scholarly journals Assessing the impact of a nurse-delivered home dried blood spot service on uptake of testing for household contacts of hepatitis B-infected pregnant women across two London trusts

2016 ◽  
Vol 144 (10) ◽  
pp. 2087-2097 ◽  
Author(s):  
P. KEEL ◽  
G. EDWARDS ◽  
J. FLOOD ◽  
G. NIXON ◽  
K. BEEBEEJAUN ◽  
...  

SUMMARYDespite national guidance recommending testing and vaccination of household contacts of hepatitis B-infected pregnant women, provision and uptake of this is sub-optimal. The aim of this study was to evaluate the use of in-home dried blood spot (DBS) testing to increase testing and vaccination of household contacts of hepatitis B-infected pregnant women as an alternative approach to conventional primary-care follow-up. The study was conducted across two London maternity trusts (North Middlesex and Newham). All hepatitis B surface antigen-positive pregnant women identified through these trusts were eligible for inclusion. The intervention of in-home DBS testing for household contacts was introduced at North Middlesex Trust from November 2010 to December 2011. Data on testing and vaccination uptake from GP records across the two trusts were compared between baseline (2009) and intervention (2010–2011) periods. In-home DBS service increased testing uptake for all ages (P < 0·001) with the biggest impact seen in partners, where testing increased from 30·3% during the baseline period to 96·6% during the intervention period in North Middlesex Trust. Although impact on vaccine uptake was less marked, improvements were observed for adults. The provision of nurse-led home-based DBS may be useful in areas of high prevalence.

2020 ◽  
Vol 20 (3) ◽  
pp. 341-347
Author(s):  
Xinting Lu ◽  
Helen E. Quinn ◽  
Rob I. Menzies ◽  
Linda Hueston ◽  
Lyn Gilbert ◽  
...  

Background: This study assessed the impact of the staged introduction of universal infant and adolescent catch-up hepatitis B vaccination programs on the prevalence of immunity and past hepatitis B virus (HBV) infection in targeted cohorts over almost a decade in Australia. Methods: We compared the prevalence of immunity in relevant cohorts of children and adolescents in repeated national serological surveys conducted in 1998-99, 2002 and 2007. Residual sera (n =2210) collected opportunistically from Australian laboratories in 2007 were tested for antibody to hepatitis B surface antigen (anti-HBs) indicating vaccine-induced immunity; sera from individuals aged 12-29 years with anti-HBs detected (n =386) were then tested for hepatitis B core antibody (anti-HBc) to identify past hepatitis B infection. Results: In 2007, compared with the baseline period of 1998-99, anti-HBs prevalence had increased significantly in all age groups below 24 years, by more than double in target children. Prevalence of anti-HBc was zero in the 12-14 years and reduced by 71% in those aged 15-19 years. The hepatitis B vaccination protected a significant number of targeted adolescents with a modest vaccine uptake (57% to 60% nationally). Conclusion: In a setting without incentives or school entry requirements, adolescent vaccination coverage was significantly higher when delivered by school-based rather than GP-based mechanisms. A cohort of children was growing up in Australia with a high prevalence of vaccineinduced immunity against hepatitis B, providing the best opportunity for controlling HBV infection in Australia.


2018 ◽  
Vol 220 (7) ◽  
pp. 1118-1126 ◽  
Author(s):  
Wei-Ju Su ◽  
Shu-Fong Chen ◽  
Chin-Hui Yang ◽  
Pei-Hung Chuang ◽  
Hsiu-Fang Chang ◽  
...  

Abstract Background The hepatitis B virus (HBV) status of pregnant women affects HBV vaccine failure in their offspring. This study is aimed to investigate the impact of the universal infant HBV vaccination program on the long-term hepatitis B surface antigen (HBsAg) rate in pregnant women. Methods Using the National Immunization Information System, we examined a 32-year period of cross-sectional data on a maternal HBsAg and hepatitis B e antigen (HBeAg) screening program launched in July 1984. An age-period-cohort model analysis of 940 180 pregnant women screened for July 1996–June 1997 and the years 2001, 2006, 2011, and 2016 was applied. Results The annual HBsAg- and HBeAg-seropositive rates decreased from 13.4% and 6.4%, respectively, for the period 1984–1985 to 5.9% and 1.0% in 2016 (P for both trends < .0001). Pregnant women with birth years after July 1986 (the HBV vaccination cohort) had the lowest relative risk (0.27 [95% confidence interval, .26–.28]) of HBsAg positivity compared with birth years before June 1984. Conclusions The birth cohort effect in relation to the universal infant HBV immunization program has effectively reduced the HBV carrier rate in pregnant women and the burden of perinatal HBV infection on the next generation.


