Results from nationwide hepatitis B serosurvey in Cambodia using simple and rapid laboratory test: implications for National Immunization Program.

Chronic liver infection and cancer in the western Pacific region is disproportionate to the population globally. This study provides the first nationwide estimates of hepatitis B surface antigen (HBsAg) seroprevalence in Cambodia among children five year of age. Using a simple and rapid test for HBsAg and multi-stage stratified cluster sampling design, we estimated HBsAg seroprevalence to be 3.5% (95% confidence interval = 2.4-4.8%) among five-year old children. Triangulating the results with other studies, we demonstrate the importance of interrupting perinatal transmission and one-time catch-up vaccination of older children born before nationwide introduction of vaccination for effective hepatitis B control in Cambodia and for reaching the disease control goal of less than 2% chronic infection rates among children > or = 5 years of age. The results demonstrate the feasibility of conducting nationwide serosurveys using simple and rapid tests to evaluate the impact of hepatitis B vaccination programs in lieu of standard enzyme-linked immunosorbent assays.