Akbar Sheikh Mohammad Fazle, Al Mahtab Mamun, Begum Ferdousi, Hossain Shaikh A Shahed, Sarker Sukumar, Shrestha Ananta, Khan Md Sakirul Islam, Yoshida Osamu, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Ehime 791-0295, Japan.
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh.
Vaccines (Basel). 2021 Apr 12;9(4):374. doi: 10.3390/vaccines9040374.
The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in the Expanded Program of Immunization (EPI) and vaccinating all infants and children three times within 1 year of birth (HepB3). Recently, the WHO advocate birth-dose hepatitis B vaccination (HepB-BD) as soon as possible after birth, preferably within 24 hours. In 2016, the SEARO endorsed a regional hepatitis B control goal with a target of hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020. Of the 11 SEARO countries, four achieved this target on schedule. Out of these four countries, two countries (Bangladesh and Nepal) have not adopted HepB-BD in EPI program. On the other hand, the coverage of HepB3 is not satisfactory in some SEARO countries, including India which adopted HepB-BD but could not achieve the overall target of SEARO. Thus, it is a point of debate whether emphasis should be placed on proper implementation of HepB3 or whether a new agenda of HepB-BD should be incorporated in developing countries of SEARO. The article discusses strengthening and expanding the Hepatitis B vaccination program in SEARO countries with an emphasis on HepB and HepB-BD programs.
世界卫生组织(WHO)东南亚区域办事处(SEARO)覆盖11个国家,总人口约20亿,是WHO六个区域中人口最多的地区。1992年,WHO主张将乙肝疫苗纳入扩大免疫规划(EPI),并在婴儿出生1年内对其进行3次接种(HepB3)。最近,WHO主张在婴儿出生后尽快接种首剂乙肝疫苗(HepB-BD),最好在24小时内。2016年,SEARO批准了一项区域乙肝控制目标,即到2020年,5岁及以上儿童的乙肝表面抗原(HBsAg)血清流行率目标为≤1%。在SEARO的11个国家中,有4个国家按时实现了这一目标。在这4个国家中,有2个国家(孟加拉国和尼泊尔)尚未在EPI项目中采用HepB-BD。另一方面,在一些SEARO国家,包括已采用HepB-BD但未实现SEARO总体目标的印度,HepB3的覆盖率并不理想。因此,是应该强调正确实施HepB3,还是应在SEARO的发展中国家纳入HepB-BD新议程,这是一个有争议的问题。本文讨论了加强和扩大SEARO国家的乙肝疫苗接种计划,重点是乙肝疫苗和HepB-BD计划。