division of Public Health as having positive HCV antibody test results and a history of injection drug use. We calculated the percentage of persons who were vaccinated according to national recommendations. RESULTS: Of 215 persons reported, 204 (94.9%) had a client record in the Wisconsin Immunization Registry. Of these 204 persons, 66 (32.4%) had received ≥1 dose of hepatitis A vaccine, 46 (22.5%) had received 2 doses of hepatitis A vaccine, and 115 (56.4%) had received 3 doses of hepatitis B vaccine. Hepatitis B vaccine coverage decreased with increasing age, from 88.0% (22 of 25) among adults aged 20-24 to 30.3% (10 of 33) among adults aged 35-39. CONCLUSIONS: These findings suggest that most persons who inject drugs in Wisconsin are susceptible to HAV infection and that most persons aged ≥35 who inject drugs are susceptible to HBV infection. In addition to routine vaccination of children, targeted hepatitis vaccination programs should focus on adults who inject drugs to help prevent future infections.


Assuntos
Hepatite A/epidemiologia , Hepatite B/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Adulto , Feminino , Vacinas contra Hepatite A/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/imunologia , Wisconsin/epidemiologia
12.
Rev Esp Quimioter ; 32(5): 432-439, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31558008

RESUMO

OBJECTIVE: The aim of the study was to describe the type of vaccines administered in the Vaccine Unit at a reference hospital. Calculate the overall and specific reporting rate of adverse reactions. METHODS: Retrospective observational study for the period between November 2014 and November 2017, on patients who developed an adverse drug reaction (ADR) after the administration of a vaccine and who were notified to the Spanish Pharmacovigilance System. The variables analyzed were age, sex, risk group, vaccine class, co-administration and type of ADR. A univariate and bivariate analysis was performed. The global and vaccine specific rate of ADR notification was calculated. RESULTS: A total of 18,123 vaccines were administered, of which 20.7% corresponded to hepatitis B virus vaccine. Fifty-three RAM suspects were reported. In 64.2% of cases only one vaccine was administered. Inactivated vaccines accounted for 88.7% of notifications. The highest number of notifications was generated by the 23 serotypes pneumococcal polysaccharide vaccine. The overall reporting rate was 0.42%. The hexavalent vaccine had the highest reporting rate (2.81%). 49.1% of the ADR were systemic. CONCLUSIONS: The overall reporting rate was low but higher than that of other authors. Proper reporting of possible adverse post-vaccine reactions is essential to contribute to vaccine safety and to increase public confidence in vaccines.


Assuntos
Hospedeiro Imunocomprometido , Farmacovigilância , Vacinas/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Criança , Pré-Escolar , Feminino , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/efeitos adversos , Estudos Retrospectivos , Espanha , Vacinas Estreptocócicas/administração & dosagem , Vacinas Estreptocócicas/efeitos adversos , Vacinas/administração & dosagem , Vacinas de Produtos Inativados/administração & dosagem , Vacinas de Produtos Inativados/efeitos adversos , Adulto Jovem
13.
BMC Health Serv Res ; 19(1): 627, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484515

RESUMO

BACKGROUND: In countries where hepatitis B virus (HBV) is endemic, including Senegal, the World Health Organization recommends systematic HBV screening of pregnant women and vaccination at birth to prevent mother-to-child transmission (MTCT). This study investigated healthcare workers' (HCW) knowledge and practices regarding HBV prevention and care in the rural region of Fatick in Senegal, as well as challenges they faced in implementing prevention activities related to HBV MTCT. METHODS: A mixed-methods survey was conducted between May-July 2017 among 112 HCW working in 15 healthcare facilities in two districts of the Fatick region using face-to-face questionnaires and semi-structured interviews. Descriptive statistics and chi-square/Mann-Whitney tests were used to analyze quantitative data, while qualitative data were analyzed thematically. RESULTS: The study population included 87 HCW in the quantitative component (83% women, median age [interquartile range, IQR] = 35 [31-40] years) and 11 in the qualitative component. A knowledge gap was observed in key areas of HBV infection: only 24, 51 and 38%, respectively, correctly reported that early HBV acquisition is associated with a high risk of developing chronic infection, that perinatal transmission is one of the main modes of HBV transmission in Senegal, and that three to four doses of HBV vaccine are required to ensure immunization in children. Despite good acceptability of systematic screening of pregnant women and vaccination at birth, only 48% of HCW mainly involved in prenatal care and 71% of those involved exclusively in vaccination routinely performed these two key interventions. HCW reported several structural barriers that may hinder their implementation: a lack of training in HBV and in counseling, poor availability of rapid diagnostic tests (RDT), high costs of both screening and treatment, a lack of adequate information on treatment options and missed opportunities for vaccination at birth. CONCLUSIONS: HCW working in the Fatick region may be insufficiently trained and supported to effectively implement HBV prevention strategies. Our findings suggest an urgent need to strengthen MTCT prevention in this region, by improving HCW knowledge in key areas of HBV infection, providing RDT and antiviral treatment at low cost, and enhancing community-based interventions for the timely vaccination of newborns.


