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Adugna A, Demeke G, Toru M, Tsehay D, Esmael A, Mihret A, Mulu A. Reduced protective efficacy of hepatitis B vaccine among fully vaccinated children in Ethiopia. PLoS One 2023; 18:e0288355. [PMID: 37418447 DOI: 10.1371/journal.pone.0288355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/25/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Hepatitis B vaccination is recommended for all children at birth within 24 hours or during childhood. OBJECTIVE This study was aimed to evaluate protective efficacy of hepatitis B vaccine and estimate the sero-prevalence of hepatitis B virus infection among vaccinated children. MATERIALS AND METHODS A community-based cross-sectional study was conducted from March, 2021 to October, 2021 in Debre Markos town. A simple random sampling technique was used to select 165 fully vaccinated children aged 5-12 years old. A serum sample was used to determine hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), anti-hepatitis B surface antibody titer (anti-HBs) using ELISA. RESULTS The seroprevalence of HBsAg and anti-HBc anti-body was found to be 4.2% and 4.8% respectively. Of 165 fully vaccinated children, 129 (78.2%) had anti-HBs titer ≥ 10 mIU/ml. Among 129 sero-protected children, 76 (58.9%) were hypo-responders whereas the rest 53 (41.1%) were good responders. Those children within the age group of 5-7 years were 2.9 times (AOR: 2.873, 95% CI: 1.156, 7.141) (P<0.023) more likely to respond to HBV vaccine. Multivariate logistic regression revealed that children who were born from HBV positive mothers (AOR 3.917, 95% CI: 1.456, 5.365, P<0.027) and those who had history of injectable medications (AOR 9.232, 95% CI: 1.503, 11.697, P<0.016) were more likely to be HBsAg positive. Children who had history of hospital admission (AOR 6.973, 95% CI: 1.495, 8.530, P<0.013) were more likely to be anti-HBcAb positive. CONCLUSIONS There was an intermediate prevalence of childhood HBV infection despite being vaccinated suggesting low protective efficacy of hepatitis B vaccine in the study area.
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Affiliation(s)
- Adane Adugna
- Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Gebereselassie Demeke
- Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Milkiyas Toru
- Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Ahmed Esmael
- Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Castro RS, Cordeiro BS, Rolim MAF, Costa APDM, Santos MDC, Silva MACND, Albuquerque IDC, Fonseca LMB, Pinho JRR, Gouvêa MSG, Silva AAMD, Ferreira ADSP. High prevalence of hepatitis B virus and low vaccine response in children and adolescents in Northeastern Brazil. Rev Inst Med Trop Sao Paulo 2023; 65:e33. [PMID: 37098921 PMCID: PMC10124778 DOI: 10.1590/s1678-9946202365033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/21/2023] [Indexed: 04/27/2023] Open
Abstract
Children have an increased likelihood of becoming carriers of the chronic hepatitis B virus. A total of 1,381 children and adolescents were assessed in five municipalities of Maranhao State, Brazil, for detection of anti-HBc, HBsAg and anti-HBs serologic markers and sociodemographic and behavioral features. Among those who were HBsAg negative and anti-HBc negative, the proportion of anti-HBs positives was calculated after the individuals had completed the vaccination schedule. The robust variance of the Poisson's regression model was used in order to have adjusted tables and calculate the prevalence ratio. Multivariate analysis was performed to identify the factors associated with the prevalence of anti-HBc with or without HBsAg and the vaccine response. It was observed that 163 children were anti-HBc positive and nine individuals were HBsAg positive. The factors associated with the infection were: municipality of residence (residing in Morros municipality or Humberto de Campos municipality), residence in a rural area, aged between 13 and 15 years old, and illicit drug use. The percentage of individuals who were anti-HBc negative and received all three doses of the vaccine was 48.5%. Among these, only 276 (38.9%) had antibodies at protective concentrations. In an adjusted analysis, Morros municipality presented an increased positivity of vaccine response (p < 0.001), and the age ranging between 6 and 10 years old presented a reduced frequency of response. This study reveals a high prevalence of current and past HBV infection within the targeted age group which, in addition to the low vaccination coverage and serological responses, raises concerns about the management of prevention measures, especially the quality of vaccination in these locations.
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Affiliation(s)
- Rogério Soares Castro
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
| | - Bárbara Silva Cordeiro
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
| | - Marco Aurélio Ferreira Rolim
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
| | - Alessandra Porto de Macedo Costa
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
| | - Max Diego Cruz Santos
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
| | | | | | | | - João Renato Rebello Pinho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Gastroenterologia e Hepatologia Tropical (LIM-07), São Paulo, São Paulo, Brazil
| | - Michelle Soares Gomes Gouvêa
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Gastroenterologia e Hepatologia Tropical (LIM-07), São Paulo, São Paulo, Brazil
| | | | - Adalgisa de Souza Paiva Ferreira
- Universidade Federal do Maranhão, Hospital Universitário, Empresa Brasileira de Serviços Hospitalares, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Departamento de Medicina I, São Luís, Maranhão, Brazil
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van den Ende C, Marano C, van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity of GSK’s recombinant hepatitis B vaccine in children: a systematic review of 30 years of experience. Expert Rev Vaccines 2017; 16:789-809. [DOI: 10.1080/14760584.2017.1338569] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Ayla van Ahee
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
| | - Eveline M. Bunge
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
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