Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, Chapel Hill, NC, USA.
Glob Health Sci Pract. 2022 Feb 28;10(1). doi: 10.9745/GHSP-D-21-00277.
In sub-Saharan Africa (SSA), chronic viral hepatitis B (HBV) affects more than 60 million people. Mother-to-child transmission is a major contributor to the ongoing HBV epidemic and yet only 11 of 54 (20.3%) SSA countries have introduced the birth dose of HBV vaccine (HepB-BD) into their regular immunization schedule. As more African countries adopt HepB-BD, implementation approaches must be targeted to ensure effective and timely HepB-BD delivery, especially in rural and under-resourced settings. We conducted a systematic literature review of published literature using PubMed. We included 39 articles published from January 2010 to August 2020, as well as gray literature, case studies, and research performed in SSA. We describe barriers to the uptake of HepB-BD in SSA at the policy, facility, and community levels and propose solutions that are relevant to stakeholders wishing to introduce HepB-BD. We highlight the importance and challenge of reaching infants who are born outside of health care facilities (i.e., home deliveries) with HepB-BD in partnership with community health workers. We also discuss the critical role of maternal education and community engagement in future HepB-BD scale-up efforts in SSA.
在撒哈拉以南非洲（SSA），慢性乙型肝炎病毒（HBV）影响着超过 6000 万人。母婴传播是 HBV 持续流行的一个主要原因，但在 54 个 SSA 国家中，仅有 11 个国家（20.3%）将乙型肝炎疫苗（HepB-BD）纳入常规免疫接种计划。随着越来越多的非洲国家采用 HepB-BD，实施方法必须有针对性，以确保有效和及时地提供 HepB-BD，特别是在农村和资源匮乏的环境中。我们使用 PubMed 对已发表的文献进行了系统的文献回顾。我们纳入了 2010 年 1 月至 2020 年 8 月期间发表的 39 篇文章，以及灰色文献、案例研究和在 SSA 进行的研究。我们描述了 SSA 在政策、设施和社区层面上采用 HepB-BD 的障碍，并提出了一些解决方案，这些方案对于希望引入 HepB-BD 的利益相关者来说是相关的。我们强调了与社区卫生工作者合作，向在医疗保健机构之外（即在家分娩）出生的婴儿提供 HepB-BD 的重要性和挑战。我们还讨论了在 SSA 未来扩大 HepB-BD 规模的努力中，母亲教育和社区参与的关键作用。