Assuntos
Pessoal de Saúde/psicologia , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto , Atitude do Pessoal de Saúde , Feminino , Hepatite B/tratamento farmacológico , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , População Rural , Senegal/epidemiologia , Vacinação/estatística & dados numéricos
14.
Pan Afr Med J ; 33: 96, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489074

RESUMO

Introduction: Hepatitis B vaccination among healthcare workers (HCWs) in Ghana has not been actively pursued despite the endemicity of the infection. This study measures the hepatitis B vaccine uptake among HCWs at the University of Ghana Hospital, Legon (UGHL) and identifies the factors associated with vaccination. Methods: An analytical cross-sectional study involving all staff who have direct contact with patients was conducted. Self-administered questionnaires were used to collect data on vaccination status, age, sex, type of staff, duration of work in the facility, exposure to blood or blood products, blood stained linens/waste, sharp instruments and performance of invasive procedures. Data was analysed using STATA 14. Continuous variables were described using median values and interquartile ranges (IQR) and categorical variables as proportions. Bivariate and multivariate analysis were conducted to identify the factors associated with hepatitis B vaccination status. Results: Of the 161 participants interviewed, 63.4% were females with median age 35 years (IQR: 27-45). Eighty-six (53.4%) of the respondents had taken the hepatitis B vaccine with 79.1% of them having completed the vaccination schedule. Factors associated with vaccination were working for more than 16 years (OR: 3.8, CI: 1.02-12.72), daily exposure to blood/blood products (OR: 4.1, CI: 1.43-11.81) and sharp instruments (OR: 4.45, CI: 1.39- 14.24), performing invasive procedures daily (OR: 3.0, CI: 1.07-8.45) and frequent exposure to blood stained linens/waste (OR: 6.1, CI: 1.41-26.51). Conclusion: The lack of hepatitis B vaccination among some HCWs at UGHL puts them at risk of contracting hepatitis B infection.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Recursos Humanos em Hospital/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gana , Hepatite B/transmissão , Humanos , Esquemas de Imunização , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doenças Profissionais/prevenção & controle , Doenças Profissionais/virologia , Exposição Ocupacional/estatística & dados numéricos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
15.
Medicine (Baltimore) ; 98(32): e16401, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393348

RESUMO

Viral hepatitis is caused by different etiological agents with distinct epidemiological, clinical, and laboratory characteristics accounting for significant worldwide morbidity and mortality. Since 1996, the Brazilian Department of Sexually Transmitted Infections (STIs), Acquired Immune Deficiency Syndrome (AIDS) and Viral Hepatitis (DIAHV) in collaboration with the Ministry of Defense has been conducting periodic serosurveys of conscripts enlisted for the Brazilian army to assess STI prevalence and obtain data on knowledge and risk factors pertaining to STIs. This article aims to present the hepatitis B (hepatitis B surface antigen - HBsAg) and C (anti-HCV) seroprevalence estimates and risk factors as per the 8th edition of the Conscript Survey performed in 2016.This cross-sectional study was conducted among conscripts across Brazil aged 17 to 22 years from August to December 2016. It included a self-reported questionnaire and blood testing for syphilis, human immunodeficiency virus (HIV), and hepatitis B and C.In total 38,247 conscripts were enrolled; after applying exclusion criteria, 37,282 conscripts were included. The estimated HBsAg and anti-HCV prevalence rates were 0.22% and 0.28%, respectively. Higher HBsAg and anti-HCV prevalence rates were observed in the North Region (0.49%) and in the Central-west Region (0.65%), respectively. Regarding hepatitis B vaccination, 23.5% (n = 8412) of the individuals reported being unvaccinated and 47.4% (n = 16,970) did not know if they had been vaccinated. Among the anti-HCV positive conscripts, 53% (n = 51, 0.56%, P = .049) reported that they had never had sexual intercourse. Regarding self-reported STI status, most of the positive anti-HCV (n = 100, 0.29%, P < .01) and positive HBsAg (n = 76, 0.22%, P = .205) conscripts reported not having a STI. From those who tested positive for HBsAg, 89% (n = 42, 0.28%, P = .005) reported not making consistent use of condoms with steady partners.Our data suggest a low prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian young men, and relatively low rates of self-reported HBV immunization. History of STIs, higher number of partners, inconsistent use of condoms, and lack of awareness of routes of transmission were significantly associated with HBV and HCV infections. To achieve the World Health Organization's goal of viral hepatitis elimination, access to hepatitis information, testing, and surveillance need to be improved.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Fatores Etários , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/imunologia , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Hepatite C/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Militares/estatística & dados numéricos , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Doenças Sexualmente Transmissíveis/epidemiologia , Adulto Jovem
16.
MMWR Morb Mortal Wkly Rep ; 68(33): 718-723, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31437143

