title: Evaluation of a programme for prevention of vertical transmission of hepatitis B in a rural block in southern India.
abstract: OBJECTIVE
  This study was undertaken to evaluate a community based programme of antenatal screening for hepatitis B surface antigen (HBsAg) and selective immunization of children commencing at birth, at a secondary care hospital in south India. The primary objective was to assess immunization coverage among children born to HBsAg positive women; secondary objectives were to study the prevalence of HBsAg among antenatal women, prevalence of HBsAg among immunized children (to estimate vaccine efficacy), seroconversion rate and relationship of maternal hepatitis B e antigen (HBeAg) to hepatitis infection.
  
  
  METHODS
  The prevalence of hepatitis B antigen among antenatal women and immunization coverage achieved with hepatitis B vaccine in a rural block in Vellore, Tamil Nadu were assessed through examination of records. Children born between May 2002 and December 2007 to hepatitis B positive women were followed up for a serological evaluation, based on which vaccine efficacy and the effect of maternal hepatitis B e antigen (HBeAg) on breakthrough infection was estimated.
  
  
  RESULTS
  The prevalence of hepatitis B surface antigen among antenatal women was 1.58 % (95% CI: 1.35-1.81%). Vaccine coverage for three doses as per a recommended schedule (including a birth dose) was 70 per cent, while 82.4 per cent eventually received three doses (including a birth dose). Estimated vaccine efficacy was 68 per cent and seroconversion 92.4 per cent in children aged 6-24 months. Maternal HBeAg was significantly associated with either anti-HBc or HBsAg in immunized children, RR=5.89 (95% CI: 1.21-28.52%).
  
  
  CONCLUSIONS
  The prevalence of hepatitis B among antenatal women in this region was low and a programme of selective immunization was found to be feasible, achieving a high coverage for three doses of the vaccine including a birth dose.
authors.affiliation: Department of Community Medicine, Christian Medical College,Vellore, India. anualexander@rediffmail.com
authors.forename: Anu Mary
authors.initials: AM
authors.lastname: Alexander
authors.forename: Jasmin Helen
authors.initials: JH
authors.lastname: Prasad
authors.forename: Priya
authors.initials: P
authors.lastname: Abraham
authors.forename: John
authors.initials: J
authors.lastname: Fletcher
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Muliyil
authors.forename: Vinohar
authors.initials: V
authors.lastname: Balraj
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000276:immunology* / Q000517:prevention & control / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D006511:Hepatitis B Antigens / Q000097:blood / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D007114:Immunization; D007194:India; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood; D015995:Prevalence
chemical_list: D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
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