Implications of Birth-Dose Vaccination against Hepatitis B Virus in Southeast Asia

The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in the Expanded Program of Immunization (EPI) and vaccinating all infants and children three times within 1 year of birth (HepB3). Recently, the WHO advocate birth-dose hepatitis B vaccination (HepB-BD) as soon as possible after birth, preferably within 24 hours. In 2016, the SEARO endorsed a regional hepatitis B control goal with a target of hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020. Of the 11 SEARO countries, four achieved this target on schedule. Out of these four countries, two countries (Bangladesh and Nepal) have not adopted HepB-BD in EPI program. On the other hand, the coverage of HepB3 is not satisfactory in some SEARO countries, including India which adopted HepB-BD but could not achieve the overall target of SEARO. Thus, it is a point of debate whether emphasis should be placed on proper implementation of HepB3 or whether a new agenda of HepB-BD should be incorporated in developing countries of SEARO. The article discusses strengthening and expanding the Hepatitis B vaccination program in SEARO countries with an emphasis on HepB and HepB-BD programs.

Parents Perception Regarding Immunization of Two Years Old Children: An Analysis of EPI Communication Campaign in Pakistan

This research study aimed to explore the parents' perceptions and knowledge with reference to child immunization under the expanded program of immunization. A sample of 200 couples was taken from different provinces of Pakistan, including Punjab, Sindh, Baluchistan and KPK, by utilizing the convenient sampling technique. The findings of the study indicated that the young couples had more knowledge about the covered diseases, schedule of immunization and expanded the program of immunization. Mothers were having good knowledge of EPI, and their mean knowledge was greater than their counterparts. Similarly, employed and urbanized couples had also significant knowledge about the expanded program of immunization and its covered diseases. Television, radio and the internet were the leading and effective sources of information regarding EPI and its covered diseases. Furthermore, access to immunization centers, migration, absence or unavailability of vaccination staff and post-immunization fever were the chief reasons for incomplete immunization.

Typhoid Vaccine in EPI; Relatively New Perhaps Overdue Strategy

Theoretically, it is possible to eliminate Salmonella, pathogenic bacteria that can cause a potentially fatal enteric fever. However, given the high prevalence of the disease in low-income countries that lack adequate facilities for sewage disposal and water treatment, and the fact that people can be long-term asymptomatic carriers, this goal is currently unrealistic. This levies constant need of a preventive measure to reduce morbidity and mortality in children associated with Typhoid Fever in endemic countries like Nepal. Currently, the best possible approach is to integrate the Typhoid vaccination into the Expanded Program of Immunization (EPI) until an improved sanitation and sewage disposal system is attained. We must acknowledge that this approach is not definitive until sufficient political and economic attention is received from all stakeholders. DOI: http://dx.doi.org/10.3126/jnps.v33i2.8715 J Nepal Paediatr Soc. 2013; 33(2):152-154