Efficacy of Selective Antenatal Screening for Hepatitis B Among Pregnant Women in Denmark: Is Selective Screening Still an Acceptable Strategy in a Low-endemicity Country?

TITLE Hepatitis B screening, outcomes and management of pregnant women and infants in the Cook Islands. SHORT TITLEAntenatal screening for hepatitis B in the Cook Islands Dr. Yin Yin May Aung, Ministry of Health Cook Islands, Rarotonga, Cook Islands. Email <a href="mailto:[email protected]">[email protected]</a> Dr. Martin Sowter, Consultant Obstetrician and Gynaecologist, National women’s Health, Auckland New Zealand. Email [email protected] Dr. Timothy Kenealy, Associate Professor of Integrated Care, University of Auckland. Email [email protected] FundingMinistry of Health, Cook Islands. Competing interestsAll authors declare they have no competing interest.<h1>ABSTRACT</h1><h2>Introduction</h2>To describe current Cook Islands practice for screening and management of Hepatitis B (HB) in pregnant women and their newborns and to consider the implications of an updated screening and management strategy.<h2>Methods</h2>Retrospective study of pregnant women booked for antenatal care in Cook Islands from January 2010 to December 2014 was conducted. Data were collected on maternal Hepatitis B serology status, timeliness of hepatitis B immune globulin given if indicated and the completion of hepatitis B immunisation for newborns who were due their vaccinations, special service referral and contact tracing from the electronic health information system. Simple descriptive statistics were used to report the data.<h2>Findings</h2>All women who attended the antenatal clinics accepted Hepatitis B screening in pregnancy. Data from 803 women were analysed. Hepatitis B surface antigen (HBsAg) was detected in 23 of 803 (2.9%) of women of which 21 were Antibody-HBs (Anti-HBs) positive and two were hepatitis B e antigen (HBeAg) positive. Hepatitis B DNA viral load was unable to be tested. Hepatitis B immune globulin was given to 21 of the 23 babies within one day, one was given on day 3 but one was missed. None of the 23 mothers and their babies had any ongoing follow up.The first Hepatitis B vaccine, due within 24 hours of birth, was given within a day to 743 of the 803 (93%) of babies. The second, due at 6 weeks, was given by 8 weeks to 645 of the 778 babies due for their six week vaccination (83%). The third, due at 3 months, was given by 4 months to 648 of the 744 (87%). The fourth, due at 5 months was given by 6 months to 553 of the 712 (78%). Of the 712 babies over 6 months of age, 601 (84%) were recorded as having completed four HB vaccines at any time.<h2>Conclusion</h2>The hepatitis B screening and immunisation in the Cook Islands appears effective but this study indicates that the follow up of both the mother and their infants needs to be improved. he research question, interpreted the data and revised the manuscript. TK reviewed the research question, analysed and interpret the data and revised the manuscript.

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Compliance with antenatal screening for hepatitis B surface antigen carrier status in pregnant women and consecutive procedures in exposed newborns

European Journal of Pediatrics ◽

10.1007/s00431-004-1522-x ◽

2004 ◽

Cited By ~ 2

Author(s):

Kirsten Beckers ◽

UrsB. Schaad ◽

Ulrich Heininger

Keyword(s):

Hepatitis B ◽

Pregnant Women ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Carrier Status ◽

Antenatal Screening ◽

Antigen Carrier

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Antenatal screening and prevalence of infection: surveillance in London, 2000-2007

Eurosurveillance ◽

10.2807/ese.14.09.19134-en ◽

2009 ◽

Vol 14 (9) ◽

Author(s):

I Giraudon ◽

J Forde ◽

H Maguire ◽

J Arnold ◽

N Permalloo

Keyword(s):

Human Immunodeficiency Virus ◽

National Health Service ◽

Hepatitis B ◽

Pregnant Women ◽

National Policy ◽

Antenatal Screening ◽

Quarterly Data ◽

The United Kingdom ◽

Infection Surveillance ◽

Immunodeficiency Virus

In the United Kingdom (UK), it is recommended to universally offer antenatal infection screening for human immunodeficiency virus (HIV), hepatitis B and syphilis infections, and susceptibility to rubella for the benefit of the mother and to reduce vertical transmission of infection. This paper describes the surveillance of antenatal infection including uptake of screening, and the results of testing in pregnant women in London between 2000 and 2007. Antenatal screening coordinators in liaison with midwifery heads and microbiologists at all thirty London National Health Service (NHS) Trust maternity units supplied quarterly data on the number of pregnant women booked for antenatal care, tests done, and tests results. The overall estimated uptake of screening increased since 2000 and reached 95.6% for HIV, 96.5% for syphilis, 96.2% for hepatitis B and 97% for rubella susceptibility by the second half of 2007. There is considerable variation in the performance between NHS Trusts. The overall estimated prevalence of HIV infection was 3.4/1,000 women (ranging from <1/1,000 to 10/1,000 across Trusts), of hepatitis B (HBsAg-positive) was 11.3/1,000 (2.6/1,000- 23.9/1,000), of syphilis was 4.4/1,000 (<1/1,000-16.3/1,000) and of rubella susceptibility was 39.3/1,000 (19-103/1,000). Antenatal infection screening has improved and there has been some success in implementation of national policy. However, screening uptake and prevalence of infection vary considerably across London NHS Trusts and some women are evidently disadvantaged. Improvements in information systems should help local partners to focus their interventions in those Trusts where work is still needed to increase testing as well as the capacity to monitor the uptake of screening.

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