Shwe Yee Nilar, Yu Naing Aung, Gil Cuesta Julita, Das Mrinalini, Dave Kapilkumar
Asian Harm Reduction Network, Hpakant Township, Kachin State 01161, Myanmar.
Luxembourg Operational Research Unit, Médecins Sans Frontières, 1050 Brussels, Belgium.
Trop Med Infect Dis. 2020 May 12;5(2):77. doi: 10.3390/tropicalmed5020077.
Hepatitis B vaccination (HBV) is recommended for high-risk groups, such as people who inject drugs (PWIDs). As part of a harm reduction program by a non-governmental organization, hepatitis B screening, vaccination and antibody (HBAb) testing after completion of the vaccination schedule were offered to PWIDS in Myanmar. We determined the proportions of HBV non-completion and sero-unprotection among PWIDs enrolled in the program and their association with socio-demographic and clinical characteristics. We conducted a descriptive study based on routine program data in five selected clinics in Hpakant Township, Myanmar. PWIDs who were Hepatitis B antigen negative at screening during January 2015-December 2018 were included. Among 5386 participants eligible for HBV, 9% refused vaccination. Among those who accepted vaccination ( = 3177 individuals), 65% completed vaccination. Of those tested for HBsAb ( = 2202), 30% were sero-unprotected. Young-adults (aged 18-44 years) and migrant workers had a higher risk of incomplete vaccination. However, participants who used methadone had a lower risk of incomplete vaccination. Migrant workers had higher risk of not returning for HBsAb testing and HIV-positive participants had a higher risk of being HBV sero-unprotected. Efforts to increase HBV vaccination in PWIDs for young adults and clients during methadone and anti-retroviral services should be prioritized.
建议对高危人群，如注射毒品者（PWIDs）接种乙型肝炎疫苗（HBV）。作为一个非政府组织减少伤害项目的一部分，为缅甸的注射毒品者提供了乙型肝炎筛查、疫苗接种以及完成疫苗接种计划后的抗体（HBAb）检测。我们确定了参与该项目的注射毒品者中未完成乙肝疫苗接种和血清无保护作用的比例，以及它们与社会人口统计学和临床特征的关联。我们基于缅甸帕敢镇五家选定诊所的常规项目数据进行了一项描述性研究。纳入了2015年1月至2018年12月筛查时乙型肝炎抗原阴性的注射毒品者。在5386名符合乙肝疫苗接种条件的参与者中，9%拒绝接种疫苗。在接受疫苗接种的人群中（n = 3177人），65%完成了疫苗接种。在接受乙肝表面抗体检测的人群中（n = 2202人），30%血清无保护作用。年轻成年人（18 - 44岁）和农民工未完成疫苗接种的风险较高。然而，使用美沙酮的参与者未完成疫苗接种的风险较低。农民工未返回进行乙肝表面抗体检测的风险较高，而艾滋病毒呈阳性的参与者乙肝血清无保护作用的风险较高。应优先努力提高年轻成年人以及接受美沙酮和抗逆转录病毒治疗服务者中的注射毒品者的乙肝疫苗接种率。