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11-12 years to protect against certain diseases, including human papillomavirus (HPV)-associated cancers, meningococcal disease, and pertussis (1). A booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended at age 16 years, and serogroup B meningococcal vaccine (MenB) may be administered to persons aged 16-23 years (1). To estimate vaccination coverage among adolescents in the United States, CDC analyzed data from the 2018 National Immunization Survey-Teen (NIS-Teen) which included 18,700 adolescents aged 13-17 years.* During 2017-2018, coverage with ≥1 dose of HPV vaccine increased from 65.5% to 68.1%, and the percentage of adolescents up-to-date† with the HPV vaccine series increased from 48.6% to 51.1%, although the increases were only observed among males. Vaccination coverage increases were also observed for ≥1 MenACWY dose (from 85.1% to 86.6%) and ≥2 MenACWY doses (from 44.3% to 50.8%). Coverage with tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap) remained stable at 89%. Disparities in coverage by metropolitan statistical area (MSA)§ and health insurance status identified in previous years persisted (2). Coverage with ≥1 dose of HPV vaccine was higher among adolescents whose parents reported receiving a provider recommendation; however, prevalence of parents reporting receiving a recommendation for adolescent HPV vaccination varied by state (range = 60%-91%). Supporting providers to give strong recommendations and effectively address parental concerns remains a priority, especially in states and rural areas where provider recommendations were less commonly reported.


Assuntos
Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Adolescente , Comitês Consultivos , Vacina contra Varicela/administração & dosagem , District of Columbia , Feminino , Pesquisas sobre Serviços de Saúde , Vacinas contra Hepatite B/administração & dosagem , Humanos , Esquemas de Imunização , Masculino , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Guias de Prática Clínica como Assunto , Estados Unidos , Vacinação/normas , Vacinas Conjugadas/administração & dosagem
17.
Int J Infect Dis ; 87: 170-176, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31404673

RESUMO

OBJECTIVES: Sex workers (SWs) face an increased burden of sexually transmitted and blood-borne infections, yet little is known regarding hepatitis B virus (HBV) prevention and care. This study was performed to characterize cross-sectional and prospective correlates of HBV vaccination among SWs in Vancouver. METHODS: Questionnaire data were drawn from a community-based cohort of SWs (2010-2017). Multivariable logistic regression was used to examine correlates of lifetime self-reported HBV vaccination. Multivariable generalized estimating equation (GEE) regression was used to assess correlates of recent vaccination. RESULTS: Among 855 participants, 68.3% reported lifetime HBV vaccination. Multivariable logistic regression showed that im/migrants (adjusted odds ratio (AOR) 0.50, 95% confidence interval (CI) 0.32-0.78) had lower odds of vaccination and that those using injection drugs (AOR 1.88, 95% CI 1.27- 2.78) and those who had undergone HIV testing (AOR 1.94, 95% CI 1.14-3.29) had higher odds of vaccination. In the multivariable GEE analysis, HIV seropositivity (AOR 1.93, 95% CI 1.26-2.97) and recent STI testing (AOR 2.95, 95% CI 1.99-4.39) correlated with recent HBV vaccination. CONCLUSIONS: Im/migrant SWs from HBV-endemic settings appear to face gaps in HBV prevention. Evidence-based interventions addressing gaps in voluntary HBV prevention and care are needed, including community-based and culturally safe services. Injection drug use and HIV testing were linked to enhanced vaccination, suggesting that harm reduction and HIV programmes may facilitate linkage to HBV prevention.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Profissionais do Sexo/estatística & dados numéricos , Adulto , Canadá , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Hepatite B/psicologia , Humanos , Masculino , Estudos Prospectivos , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/psicologia , Abuso de Substâncias por Via Intravenosa/prevenção & controle , Migrantes/estatística & dados numéricos , Vacinação
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 706-712, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288342

