title: Using data to guide policy: next steps for preventing perinatal hepatitis B virus transmission in Cambodia.
abstract: BACKGROUND
  Cambodia is highly endemic for hepatitis B virus (HBV) infection. Preventing perinatal HBV transmission should be prioritized in health facilities by providing hepatitis B vaccination to all infants within 24 h of birth (timely birth dose coverage).
  
  
  METHODS
  Teams assessed birth dose policy, practices and coverage in hospitals and health facilities in 10 provinces in Cambodia.
  
  
  RESULTS
  Fifty-one sites were assessed. Median (interquartile range) timely birth dose coverage was 66% (48-92%); coverage was 88% (range=60-96%) in facilities vaccinating on-site and 48% (range=20-52%) in those referring off-site (p<0.0001). Overall, 5 (29%) of 16 hospitals that referred vaccination off-site did not tell mothers vaccination should take place within 24 h of birth, and 6 (35%) discharged mothers when no vaccination services were available for infants to receive the birth dose.
  
  
  CONCLUSIONS
  Newborns can miss a time-sensitive opportunity to be protected against perinatal HBV infection when they are referred for vaccination off-site rather than being vaccinated in the delivery facility. These data support the case to strengthen policies and practices to provide hepatitis B birth dose vaccination in the delivery facility.
authors.affiliation: Ministry of Health, Phnom Penh, Cambodia.
authors.forename: Sann Chan
authors.initials: SC
authors.lastname: Soeung
authors.forename: Chanthan
authors.initials: C
authors.lastname: Thiep
authors.forename: Richard
authors.initials: R
authors.lastname: Duncan
authors.forename: Minal
authors.initials: M
authors.lastname: Patel
authors.forename: Karen
authors.initials: K
authors.lastname: Hennessey
mesh_terms: D002160:Cambodia / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control / Q000635:transmission*; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control