Feasibility, benefits, and cost-effectiveness of adding universal hepatitis B and syphilis testing to routine antenatal care services in Thai Nguyen province, Vietnam

2020 ◽  
pp. 095646242095372
Author(s):  
Van Thi Thuy Nguyen ◽  
Ho Thi Quynh Trang ◽  
Naoko Ishikawa ◽  
Lan Anh Nguyen ◽  
Le Ai Kim Anh ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Descriptive Analysis ◽  
Integrated Approach ◽  
Pilot Project ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Syphilis Testing ◽  
Mother To Child

Pregnant women in Vietnam have a high prevalence of hepatitis B virus (HBV) and low prevalence of human immunodeficiency virus (HIV) and syphilis. This study aims to assess the feasibility and benefit of universal testing for HIV, HBV and syphilis in antenatal care (ANC) services. A pilot project was conducted in the Thai Nguyen province of Vietnam between 2012 and 2014. HIV, HBV and syphilis testing were offered to pregnant women. Interventions to eliminate mother-to child-transmission (MTCT) of the three pathogens were provided to infected mothers and their infants. Descriptive analysis was conducted, and the number of infections averted from integrating hepatitis B tests into ANC was estimated. Testing coverage for HIV, HBV and syphilis for the cohort of pregnant women during the pilot project was 98%. Prevalence of HIV, HBV and syphilis infections in this cohort was 0.14%, 7.8%, and 0.03%, respectively. No infant was infected with HIV or syphilis, while HBV infection was diagnosed in 27 infants (13.9%). An estimated 23 mother to child HBV infections were prevented by integrated interventions. The triple prevention of mother-to-child transmission of HIV, HBV and syphilis is feasible. Investment in the expansion of the integrated approach is required to achieve the goal of eliminating MTCT.

scholarly journals Integrated approach for triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis is highly effective and cost-effective: an economic evaluation

2019 ◽  
Vol 48 (4) ◽  
pp. 1327-1339 ◽  
Author(s):  
Lei Zhang ◽  
Yusha Tao ◽  
Joseph Woodring ◽  
Kim Rattana ◽  
Samreth Sovannarith ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis B ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Cost Effective ◽  
Integrated Approach ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Total Cost ◽  
Mother To Child

Abstract Background The Regional Framework for Triple Elimination of Mother-to-Child Transmission (EMTCT) of HIV, Hepatitis B (HBV) and Syphilis in Asia and the Pacific 2018-30 was endorsed by the Regional Committee of WHO Western Pacific in October 2017, proposing an integrated and coordinated approach to achieve elimination in an efficient, coordinated and sustainable manner. This study aims to assess the population impacts and cost-effectiveness of this integrated approach in the Cambodian context. Methods Based on existing frameworks for the EMTCT for each individual infection, an integrated framework that combines infection prevention procedures with routine antenatal care was constructed. Using decision tree analyses, population impacts, cost-effectiveness and the potential reduction in required resources of the integrated approach as a result of resource pooling and improvements in service coverage and coordination, were evaluated. The tool was assessed using simulated epidemiological data from Cambodia. Results The current prevention programme for 370,000 Cambodian pregnant women was estimated at USD$2.3 ($2.0–$2.5) million per year, including the duration of pregnancy and up to 18 months after delivery. A model estimate of current MTCT rates in Cambodia was 6.6% (6.2–7.1%) for HIV, 14.1% (13.1–15.2%) for HBV and 9.4% (9.0–9.8%) for syphilis. Integrating HIV and syphilis prevention into the existing antenatal care framework will reduce the total time required to provide this integrated care by 19% for health care workers and by 32% for pregnant women, resulting in a net saving of $380,000 per year for the EMTCT programme. This integrated approach reduces HIV and HBV MTCT to 6.1% (5.7–6.5%) and 13.0% (12.1–14.0%), respectively, and substantially reduces syphilis MCTC to 4.6% (4.3–5.0%). Further introduction of either antiviral treatment for pregnant women with high viral load of HBV, or hepatitis B immunoglobulin (HBIG) to exposed newborns, will increase the total cost of EMTCT to $4.4 ($3.6–$5.2) million and $3.3 ($2.7–$4.0) million per year, respectively, but substantially reduce HBV MTCT to 3.5% (3.2–3.8%) and 5.0% (4.6–5.5%), respectively. Combining both antiviral and HBIG treatments will further reduce HBV MTCT to 3.4% (3.1–3.7%) at an increased total cost of EMTCT of $4.5 ($3.7–$5.4) million per year. All these HBV intervention scenarios are highly cost–effective ($64–$114 per disability-adjusted life years averted) when the life benefits of these prevention measures are considered. Conclusions The integrated approach, using antenatal, perinatal and postnatal care as a platform in Cambodia for triple EMTCT of HIV, HBV and syphilis, is highly cost-effective and efficient.

scholarly journals Prevalence, Seroconversion and Mother-To-Child Transmission of Dual and Triplex Infections of HIV, Hepatitis B and C Viruses Among Pregnant Women in Nigeria: Study Protocol

2020 ◽  
Author(s):  
George Uchenna Eleje ◽  
Ikechukwu Innocent Mbachu ◽  
Uchenna Chukwunonso OGWALUONYE ◽  
Stephen Okoroafor KALU ◽  
Chinyere Ukamaka ONUBOGU ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Hiv Care ◽  
Seroprevalence Rate ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Triple Infection ◽  
Mother To Child

Abstract Background: Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available.Objectives: To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. Method: A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007-23/01/2020).Conclusion: Pregnant women with multiple of HIV, HBV and C infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

THU-410-Hepatitis B prevention of mother to child transmission integrated into antenatal care services in Mozambique

2019 ◽  
Vol 70 (1) ◽  
pp. e336-e337
Author(s):  
Aude Nguyen ◽  
Natalia Tamayo Antabak ◽  
Maira Chanase Rodrigues Marra ◽  
Natercia Madeira ◽  
Lucas Molfino ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Antenatal Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Care Services ◽  
Hepatitis B Prevention ◽  
Mother To Child

scholarly journals Efficacy of Nucleotide/Nucleoside Analogues and Hepatitis B Immunoglobulin Therapy in Blocking Mother-to-Child Transmission of Hepatitis B in an Eastern Chinese Group

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Xiaojun Sun ◽  
Chengwei Wang ◽  
Bian Wang ◽  
Xiuzhen Yang ◽  
Hongtao Xu ◽  
...  
Keyword(s):  
Side Effects ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Laboratory Data ◽  
Nucleoside Analogues ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hepatitis B Immunoglobulin ◽  
Mother To Child ◽  
Hbv Transmission

The objective of this study was to investigate the efficacy and potential side-effects of nucleotide/nucleoside analogues and hepatitis B immunoglobulin injection of newborns in blocking mother-to-child transmission of hepatitis B virus in the middle and late pregnancy period. 238 cases of enrolled pregnant women were divided into the Telbivudine group, the Tenofovir group, the Lamivudine group, and the hepatitis B immunoglobulin (HBIG) group. Enrolled patients received corresponding therapies. Clinical and laboratory data were collected. Results showed that the levels of HBV DNA of the enrolled pregnant women in the Telbivudine, Tenofovir, and Lamivudine groups decreased rapidly after 12 weeks of drug intervention compared with those in the control. HBsAg positive rate in newborns and in children 24 weeks after birth was 0/60, 0/60, 0/60, 3/30, and 11/28 in the Telbivudine, Tenofovir, Lamivudine, HBIG, and control groups, respectively. No significant side-effects were identified after following up to 12 months after birth. Our results show that routine HBV vaccine plus HBIG injections is insufficient in blocking mother-to-child HBV transmission. Administration of nucleotide/nucleoside analogues or HBIG at pregnancy is suggested to maximize the blocking of vertical HBV transmission.

Prevalence, Seroconversion and Mother-to-Child Transmission of Dual and Triplex Infections of HIV, Hepatitis B and C Viruses Among Pregnant Women in Nigeria: A Protocol

2020 ◽  
Author(s):  
George Eleje ◽  
Ikechukwu Innocent Mbachu ◽  
Uchenna C. Ogwaluonye ◽  
Stephen Okoroafor Kalu ◽  
Chinyere Ukamaka Onubogu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

scholarly journals A study evaluating knowledge of and attitude towards hepatitis B among pregnant women at a teaching hospital in Nellore, India.

2019 ◽  
Vol 8 (8) ◽  
pp. 3183
Author(s):  
Swetha Munivenkatappa ◽  
Srinivas M. Govindaraj
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Demographic Data ◽  
Unprotected Sex ◽  
Hepatitis B Infection ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Attitude And Practice ◽  
The Mean ◽  
Mother To Child

Background: Hepatitis B infection is a common and preventable infection in India. Mother to child transmission is the most common method of infection in our country. Awareness regarding hepatitis B among pregnant women is important to take preventive measures like screening during pregnancy, vaccination of child. Studies evaluating knowledge, attitude and practice (KAP) towards hepatitis B among the pregnant women in our country are sparse.Methods: A cross sectional survey was conducted to evaluate KAP towards hepatitis B among pregnant women was conducted after handing over an information hand-out. Data was collected using a standard questionnaire with three sections: i) Demographic data ii) Knowledge questions iii) Attitude and Practice questions.   Results: 42% of the 350 participants were aware about hepatitis B infection. The mean knowledge score was 6.33 (±2.86). Only 33.3% were aware that hepatitis B is transmitted by unprotected sex and 8.2% were knowledgeable of mother to child transmission. The mean attitude/practice score was 2.97 (±1.69). Only 30% would insist on safe equipment and blood/blood products. 84% would hesitate to have casual contact with hepatitis B infected persons. Most feared the stigma associated with hepatitis b infection than its health consequences. 70% would vaccinate their child to prevent hepatitis B infection. Women with greater knowledge about hepatitis B had better attitude/practice towards its prevention.Conclusions: Knowledge about HBV among pregnant women was poor and needs to be improved to prevent mother to child transmission. Educational programs need to be tailored for the target population for better uptake.

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