Biomaterial Database

Effectiveness of hepatitis B virus vaccination program in Egypt: Multicenter national project. 2015

Iman I Salama, and Samia M Sami, and Zeinab Nabil Ahmed Said, and Manal H El-Sayed, and Lobna A El Etreby, and Thanaa M Rabah, and Dalia M Elmosalami, and Amany T Abdel Hamid, and Somaia I Salama, and Aida M Abdel Mohsen, and Hanaa M Emam, and Safaa M Elserougy, and Amal I Hassanain, and Naglaa F Abd Alhalim, and Fatma A Shaaban, and Samia A Hemeda, and Nihad A Ibrahim, and Ammal M Metwally

Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt.

OBJECTIVE To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children. METHODS A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen (HBsAg), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBsAg/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS Sero-protection was detected among 2059 children (57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among non-seroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non sero-protective level, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to < 10, 10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and P < 0.01.The prevalence was higher among girls (0.48%) than boys (0.29%) with P > 0.05. CONCLUSIONS The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.