Li Xi, Heffelfinger James, Wiesen Eric, Diorditsa Sergey, Valiakolleri Jayaprakash, Nikuata Agnes Bauro, Nukuro Ezekial, Tabwaia Beia, Woodring Joseph
World Health Organization Regional Office for the Western Pacific, Philippines.
Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States.
Vaccine. 2017 Aug 3;35(34):4396-4401. doi: 10.1016/j.vaccine.2017.06.056. Epub 2017 Jul 5.
Hepatitis B is highly endemic in the Republic of Kiribati, while the coverage of timely birth dose vaccination, the primary method shown to prevent mother-to-child transmission of hepatitis B virus, was only 66% in 2014. Children born at home are especially at high risk, as they have limited access to timely birth dose (i.e. within 24 h) vaccination. To improve birth dose coverage, a project to improve linkages between village health volunteers and health workers and educate pregnant women on hepatitis B vaccination was carried out in 16 communities with low birth dose coverage in Kiribati from November 2014 to May 2015. After project completion, the coverage of timely birth dose administration increased significantly both in the densely populated capital region of South Tarawa (from 89% to 95%, p=0.001) and the Outer Islands (from 57% to 83%, p<0.001). The coverage of timely birth dose administration among infants born at home increased significantly from 70% to 84% in South Tarawa (p=0.001) and from 49% to 75% in the Outer Islands (p<0.001). Timely birth dose was associated with being born in a hospital, being born during the study period and caregivers having developed an antenatal birth dose plan. The project demonstrates a successful model for improving hepatitis B vaccine birth dose coverage that could be adopted in other areas in Kiribati as well as other similar settings.
乙型肝炎在基里巴斯共和国高度流行，而预防乙肝病毒母婴传播的主要方法——及时接种首剂疫苗，在2014年的覆盖率仅为66%。在家出生的儿童尤其面临高风险，因为他们获得及时接种首剂疫苗（即24小时内）的机会有限。为提高首剂疫苗覆盖率，2014年11月至2015年5月，在基里巴斯16个首剂疫苗覆盖率较低的社区开展了一个项目，以改善乡村卫生志愿者与卫生工作者之间的联系，并对孕妇进行乙肝疫苗接种教育。项目完成后，在人口密集的南塔拉瓦首都地区，及时接种首剂疫苗的覆盖率显著提高（从89%提高到95%，p=0.001），在外岛地区也显著提高（从57%提高到83%，p<0.001）。在南塔拉瓦，在家出生婴儿的及时接种首剂疫苗覆盖率从70%显著提高到84%（p=0.001），在外岛地区从49%提高到75%（p<0.001）。及时接种首剂疫苗与在医院出生、在研究期间出生以及照顾者制定了产前首剂疫苗接种计划有关。该项目展示了一个提高乙肝疫苗首剂疫苗覆盖率的成功模式，可在基里巴斯的其他地区以及其他类似环境中采用。
