Pezzoli Lorenzo, Mathelin Jean Pierre, Hennessey Karen, Eswara-Aratchige Padmasiri, Valiakolleri Jayaprakash, Kim Sung Hye
Epidemiology Consultant, London, United Kingdom.
Public Health Agency, Wallis and Futuna, London, United Kingdom.
Am J Trop Med Hyg. 2017 Mar;96(3):715-719. doi: 10.4269/ajtmh.16-0596. Epub 2017 Apr 6.
The prevalence of hepatitis B virus (HBV) in Wallis and Futuna (WAF) was one of the highest in the Pacific and was the driving factor for introducing hepatitis B (HepB) vaccination in 1992 and HepB birth dose (HepB-BD) in 2006. Using lymphatic filariasis (LF) transmission assessment survey (TAS) as a survey platform for eliminating LF, we assessed HBV surface antigen (HBsAg) seroprevalence, HepB vaccination coverage, and its timeliness among schoolchildren in WAF. From one finger prick of all registered fourth and fifth grade students, we tested HBsAg and filariasis antigen simultaneously, and estimated HepB vaccination coverage and timeliness by reviewing students' immunization cards. Since the children targeted were born when the three-dose HepB schedule was 2, 3, and 8 months, we defined timely vaccination if each dose was given by 3, 4, and 12 months. Of 476 targeted, 427 were enrolled. HBsAg prevalence was 0.9%. Estimated HepB vaccination coverage was 97%, 97%, and 96% for the first, second, and third doses, respectively, yielding coverage for all three doses of 96%. Proportion of timely vaccination was lower: 80%, 56%, and 65%, respectively, and less than 50% for all three doses combined. The seroprevalence of HBsAg among schoolchildren in WAF is less than 1%, close to the control goal. HepB vaccination coverage was high, but many children were vaccinated late. We recommend increasing the efforts for timely HepB vaccination. By combining an HBV seroprevalence survey and coverage assessment, we demonstrated the benefit of using TAS as a public health platform to access schoolchildren.
瓦利斯和富图纳群岛（WAF）的乙肝病毒（HBV）流行率在太平洋地区位居前列，这也是该地区于1992年引入乙肝（HepB）疫苗接种以及2006年引入乙肝首剂疫苗（HepB-BD）的驱动因素。我们以淋巴丝虫病（LF）传播评估调查（TAS）作为消除LF的调查平台，评估了WAF地区学童的HBV表面抗原（HBsAg）血清流行率、乙肝疫苗接种覆盖率及其及时性。通过对所有注册的四年级和五年级学生进行一次手指采血，我们同时检测了HBsAg和丝虫病抗原，并通过查看学生的免疫卡来估计乙肝疫苗接种覆盖率和及时性。由于目标儿童出生时三剂次乙肝疫苗接种程序分别是在2、3和8月龄，我们将每剂疫苗在3、4和12月龄前接种定义为及时接种。在476名目标儿童中，427名被纳入研究。HBsAg流行率为0.9%。首剂、第二剂和第三剂乙肝疫苗的估计接种覆盖率分别为97%、97%和96%，三剂疫苗的总体接种覆盖率为96%。及时接种的比例较低，分别为80%、56%和65%，三剂疫苗综合及时接种率不到50%。WAF地区学童中HBsAg的血清流行率低于1%，接近控制目标。乙肝疫苗接种覆盖率较高，但许多儿童接种延迟。我们建议加大力度确保及时接种乙肝疫苗。通过结合HBV血清流行率调查和接种覆盖率评估，我们证明了利用TAS作为公共卫生平台来接触学童的益处。
