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Screening for hepatitis B virus and accelerated vaccination schedule in prison: A pilot multicenter study
Authors:Cristina Stasi  Mirko Monnini  Valerio Cellesi  Marco Salvadori  Daniele Marri  Mateo Ameglio  Andrea Gabbuti  Teresa Di Fiandra  Fabio Voller  Caterina Silvestri
Institution:1. Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy;2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy;3. Prison Healthcare of Volterra, Local Healthcare Tuscany North West, Volterra, Italy;4. “Sollicciano” District House, Local Healthcare Tuscany Centre, Florence, Italy;5. Infectious Diseases and Hepatology Unit, University Hospital of Siena, Siena, Italy;6. Departmental Operational Units in Prison, Local Healthcare Tuscany Southest, Colle Val D’Elsa, Siena, Italy;7. Infectious Diseases Unit, Local Healthcare Tuscany Centre, Firenze, Italy;8. General Directorate for Health Prevention, Ministry of Health, Rome, Italy
Abstract:

Background and Aim

Vaccine against hepatitis B virus (HBV) is highly effective in preventing HBV infection. The aims of this study were to (1) increase the epidemiological knowledge on the impact of HBV in Tuscany region prisons by registering the results of serum screening on a clinical medical record and (2) increase the anti-HBV vaccination using an accelerated schedule.

Methods

Our study population was composed of all detainees present in prisons and all constrained from freedom or at institutions in the Tuscany region and not vaccinated at these facilities from 1 December 2016 to 31 May 2017.

Results

Of 17 detention facilities in the Tuscany region, 15 were enrolled in the study. On 28 February 2017, there were 3068 detainees present in these institutions. Considering the 1075 subjects screened for HBV serum markers, 730 (67.9%) were susceptible to infection and needed to be vaccinated. Five hundred and ninety-six agreed to be vaccinated (82%); 27 (2.5%) of our subjects had an isolated anti-HBc, 20 (1.9%) were HBV infected (HBsAg+), 127 (11.8%) had previous HBV infection (anti-HBs+, anti-HBc+ and HBsAg?), and 171 had been previously vaccinated. Five hundred and fifty-five inmates (95.1%) received the first vaccine dose, and 404 (83%) underwent the third dose at day 21.

Conclusion

This study showed that of a high percentage of subjects who underwent screening, more than half needed to be vaccinated. Moreover, our study reached very high levels of vaccination coverage, considering both the entire enrolled population and the new inmates.
Keywords:Hepatitis B virus infection  Screening  Vaccination  Prison
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