RESUMO

Objective: To evaluate the cost-benefit and cost-effectiveness of current strategy for preventing mother-to-child transmission (PMTCT) of hepatitis B virus. Methods: A decision tree model with the Markov process was developed and simulated over the lifetime of a birth cohort in Zhejiang Province in 2016. The current PMTCT strategy was compared with universal vaccination and non-vaccination. Costs were assessed from social perspective. Benefits were the savings from reduced costs associated with disease and effectiveness were measured by quality-adjusted of life-years (QALY) gained. The net present value (NPV), cost-benefit ratio (BCR) and incremental cost-effectiveness ratio (ICER) were calculated. Univariate and Probabilistic Sensitivity Analyses (PSA) were performed to assess parameter uncertainties. The parameters of costs and utilities value of hepatitis B-related disease came from the results of the field survey, which were obtained by face-to-face questionnaire survey combined with inpatient medical records, including eight county and municipal hospitals in Jinhua, Jiaxing and Taizhou. A total of 626 outpatients and 523 inpatient patients were investigated. The annual total costs of infection was calculated by combining the costs of outpatient and inpatient. Results: The PMTCT strategy showed a net-gain as 38 323.78 CNY per person, with BCR as 21.10, which was higher than 36 357.80 CNY per person and 13.58 respectively of universal vaccination. Compared with universal vaccination, the PMTCT strategy would save 2 787.07 CNY per additional QALY gained for every person, indicating that PMTCT would be cost-saving. The most important parameters that could affect BCR and ICER were the vaccine coverage rate and costs of hepatitis B related diseases respectively. The PSA showed the PMTCT strategy was preferable as it would gain more QALY and save costs. Conclusions: The PMTCT strategy appeared as highly cost-beneficial and highly cost-effective. High vaccination rate was a key factor of high economic value.


Assuntos
Vacinas contra Hepatite B/economia , Hepatite B/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Vacinação/economia , China , Análise Custo-Benefício , Feminino , Hepatite B/economia , Hepatite B/transmissão , Vacinas contra Hepatite B/administração & dosagem , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa/economia , Gravidez , Anos de Vida Ajustados por Qualidade de Vida , Vacinação/estatística & dados numéricos
19.
Int J Pharm ; 567: 118489, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31276760

RESUMO

This study systematically demonstrated the antigenicity kinetics of HBV vaccine microneedles (MNs) during the fabrication, application and storage. To improve the stability of HBsAg in a microneedle patch, several selected saccharides were added to the MN formulations as stabilizers. According to the experimental data, no significant decrease of the bio-activity of HBsAg antigen was found during the microneedle fabrication process. And then immune effects of HBsAg added with different sugars were tested. Chitosan and trehalose loaded HBsAg MNs enhanced the antibody levels to approximately 1.5-fold and 2-fold of the plain HBsAg MNs respectively while sucrose and glucose were not obviously beneficial. During the short-term storage under 60 °C, the antigenicity of HBsAg MNs encapsulated with glucose and chitosan declined sharply in 24 h and hardly left after 7 days. As for the groups of HBsAg MNs added with sucrose and trehalose, approximately 90% of HBsAg initial antigenicity maintained, which could be attributed to the protective function of non-reductive disaccharides. As for the long-term storage experiments, the pharmacological activity of HBsAg antigen protected by sucrose and trehalose slightly reduced in 3 months except for the samples under 60 °C. In extreme condition, trehalose performed even better protection function than sucrose, of which the antigenicity of HBsAg in MNs left approximately 81% and 63% of its initial, respectively. These results confirmed that trehalose loaded HBsAg MNs enabled stable encapsulation and storage of HBsAg antigen and realized reasonable enhancement of immune effect in a relatively painless, safe, and convenient manner.


Assuntos
Antígenos de Superfície da Hepatite B/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Trealose/administração & dosagem , Animais , Quitosana/administração & dosagem , Estabilidade de Medicamentos , Feminino , Anticorpos Anti-Hepatite B/sangue , Cinética , Camundongos Endogâmicos BALB C , Microinjeções , Agulhas , Sacarose/administração & dosagem , Adesivo Transdérmico
20.
Rev Soc Bras Med Trop ; 52: e20180534, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31271621

RESUMO

INTRODUCTION: Occupational exposure is a major risk factor for hepatitis B (HB) transmission. METHODS: Vaccination coverage and immunity verification from 64 dentists of the Brazilian Unified Health System were investigated. An immunochromatographic method was used to verify immunity against the disease. RESULTS: Overall, 77.77% of participating dentists completed the vaccination schedule; 37.50% had negative anti-HBs test results. Furthermore, 60.93% of participants never underwent anti-HBs tests and 40% did not know how to correctly interpret results. CONCLUSIONS: Numerous dentists were not immune to the disease. Few participants previously performed the test, with many not knowing how to interpret the results.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Exposição Ocupacional/prevenção & controle , Cobertura Vacinal , Adulto , Brasil , Odontólogos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Saúde Pública , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
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