2021 ◽  
Vol 32 (Sup9) ◽  
pp. S7-S10
Author(s):  
Michelle Falconer

Hepatitis B is a vaccine preventable disease that can lead to serious complications such as cirrhosis, liver failure and death. Globally, the most common route of HBV acquisition is via perinatal transmission: from mother to baby at the time of birth. Pregnant women in the UK are tested for hepatitis B infection to reduce the risk of perinatal transmission by ensuring early identification, treatment and management of any pregnant women, and their unborn babies, who test positive. If infants born to women with hepatitis B infection receive post-exposure vaccination (+/− hepatitis B immunoglobulin) within the recommended timescales, 90% of them will be protected from chronic persistent infection and serious complications such as cirrhosis, liver failure and death. However, HBV infection in infants can be asymptomatic so testing them at 1 year old is essential to detect whether they are infected and require treatment. Public Health England provide a national dried blood spot (DBS) testing service for infants born to mothers with hepatitis B infection during pregnancy. Practice nurses can play a key role in this process, helping to protect infants.


2014 ◽  
Vol 165 (4) ◽  
pp. 773-778 ◽  
Author(s):  
Steven L. Veselsky ◽  
Tanja Y. Walker ◽  
Nancy Fenlon ◽  
Chong-Gee Teo ◽  
Trudy V. Murphy

2011 ◽  
Vol 83 (9) ◽  
pp. 1522-1529 ◽  
Author(s):  
Livia Melo Villar ◽  
Jaqueline Correia de Oliveira ◽  
Helena Medina Cruz ◽  
Clara Fumiko Tachibana Yoshida ◽  
Elisabeth Lampe ◽  
...  

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1041-1048
Author(s):  
Solko W. Schalm ◽  
J. Adriaan Mazel ◽  
Gijsbert C. de Gast ◽  
Rudolf A. Heijtink ◽  
Meindert J. Botman ◽  
...  

Beginning in 1982 all pregnant women undergoing prenatal routine blood analysis in three large city hospitals and one large rural area were tested for hepatitis B surface antigen (HBsAg). Infants of all HBsAg-positive mothers received hepatitis B immunoglobulin (HBIg), 0.5 mL/kg of body weight within two hours of birth and, after randomization, 10 µg of hepatitis B vaccine either at 0, 1, 2, and 11 months of age (schedule A) or at 3, 4, 5, and 11 months of age (schedule B). A second injection of HBIg (1 mL) was given to infants on schedule B at 3 months of age. Blood samples were obtained at 3, 6, 11, 12, 24, and 36 months. In a two-year period, 28,412 pregnant women were tested for HBsAg; screening efficiency varied between 85% and 98%. The overall prevalence of HBsAg was 0.8%, with a marked variation between urban centers (2.2%) and the rural area (0.3%). Vaccinations were received by 180 of 193 infants of HBsAg-positive mothers (90 on schedule A and 90 on schedule B). Concentrations of hepatitis B surface antibody less than 10 IU/L were observed in nine instances in five children from group A and in seven instances in six children from group B. Four hepatitis B viral infections (two HBsAg carriers, two who underwent antihepatitis B core seroconversions) were recorded in group A v one infection (antihepatitis B core seroconversion) in group B. The protective efficacy of the program (screening plus passive immunization and delayed vaccination) was 94%. The estimated cost of preventing one case of hepatitis B infection in neonates was $3,000 (US currency). It is concluded that screening all pregnant women for HBsAg can be introduced effectively at reasonable costs in a country with a low prevalence of HBsAg and a high proportion of home deliveries. Delayed active vaccination starting at 3 months of age may be an effective and, for reasons of high compliance and low cost, attractive alternative to early active vaccination.


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