Format

Send to

Choose Destination
BMC Infect Dis. 2015 Jul 12;15:267. doi: 10.1186/s12879-015-1000-2.

HBV immunization and vaccine coverage among hospitalized children in Cameroon, Central African Republic and Senegal: a cross-sectional study.

Author information

1
Laboratoire des Virus Oncogènes, Institut Pasteur de Bangui, rue Pasteur, BP 923, Bangui, République Centrafricaine. claudinebekondi@yahoo.fr.
2
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France. zanchi.roberta@gmail.com.
3
Laboratoire de Biologie Médicale, Institut Pasteur de Dakar, 36 Avenue Pasteur, Dakar, Sénégal. seck@pasteur.sn.
4
Institut Pasteur de Madagascar, BP 1274, Antananarivo, Madagascar. benoit.garin@pasteur.fr.
5
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France. tamara.giles-vernick@pasteur.fr.
6
Services des soins intensifs, Complexe Pédiatrique, BP 911, Bangui, République Centrafricaine. jcgody@hotmail.com.
7
Complexe Pédiatrique, BP 911, Bangui, République Centrafricaine. petubata@yahoo.fr.
8
Centre Mère-Enfant, Fondation Chantal Biya, Yaoundé, Cameroun. pondyangele@yahoo.fr.
9
Centre Hospitalier d'Essos, Yaoundé, Cameroun. ndiangsuzie@yahoo.fr.
10
Hôpital Albert Royer, Dakar, Sénégal. madouba@gmail.com.
11
Centre Hospitalier d'Essos, Yaoundé, Cameroun.
12
Laboratoire de Virologie, Institut Pasteur Guyane, 23 avenue Pasteur, BP 6010, 97306, Cayenne, France. drousset@pasteur-cayenne.fr.
13
Département de virologie, Hôpital Saint Louis, Paris, France. jmsire@chi-poissy-st-germain.fr.
14
Institut National de la Santé et de la Recherche Médicale, Faculté de Médecine Paris-Diderot, Paris, France. jmsire@chi-poissy-st-germain.fr.
15
Service de Microbiologie CHU St Louis, 75010, Paris, France. sarah.maylin@sls.aphp.fr.
16
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France. chartierloic2000@yahoo.fr.
17
Service de Virologie, Centre Pasteur du Cameroun, P.O.Box 1274, Yaoundé, Cameroun. njouom@pasteur-yaounde.org.
18
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France. muriel.vray@pasteur.fr.

Abstract

BACKGROUND:

Hepatitis B is a major health concern in Africa. The vaccine against hepatitis B virus (HBV) was introduced into the Expanded Programme on Immunization (EPI) of Cameroon and Senegal in 2005, and of CAR (Central African Republic) in 2008. A cross-sectional study was conducted to assess HBV immunization coverage following the vaccine's introduction into the EPI and factors associated with having been vaccinated.

METHODS:

All hospitalized children, regardless of the reasons for their hospitalization, between 3 months and 6 years of age, for whom a blood test was scheduled during their stay and whose condition allowed for an additional 2 mL blood sample to be taken, and who provided the parent's written consent were included. All children anti-HBs- and anti-HBc + were tested for HBsAg. Vaccination coverage was assessed in three different ways: immunization card, maternal recall and serologic anti-HBs profile.

RESULTS:

1783 children were enrolled between April 2009 and May 2010. An immunization card was only available for 24 % of the children. The median age was 21 months. Overall HBV immunization coverage based on immunization cards was 99 %, 49 % and 100 % in Cameroon, CAR and Senegal, respectively (p < 0,001). The immunization rate based on maternal recall was 91 %, 17 % and 88 % in Cameroon, CAR and Senegal, respectively (p < 0,001). According to serology (anti-HBs titer ≥ 10 mUI/mL and anti-HBc-), the coverage rate was 68 %, 13 % and 46 % in Cameroon, CAR and Senegal, respectively (p < 0,001). In Senegal and Cameroon, factors associated with having been vaccinated were: mother's higher education (OR = 2.2; 95 % CI [1.5-3.2]), no malnutrition (OR = 1.6; 95 % CI [1.1-2.2]), access to flushing toilets (OR = 1.6; 95 % CI [1.1-2.3]), and < 24 months old (OR = 2.1; 95 % CI [1.3-3.4] between 12 and 23 months and OR = 2.7; 95 % CI [1.6-4.4] < 12 months). The prevalence of HBV-infected children (HBsAg+) were 0.7 %, 5.1 %, and 0.2 % in Cameroon, CAR and Senegal, respectively (p < 0.001).

CONCLUSIONS:

Assessing immunization coverage based on immunization cards, maternal recall or administrative data could be usefully reinforced by epidemiological data combined with immunological profiles. Serology-based studies should be implemented regularly in African countries, as recommended by the WHO. Malnutrition, lack of maternal education and poverty are factors associated with vaccine non-compliance. The countries' vaccination programs should actively address these problems.

PMID:
26164361
PMCID:
PMC4499446
DOI:
10.1186/s12879-015-1000-2
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center