Impact of four urban perinatal hepatitis B prevention programs on screening and vaccination of infants and household members.
During 1992-2000, the authors studied compliance with perinatal hepatitis B prevention recommendations, including vaccination of household contacts, at four metropolitan sites in Connecticut, Georgia, Texas, and Michigan. Demographic and hepatitis B-related knowledge, attitudes, practices, and barrier data were collected on pregnant women testing positive for hepatitis B surface antigen and on their infants, children, and household and sexual contacts. Generalized estimating equations with repeated measures in a multivariable model were used to obtain adjusted relative risks of household noncompliance. In 1,458 households studied, 1,490 infants and 3,502 other contacts were identified. Among infants, vaccination start/finish rates were 92%/72%, and 73% were serotested postvaccination. Prevaccination serotesting rates among contacts were 22% preenrollment and 47% postenrollment. Among 2,519 contacts whose immunity status was susceptible or unknown, the vaccination start/finish rate was 45%/41%. Site-specific adjusted relative risks of household noncompliance compared with Texas were 2.14 (Michigan), 1.96 (Georgia), and 1.30 (Connecticut). Mother's birth in the United States increased the relative risk of household noncompliance (1.32). Home visits, implemented only in Texas, most likely account for higher compliance rates in that state. Findings may indicate that many perinatal programs could achieve higher overall rates of infant and contact identification; pre- and postvaccination serologic testing in contacts and infants, respectively; and contact hepatitis B vaccination.
Euler
Gary L
GL
Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. gle0@cdc.gov
Copeland
John
J
Williams
Walter W
WW
D000328:Adult; D002648:Child; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006509:Hepatitis B / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010349:Patient Compliance; D018743:Perinatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D012698:Serologic Tests; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D019037:Urban Health Services / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*