Minta Anna A, Silva Maria Wilda T, Shrestha Achyut, de Quiroz-Castro Maricel, Tohme Rania A, Quimson Mario E, Jiz Mario Antonio, Woodring Joseph
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
National Immunization Program, Philippines Department of Health, Manila, Philippines.
Vaccine. 2021 Apr 1;39(14):1982-1989. doi: 10.1016/j.vaccine.2021.02.042. Epub 2021 Mar 9.
The World Health Organization Western Pacific Region (WPR) set a hepatitis B virus (HBV) control target to achieve HBV surface antigen (HBsAg) prevalence of <1% among children aged 5 years by 2017. The estimated HBsAg prevalence in the Philippines among adults was 16.7% during the pre-vaccine era. We estimated the HBsAg seroprevalence among children aged 5-7 years to measure the impact of vaccination. We conducted a household serosurvey, using a three-stage cluster survey methodology (provinces, clusters, and households). We estimated HBsAg prevalence using a rapid, point-of-care HBsAg test and calculated vaccination coverage by reviewing vaccination records or by caregiver recall. A questionnaire was administered to assess demographic variables for the child and family. We assessed the association between chronic HBV infection, vaccination coverage, and demographic variables, accounting for the complex survey design. Of the 2178 children tested, HBsAg was detected in 15 children [0.8%, 95% confidence interval (CI): 0.4, 1.7]. Only two of the HBsAg-positive children had been fully vaccinated against HBV. Based on documented vaccination or caregiver recall for the survey population, hepatitis B vaccine birth dose (HepB-BD) coverage was 53%, and the third dose hepatitis B vaccination (HepB3) coverage was 73 percent. Among the 1362 children with documented HepB-BD, timely HepB-BD coverage (given within 24 h of birth) was 43%; children born outside a health facility were less likely to receive a timely HepB-BD than those born in a health facility (adjusted odds ratio 0.10, 95% CI: 0.04, 0.23). HBsAg prevalence among children in the Philippines has decreased compared to the prevalence among adults in the pre-vaccination era. Strategies to further reduce HBsAg prevalence include ensuring that all children, whether born in health facilities or at home, receive a timely HepB-BD, and increasing HepB-BD and HepB3 coverage to reach the WPR goals of ≥95% coverage.
世界卫生组织西太平洋区域（西太区）设定了一项乙肝病毒（HBV）控制目标，即到2017年使5岁儿童的乙肝表面抗原（HBsAg）流行率降至<1%。在疫苗接种前时代，菲律宾成年人的估计HBsAg流行率为16.7%。我们估计了5至7岁儿童的HBsAg血清流行率，以衡量疫苗接种的影响。我们采用三阶段整群抽样调查方法（省份、群组和家庭）进行了一项家庭血清学调查。我们使用快速即时检测HBsAg的方法估计HBsAg流行率，并通过查阅疫苗接种记录或由照料者回忆来计算疫苗接种覆盖率。发放了一份问卷以评估儿童及其家庭的人口统计学变量。我们评估了慢性HBV感染、疫苗接种覆盖率与人口统计学变量之间的关联，并考虑了复杂的调查设计。在接受检测的2178名儿童中，有15名儿童检测出HBsAg[0.8%，95%置信区间（CI）：0.4，1.7]。仅2名HBsAg阳性儿童已完成乙肝疫苗全程接种。根据调查人群的疫苗接种记录或照料者回忆，乙肝疫苗首剂（HepB-BD）接种覆盖率为53%，第三剂乙肝疫苗（HepB3）接种覆盖率为73%。在有记录的1362名接种HepB-BD的儿童中，及时接种HepB-BD（出生后24小时内接种）的覆盖率为43%；在医疗机构外出生的儿童比在医疗机构内出生的儿童更不可能及时接种HepB-BD（调整优势比0.10，95%CI：0.04，0.23）。与疫苗接种前时代成年人的流行率相比，菲律宾儿童的HBsAg流行率有所下降。进一步降低HBsAg流行率的策略包括确保所有儿童，无论在医疗机构出生还是在家中出生，都能及时接种HepB-BD，并将HepB-BD和HepB3接种覆盖率提高到西太区≥95%的目标覆盖率。
