Muwanda Fahad, Kiyonga Edward, Nambafu Joan, Turyamubona Agnes, Kafeero Hussein Mukasa, Kigozi Edgar, Babikako Harriet Mupere, Wekiya Enock, Mboowa Gerald, Kateete David Patrick, Sendagire Hakim, Norman Paul J, Bagaya Bernard Ssentalo
Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda.
Department of Medical Microbiology, Habib Medical School, Islamic University in Uganda, Kampala P.O. Box 7689, Uganda.
Livers. 2024 Dec;4(4):550-561. doi: 10.3390/livers4040039. Epub 2024 Oct 24.
Pediatric hepatitis B virus (HBV) serostatus remains variably characterized, hardly determined at times, or documented as part of national monitoring of the Extended Programs for Immunization (EPI).
We cross-sectionally characterized the seroprevalence of HBV vaccine and/or infection status among 501 and 288 children <5 and 15-17 years old, respectively, in Kawempe Division, Kampala, Uganda, between May and August 2023. These children received HBV vaccination under the Uganda National Extended Program on Immunizations (UNEPI). Samples were qualitatively screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb or anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb or anti-HBe), and for hepatitis B core antibody (HBcAb or anti-HBc) using three different HBV Combo test rapid immunochromatographic diagnostic tests: Nova, Fastep, and Beright.
The seroprevalence of HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc was 1.52%, 27.75%, 0.88%, 0.63%, and 0.76%, respectively, for the combined study age groups. The HBsAg seroprevalence of 2.78% was almost 3.5-fold higher among adolescents when compared to the 0.8% observed in the under-5-year-olds. The qualitative seroprevalence of anti-HBs was 33.1% and 18.4% in the under-5 and among the 15-17-year-old study groups, respectively.
The proportion of qualitatively detectable anti-HBs in both groups of vaccinated children is low and probably indicates reduced seroprotection. Consequently, a large proportion of children who received the hepatitis B vaccine under UNEPI may be at risk of HBV infection, especially adolescents. A booster dose of the Hepatitis B Vaccine may be required for adolescents.
儿童乙肝病毒（HBV）血清学状态的特征仍然存在差异，有时难以确定，或作为国家扩大免疫规划（EPI）监测的一部分进行记录。
2023年5月至8月期间，我们对乌干达坎帕拉卡韦姆佩区分别为501名5岁以下儿童和288名15 - 17岁儿童的乙肝疫苗血清流行率和/或感染状况进行了横断面研究。这些儿童在乌干达国家扩大免疫规划（UNEPI）下接受了乙肝疫苗接种。使用三种不同的乙肝组合快速免疫层析诊断测试：Nova、Fastep和Beright，对样本进行乙肝表面抗原（HBsAg）、乙肝表面抗体（HBsAb或抗-HBs）、乙肝e抗原（HBeAg）、乙肝e抗体（HBeAb或抗-HBe）以及乙肝核心抗体（HBcAb或抗-HBc）的定性筛查。
联合研究年龄组中，HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc的血清流行率分别为1.52%、27.75%、0.88%、0.63%和0.76%。青少年中HBsAg血清流行率为2.78%，几乎是5岁以下儿童中观察到的0.8%的3.5倍。5岁以下和15 - 17岁研究组中抗-HBs的定性血清流行率分别为33.1%和18.4%。
两组接种疫苗儿童中定性可检测到的抗-HBs比例较低，可能表明血清保护作用降低。因此，在UNEPI下接种乙肝疫苗的很大一部分儿童可能有感染HBV的风险，尤其是青少年。青少年可能需要接种一剂乙肝疫苗加强针。
