Is hepatitis B birth dose vaccine needed in Africa?

Cynthia Raissa Tamandjou, Tongai Gibson Maponga, Nafiisah Chotun, Wolfgang Preiser, Monique Ingrid Andersson, Cynthia Raissa Tamandjou, Tongai Gibson Maponga, Nafiisah Chotun, Wolfgang Preiser, Monique Ingrid Andersson

Abstract

This commentary describes the need for a birth dose monovalent hepatitis B virus (HBV) vaccine and an effective programme for the prevention of mother-to-child-transmission (MTCT) of HBV in Africa. Current World Health Organization guidelines recommend routine maternal screening for HBV followed by treatment of highly infectious HBV-infected mothers, and HBV birth dose vaccination and the administration of hepatitis B immunoglobulin for HBV-exposed infants as an effective strategy for the prevention of HBV MTCT. None of these practices are currently in place in most parts of Africa. To date, fewer than 10 African countries vaccinate children at birth against HBV. Despite the hurdles associated with implementing this practice, its expansion to the rest of Africa is feasible and crucial to reducing the global number of new HBV infections by 90% by 2030, as targeted by the current Global Health Strategy for the elimination of viral hepatitis.

Keywords: Africa; HBV; birth-dose; elimination.

Figures

Figure 1
Figure 1
Map of HBV birth dose vaccine and in-country coverage rates for 2015. Only nine African countries provide HBV birth dose vaccine and where provided, coverage needs to improve in order to achieve the recommended targets set by the WHO.

References

    1. GBD 2013 Mortality and Causes of Death Collaborators Causes of Death, Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71.
    1. Ferlay J, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 201. Int J Cancer. 2015;136(5):E359–86.
    1. Hyams KC. Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis. 1995;20(4):992–1000.
    1. Shimakawa Y, et al. Natural history of chronic HBV infection in West Africa: a longitudinal population-based study from The Gambia. Gut. 2016;65(12):2007–2016.
    1. Casey RM, et al. Global Routine Vaccination Coverage, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(45):1270–1273.
    1. Decker MD. Principles of pediatric combination vaccines and practical issues related to use in clinical practice. Pediatr Infect Dis J. 2001;20(11 Suppl):S10–8.
    1. Andersson MI, et al. The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa. Vaccine. 2013;31(47):5579–84.
    1. Sangare L, et al. Antenatal transmission of hepatitis B virus in an area of HIV moderate prevalence, Burkina Faso. Bull Soc Pathol Exot. 2009;102(4):226–9.
    1. Chasela CS, et al. Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants. J Hepatol. 2014;60(3):508–14.
    1. Chotun N, et al. Hepatitis B virus infection in HIV-exposed infants in the Western Cape, South Africa. Vaccine. 2015 Aug 26;33(36):4618–22.
    1. Keane E, Funk AL, Shimakawa Y. Systematic review with meta-analysis: the risk of mother-to-child transmission of hepatitis B virus infection in sub-Saharan Africa. Aliment Pharmacol Ther. 2016;44(10):1005–1017.
    1. World Health Organization . WHO guidelines on hepatitis B and C testing. Geneva, Switzerland: 2017. Accessed 13 March 2017.
    1. Sellier PO, et al. Prospective interventional study of tenofovir in pregnancy to prevent vertical transmission of hepatitis B in highly viremic women. Eur J Gastroenterol Hepatol. 2017;29(3):259–263.
    1. Pan CQ, et al. Tenofovir to Prevent Hepatitis B Transmission in Mothers with High Viral Load. N Engl J Med. 2016;374(24):2324–34.
    1. Loriette M, et al. An experience of hepatitis B control in a rural area in Far North Cameroon. Med Santé Trop. 2015;25(4):422–7.
    1. Klingler C, Thoumi AI, Mrithinjayam VS. Cost-effectiveness analysis of an additional birth dose of Hepatitis B vaccine to prevent perinatal transmission in a medical setting in Mozambique. Vaccine. 2012;31(1):252–9.
    1. Lemoine M, et al. Acceptability and feasibility of a screen-and-treat programme for hepatitis B virus infection in The Gambia: the Prevention of Liver Fibrosis and Cancer in Africa (PROLIFICA) study. Lancet Glob Health. 2016;4(8):e559–67.
    1. Nayagam S, et al. Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis. Lancet Glob Health. 2016;4(8):e568–78.
    1. World Health Organization . Practices to improve coverage of the hepatitis B birth dose vaccine. Geneva, Switzerland: 2012. Accessed 13 March 2017.
    1. United States Agency for International Development . DHS Survey Indicators - Maternal and Child Health. Maryland, USA: 2015. Accessed 13 March 2017.
    1. Kolwaite AR, et al. Hepatitis B vaccine stored outside the cold chain setting: a pilot study in rural Lao PDR. Vaccine. 2016;34(28):3324–30.

Source: PubMed

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