Abstract
Introduction and methodsHepatitis B is a vaccine preventable disease and is notifiable in South Africa. Hepatitis B vaccination was incorporated into the Expanded Programme on Immunisation in South Africa in 1995. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. Of samples serologically negative for acute measles infection, 450 samples spanning nine provinces of South Africa were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc).ResultsTwo children (2/450; 0.4%) tested positive for HBsAg. Three hundred and three children (67.3%) had evidence of vaccine induced immunity. Vaccine induced immunity was present in 80.2% of 1–5 year olds, but only 60.3% of 10–14 year olds. Natural immunity, indicating exposure to circulating hepatitis B, was present in 13/450 (2.9%) children.ConclusionChronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction. Decreased vaccine-induced immunity with increasing age may reflect waning antibody titres over time.
Highlights
Introduction and methodsHepatitis B is a vaccine preventable disease and is notifiable in South Africa
Chronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction
Dr Suchard administered during the conduct of the study; grants from Sanofi Pasteur, speaker honoraria from Aspen- GSK and Paediatric management group, consultancy fees from Prepex Circ Med Tech ltd and personal fees from World Health Organization, outside the submitted work; In addition, Dr Suchard has an expired provisional South African patent 2010 “Method for Diagnosing a Disease” PA151392/P unrelated to the current work
Summary
Introduction and methodsHepatitis B is a vaccine preventable disease and is notifiable in South Africa. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. We estimated hepatitis B seroprevalence in South African children using residual sera from febrile rash surveillance. South Africa was considered a country of high hepatitis B endemicity, defined as 8% prevalence for hepatitis B surface antigen (HBsAg) in the general population[1]. Rates of 5–16% for hepatitis B surface antigen were seen in rural black men, with lower rates in females, urban populations and other ethnic groups [2,3,4,5]. Paediatric hepatitis B in South Africa in the pre-vaccine era was reported to be mostly due to horizontal transmission in childhood rather than vertical transmission from mother to child. Modes of horizontal transmission are not well defined but may result from exposure amongst children to infectious saliva or open sores amongst other postulated mechanisms [3, 6, 9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
