title: Socio-demographic and behavioral determinants of hepatitis B vaccination and infection in pregnant women on Mayotte Island, Indian Ocean.
abstract: BACKGROUND
  Socio-demographic and behavioral determinants of Hepatitis B virus (HBV) vaccination and infection among pregnant women (PW) of Mayotte Island (Indian Ocean) are not well understood.
  
  
  METHODS
  Six hundred and seventy-one pregnant women presenting to public antenatal clinics on Mayotte Island were included between September 15, 2008 and September 27, 2009. Socio-demographics, sexual risk behavior characteristics, and data for HBV biomarkers were collected. Logistic regression was undertaken to study determinants of HBV vaccination and factors associated with the risk of HBV infection were assessed using a survival method adapted to interval-censored data. Due to missing data for HBV biomarkers, data were analyzed using multiple imputation (MI).
  
  
  RESULTS
  Past or recent HBV infection was observed for 35.5% (95% confidence interval (CI): 30.4-40.8) of PW and 18.6% (95% CI: 14.7-23.2) had evidence of HBV vaccination. PW with unemployed and education qualification (adjusted odds ratio (aOR) 2.65, 95% CI 1.52-4.60) and student status (aOR 4.79, 95% CI 1.63-4.07) were better vaccinated against HBV, compared to those without employment and education. Being born on Comoros was associated with a 63% reduction in HBV vaccination (aOR 0.37, 95% CI 0.21-0.65), compared to be born in Mayotte/France. Women with a history of sexually-transmitted infections in the last 5 years had an increased risk of HBV infection (adjusted hazard ratio (aHR) 3.10, 95% CI: 1.13-8.50), whereas those who sometimes used condoms had a 60% reduced risk (aHR=0.40, 95% CI: 0.23-0.69).
  
  
  CONCLUSIONS
  Socio-demographic factors were identified for HBV vaccination, while behavioral factors were observed for HBV infection. These results could help to determine priorities for intervention.
authors: Université de Lyon, Université Lyon 1, CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Epidémiologie et Santé Publique, Lyon, France. Electronic address: maoulide.saindou@univ-lyon1.fr.
authors: Maoulide
authors: M
authors: Saindou
authors: Nicolas
authors: N
authors: Voirin
authors: Didier
authors: D
authors: Troalen
authors: Abdoulkarim
authors: A
authors: Abaine
authors: Philippe
authors: P
authors: Chevallier-Queyron
authors: René
authors: R
authors: Ecochard
authors: Philippe
authors: P
authors: Vanhems
mesh_terms: D000328:Adult; D017507:Comoros / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D037841:Pregnant People; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines
keywords: HBV determinants; HBV infection; HBV vaccination; Missing data; Multiple imputation; Pregnant women