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塞内加尔儿童中的乙型肝炎病毒(HBV)感染:当前流行率和血清保护水平

Hepatitis B virus (HBV) infection amongst children in Senegal: current prevalence and seroprotection level.

作者信息

Lô Gora, Sow-Sall Amina, Diop-Ndiaye Halimatou, Babacar Ndiaye, Diouf Niokhar Ndane, Daffé Sokhna Moumi, Ndao Babacar, Thiam Moussa, Mbow Moustapha, Soumboundou Mamadou Bayo, Lemoine Maud, Sylla-Niang Maguette, Ndiaye Ousseynou, Boye Cheikh Saad, Mboup Souleymane, Touré-Kane Ndeye Coumba

机构信息

Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF), Dakar, Sénégal.

Centre Médical Inter Armées Lemonier, Dakar, Senegal.

出版信息

Pan Afr Med J. 2019 Mar 25;32:140. doi: 10.11604/pamj.2019.32.140.14485. eCollection 2019.

Abstract

INTRODUCTION

Hepatitis B virus (HBV) infection is highly endemic in Senegal. HBV vaccine of all children has been introduced in 1999 and included in the Expanded Programme on Immunization in 2004. The aim of this study was to assess the HBV prevalence and immunity status against HBV amongst children in Senegal.

METHODS

Between March and August 2016, consecutive children aged from 6 months to 16 years old were recruited in outpatient department of three main children hospitals in Senegal. Serum samples were analyzed for HBV serology (HBsAg, HBcAb, HBsAb) using ARCHITECT analyzer. Children with HBsAb levels ≥ 10 IU/l) were considered as seroprotected against HBV.

RESULTS

During the study period, 295 children fulfilled the criteria for the study and were further analyzed. Three children were HBsAg positive giving a seroprevalence at 1.1% (95% CI: 0.2-3.3), 12/267 (4.5%, 95% CI=2.3-7.7) had positive HBcAb and 226/295 (76.6%, 71.4-81.3) had positive HBsAb including 191 (77.3%, 71.6-82.4) with isolated HBsAb related to previous active immunization. However only 165 children (56%, CI 50-62) had seroprotective HBsAb levels (HBsAb ≥ 10 UI/L) and 63 (21.4, 16.8-26) had a strong seroprotectiondefined by HBsAb ≥ 100 IU/L.

CONCLUSION

Our results suggest that although HBV prevalence has significantly decreased in children in Senegal following a better HBV vaccine coverage, the number of children correctly seroprotected is insufficient (56%). Assessing the levels of HBsAb and providing HBV vaccine boosters should be considered in children in Senegal.

摘要

引言

乙型肝炎病毒(HBV)感染在塞内加尔高度流行。1999年引入了针对所有儿童的乙肝疫苗,并于2004年纳入扩大免疫规划。本研究的目的是评估塞内加尔儿童中HBV的流行情况以及对HBV的免疫状态。

方法

2016年3月至8月期间,在塞内加尔三家主要儿童医院的门诊招募了连续的6个月至16岁儿童。使用ARCHITECT分析仪对血清样本进行HBV血清学分析(HBsAg、HBcAb、HBsAb)。HBsAb水平≥10 IU/l的儿童被视为对HBV具有血清保护作用。

结果

在研究期间,295名儿童符合研究标准并进行了进一步分析。3名儿童HBsAg呈阳性,血清流行率为1.1%(95%可信区间:0.2 - 3.3),12/267(4.5%,95%可信区间 = 2.3 - 7.7)HBcAb呈阳性,226/295(76.6%,71.4 - 81.3)HBsAb呈阳性,其中191名(77.3%,71.6 - 82.4)有与既往主动免疫相关的孤立HBsAb。然而,只有165名儿童(56%,可信区间50 - 62)具有血清保护性HBsAb水平(HBsAb≥10 UI/L),63名(21.4,16.8 - 26)具有由HBsAb≥100 IU/L定义的强血清保护作用。

结论

我们的结果表明,尽管在塞内加尔儿童中,随着乙肝疫苗接种覆盖率的提高,HBV流行率显著下降,但得到正确血清保护的儿童数量不足(56%)。应考虑对塞内加尔儿童评估HBsAb水平并提供乙肝疫苗加强针。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70cf/6607249/4c0220a48c61/PAMJ-32-140-g001.jpg

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