title: Pregnant women as a sentinel population to target and implement hepatitis B virus (HBV) vaccine coverage: a three-year survey in Palermo, Sicily.
abstract: Hepatitis B virus (HBV) vaccine coverage was assessed using serologic patterns of infection (HBsAg, anti HBc) and vaccine-induced immunity (isolated anti HBs) among 3318 pregnant women attending the Obstetrical Unit of the University Hospital in Palermo who were screened over 3 years (2001-2003). Three thousand and eight of them (90.6%) were born in Sicily, whereas 310 (9.4%) were immigrants from non-EU countries. The overall prevalence of HBsAg was 1.1%, and it was significantly higher among immigrant than indigenous women (4.2% versus 0.8%; OR 5.26; p < 0.0001). Serologic evidence of past HBV infection (anti HBc) also was significantly higher in immigrants than in Sicilian women (24.5% versus 5.2%, respectively). Women aged 17-21 in our study were in cohorts that had been targeted since 1991 for mandatory HBV vaccination at age 12. In this targeted age group, 74.2% of the Sicilian women had isolated anti HBs, compared to only 15.0% among immigrants. The results suggest the need to improve HBV immunization of Sicilian adolescents and especially to implement active surveillance and to launch an HBV immunization programme that targets immigrants to Sicily.
authors.affiliation: Dipartimento di Igiene e Microbiologia--Sezione Igiene, Università degli Studi-Policlinico, Palermo, Italy.
authors.forename: Filippa
authors.initials: F
authors.lastname: Bonura
authors.forename: Marco
authors.initials: M
authors.lastname: Sorgi
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Perna
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Puccio
authors.forename: Fabio
authors.initials: F
authors.lastname: Tramuto
authors.forename: Cinzia
authors.initials: C
authors.lastname: Cajozzo
authors.forename: Nino
authors.initials: N
authors.lastname: Romano
authors.forename: Francesco
authors.initials: F
authors.lastname: Vitale
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004641:Emigration and Immigration; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis / Q000096:biosynthesis; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D018571:Sentinel Surveillance
chemical_list: D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines