Abstract
BACKGROUNDThe impact of the universal infant hepatitis B (HB) immunization program initiated in 1991 in Mongolia is still unclear.METHODSA nationwide school-based cross-sectional serosurvey was conducted in 2004, with stratified, multistage, random cluster sampling from all public elementary schools (n=593) in Mongolia. All children were tested for serological markers of hepatitis B virus (HBV).RESULTSSerology results were available for 1,145 children (592 boys and 553 girls) aged 7-12 years (survey response rate: 93%). Immunization card was available for 702 (61.3%) children. The coverage of complete HB vaccination was 60.1% and it was increased by birth cohort from 44% to 76%. Significantly higher proportion of children in Metropolitan cities (75.2%) was completely vaccinated with HB compared to those in Province centers (55.7%) and rural areas (59.1%). HBV infection occurred in 5.9%, 13.2%, and 20.8% of complete vaccinees living in Metropolitan, Province centers, and rural areas, respectively; of whom 1.2%, 2.9%, and 8.6% were HB surface antigen (HBsAg) carriers, respectively. Only 17.0% of the children had protective anti-HBs which decreased from 31.1% to 16.3% among 7 to 12-year-olds indicating its decay with time.CONCLUSIONSPrevalence of HBV infection and carriage among young generation meaningfully declined compared with those of previous studies in Mongolia. The coverage of birth dose and complete HB vaccination was significantly low in Province centers and rural areas which should be taken into consideration.
Highlights
The impact of the universal infant hepatitis B (HB) immunization program initiated in 1991 in Mongolia is still unclear
5.9%, 13.2%, and 20.8% of complete vaccinees living in Metropolitan, Province centers, and rural areas, respectively; of whom 1.2%, 2.9%, and 8.6% were HB surface antigen (HBsAg) carriers, respectively
The coverage of birth dose and complete HB vaccination was significantly low in Province centers and rural areas which should be taken into consideration
Summary
A nationwide school-based cross-sectional serosurvey was conducted in 2004, with stratified, multistage, random cluster sampling from all public elementary schools (n=593) in Mongolia. We conducted a nationwide school-based serosurvey including all (n=593) public elementary schools in Mongolia. The sampling method has been described in detail elsewhere.[11,12] Briefly, a stratified, multistage, probability, random cluster sampling was used to select the study subjects. The total number of students attending the 2nd grade of all public elementary schools during the academic year of 2003-2004 was used for sample size calculation. The territory of Mongolia is divided into 4 main geographical regions. To represent the whole country's geographic and economic characteristics, we divided Mongolia into 10 strata: Province centers and rural Soums in four main geographical regions and capital
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