Kirbak Anthony Laku Stephen, Ng'ang'a Zipporah, Omolo Jared, Idris Hakim, Usman Abdulmumini, Mbabazi William Baguma
EPI and Child Health Department, Ministry of Health, P.O Box 88, Juba, Republic of South Sudan.
Jommo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200 Nairobi, Kenya.
Pan Afr Med J. 2017 Feb 20;26:72. doi: 10.11604/pamj.2017.26.72.11410. eCollection 2017.
Hepatitis B virus infection is a major public health problem worldwide and in Africa. This would be the first ever documented study on epidemiology of Hepatitis B infections in the newly formed Republic of South Sudan. This study was designed to estimate the sero-prevalence of Hepatitis B virus infection amongst pregnant women attending antenatal services in Juba.
A cross-sectional study was conducted among pregnant women attending antenatal clinic services in Juba Teaching Hospital, in the period between December 2012 and March 2013. Any pregnant woman, attending antenatal care services at Juba Teaching Hospital, was included if she was a resident of Juba County for at least 1 year before pregnancy. A Hepatitis B case was defined as any women participating in the study and was found to be positive for HbsAg and confirmed by ELISA.
This study documented that the prevalence of Hepatitis B surface antigen (HBsAg) among pregnant women attending ANC in Juba was 11% (31 out of the 280 samples). Other samples tested were indeterminate (36%), naturally immune (27.1%), susceptible (23%) and the remaining 1.8% was immune due to vaccination. Significant risk factors for Hepatitis B infection were loss of partner (OR 4.4 and CI of 1.4-13.9) and history of Jaundice (OR 1.7 and CI of 1.2-2.1).
These study findings show that only 29% of infants in Juba county are born to immune mothers (naturally or vaccine induced). The remaining 70% of babies would be at risk of infection, if a birth dose of Hepatitis B is not provided. We therefore recommended introduction of Hepatitis B Vaccine birth dose into routine infants' vaccination series to eliminate this risk.
乙型肝炎病毒感染是全球及非洲的一个主要公共卫生问题。这将是有史以来首次对新成立的南苏丹共和国乙型肝炎感染流行病学进行的记录研究。本研究旨在估计朱巴接受产前检查的孕妇中乙型肝炎病毒感染的血清流行率。
2012年12月至2013年3月期间,在朱巴教学医院对接受产前门诊服务的孕妇进行了一项横断面研究。任何在朱巴教学医院接受产前护理服务的孕妇,只要在怀孕前至少在朱巴县居住1年,均被纳入研究。乙型肝炎病例定义为参与研究且乙肝表面抗原(HbsAg)检测呈阳性并经酶联免疫吸附测定(ELISA)确认的任何女性。
本研究记录显示,在朱巴接受产前检查的孕妇中,乙型肝炎表面抗原(HBsAg)的流行率为11%(280份样本中有31份)。其他检测样本结果不确定(36%)、自然免疫(27.1%)、易感(23%),其余1.8%因接种疫苗而免疫。乙型肝炎感染的显著风险因素是伴侣死亡(比值比4.4,可信区间1.4 - 13.9)和黄疸病史(比值比1.7,可信区间1.2 - 2.1)。
这些研究结果表明,朱巴县只有29%的婴儿出生于免疫母亲(自然免疫或疫苗诱导免疫)。如果不提供首剂乙肝疫苗,其余70%的婴儿将有感染风险。因此,我们建议将首剂乙肝疫苗纳入常规婴儿疫苗接种系列,以消除这一风险。