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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
The first five years of universal hepatitis B vaccination in South Africa: Evidence for elimination of HBsAg carriage in under 5-year-olds
Vaccine, Volume 19, No. 28-29, Year 2001
Notification
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Description
South Africa implemented a vaccine against hepatitis B virus (HBV) into the Expanded Programme on Immunisation (EPI) in April 1995. The HBV vaccine is given at 6, 10, and 14 weeks, in parallel with OPV, DTP and Hib vaccines. This study assessed the impact of universal childhood HBV vaccination programme in reducing HBsAg carriage, in the first five years (1995-1999) since its implementation. In parallel, we investigated the current burden of HBV infection in mothers of vaccinees and the adult general population. A total of 598 babies (mean age = 23.3 months) who received 3 doses of 1.5 μg/0.5 ml Hepaccine-B (Cheil) were recruited from the Northern Province (one of the nine provinces in South Africa). HBsAg, anti-HBs, anti-HBc, HBeAg and anti-HBe were tested using the IMx or Axsym kits (Abbott Laboratories). PCR assays were performed following established protocols. The overall seroprotection rate (i.e. anti-HBs titre ≥ 10 mIU/ml) was 86.8% (519/598) in vaccinated babies, while 13.2% had anti-HBs levels < 10 mIU/ml. Seroprotection rates and geometric mean titres (GMT) decreased significantly with increasing age, possibly reflecting waning anti-HBs titre over time. Total HBV exposure (positive for either HBsAg, anti-HBs, or anti-HBc) was 31.0% (58/187) in mothers of vaccinees and 40% (72/180) in the adult general population. HBsAg carrier rate was virtually similar in both groups (3.2% in mothers of vaccinees vs. 3.3% in the general population). Against this background, no vaccine failures resulting in HBsAg and HBV DNA positivity were seen in vaccinated babies, including 6 babies born to HBsAg positive carrier mothers (one carrier mother was positive for HBeAg and HBV DNA). However, 0.9% (5/582) babies, aged between 8-11 months, tested positive for anti-HBc, all of whom had anti-HBs titres > 10 mIU/ml and were negative for HBV DNA. Anti-HBc positivity was probably maternal in origin, or may represent sub-clinical averted HBV infections. It can be concluded that the HBV vaccine is highly effective within the framework of the South African EPI and already shows a positive impact in the elimination of HBsAg carrier rate in children < 5 years. © 2001 Elsevier Science Ltd.
Authors & Co-Authors
Tsebe, Khomotso V.
South Africa, Pretoria
Sefako Makgatho Health Sciences University Smu
Burnett, Rosemary J.
South Africa, Pretoria
Sefako Makgatho Health Sciences University Smu
Hlungwani, Nyiko P.
South Africa, Pretoria
Sefako Makgatho Health Sciences University Smu
Sibara, Mbudzeni M.
South Africa, Sovenga
University of Limpopo
Venter, Philip A.
South Africa, Sovenga
University of Limpopo
Mphahlele, M. Jeffrey
South Africa, Pretoria
Sefako Makgatho Health Sciences University Smu
Statistics
Citations: 129
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1016/S0264-410X(01)00120-7
ISSN:
0264410X
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
South Africa