Prevalence of chronic hepatitis B virus infection before and after implementation of a hepatitis B vaccination program among children in Nepal

Background

In Nepal, an estimated 2–4% of the population has chronic hepatitis B virus (HBV) infection. To combat this problem, from 2002 to 2004, a national three dose hepatitis B vaccination program was implemented to decrease infection rates among children. The program does not currently include a birth dose to prevent perinatal HBV transmission. In 2012, to assess the impact of the program, we conducted a serosurvey among children born before and after vaccine introduction.

Methods

In 2012, a cross-sectional nationally representative stratified cluster survey was conducted to estimate hepatitis B surface antigen (HBsAg) prevalence among children born from 2006 to 2007 (post-vaccine cohort) and among children born from 2000 to 2002 (pre-vaccine cohort). Demographic data, as well as written and oral vaccination history were collected. All children were tested for HBsAg; mothers of HBsAg positive children were also tested. Furthermore, we evaluated the field sensitivity and specificity of the SD Bioline HBsAg rapid diagnostic test by comparing results with an enzyme immunoassay.

Results

Among 2181 post-vaccination cohort children with vaccination data by either card or recall, 86% (95% confidence interval [CI] 77–95%) received ≥3 hepatitis B vaccine doses. Of 1200 children born in the pre-vaccination cohort, 0.28% (95% CI 0.09–0.85%) were positive for HBsAg; of 2187 children born in the post-vaccination cohort, 0.13% (95% CI 0.04–0.39%) were positive for HBsAg (p = 0.39). Of the six children who tested positive for HBsAg, two had mothers who were positive for HBsAg. Finally, we found the SD Bioline HBsAg rapid diagnostic test to have a sensitivity of 100% and a specificity of 100%.

Conclusions

This is the first nationally representative hepatitis B serosurvey conducted in Nepal. Overall, a low burden of chronic HBV infection was found in children born in both the pre and post-vaccination cohorts. Current vaccination strategies should be continued.     

Socioecological and message framing factors influencing maternal influenza immunization among minority women

Objective

A suboptimal level of seasonal influenza vaccination among pregnant minority women is an intractable public health problem, requiring effective message resonance with this population. We evaluated the effects of randomized exposure to messages which emphasize positive outcomes of vaccination (“gain-frame”), or messages which emphasize negative outcomes of forgoing vaccination (“loss-frame”). We also assessed multilevel social and community factors that influence maternal immunization among racially and ethnically diverse populations.

Study design

Minority pregnant women in metropolitan Atlanta were enrolled in the longitudinal study and randomized to receive intervention or control messages. A postpartum questionnaire administered 30 days postpartum evaluated immunization outcomes following baseline message exposure among the study population. We evaluated key outcomes using bivariate and multivariate analyses.

Results

Neither gain- [OR = 0.5176, (95% CI: 0.203,1.322)] nor loss-framed [OR = 0.5000, 95% CI: (0.192,1.304)] messages were significantly associated with increased likelihood of immunization during pregnancy. Significant correlates of seasonal influenza immunization during pregnancy included healthcare provider recommendation [OR = 3.934, 95% CI: (1.331,11.627)], use of hospital-based practices as primary source of prenatal care [OR = 2.584, 95% CI: (1.091,6.122)], and perceived interpersonal support for influenza immunization [OR = 3.405, 95% CI: (1.412,8.212)].

Conclusion

Dissemination of vaccine education messages via healthcare providers, and cultivating support from social networks, will improve seasonal influenza immunization among pregnant minority women.     

Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status

This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short‐stayed (≤10 years) and long‐stayed (>10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign‐born adults (18‐64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic‐regression two‐part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long‐stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long‐stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short‐stayed documented immigrants may encounter difficulties getting health insurance coverage. Copyright © 2013 John Wiley & Sons, Ltd.     

新型农村合作医疗制度实施10年发展概述

从参保情况、筹资水平、基金管理、补偿程度和支付方式等方面回顾新型农村合作医疗制度实施10年来的发展概况。研究显示,新型农村合作医疗制度在各环节取得了一定成效,政策和工作重点也随制度的变迁而改变。新型农村合作医疗制度的实施仍处在设计和探索阶段,需要各部门分工合作,进一步分析问题,提出合理有效的措施,不断完善制度的发展。     

Content analysis of media coverage of breastfeeding in Mexico

Media can be a powerful communication tool to promote breastfeeding programs, influence mother's breastfeeding behaviour, and generate support among stakeholders for breastfeeding. Yet, there is little information on how media coverage influences a country's breastfeeding enabling environment. This study addressed this gap by conducting a retrospective content analysis of documents published between January 1, 2017 and January 1, 2018 to analyse the media coverage related to breastfeeding in Mexico. Content analysis was based on the breastfeeding gear model and a strategic planning technique to identify strengths, weaknesses, opportunities, and threats for enabling the national breastfeeding environment. Media coverage of breastfeeding was more frequent in August (36% of all documents). The top three topics commonly covered by the media were advocacy events promoting breastfeeding, promotion campaigns, and changes in breastfeeding legislation and policy. In general, the media coverage focused on strengths of specific breastfeeding policies. There was limited news coverage of key factors that negatively influenced or threatened the breastfeeding environment. Findings support the need to design strategies to engage the media covering in more depth and breadth diverse aspects of breastfeeding protection, promotion, and support efforts in Mexico.     

2000-2004年浙江省常规免疫监测结果分析

目的 评价浙江省常规免疫接种率报告现状、存在问题及其影响因素.方法 对2000年以来的常规免疫监测资料进行分析.结果 2000-2004年卡介苗、口服脊髓灰质炎疫苗、百白破混合制剂、麻疹疫苗、乙型肝炎疫苗的常规免疫报告接种率为98.71%～99.65%,估算接种率为72.86%～112.11%,与报告接种率之间还有差距.差值显示:全省2000年的数据为不可信,2001、2002、2004年的数据为可疑,2003年数据为可信,主要与流动儿童的计划免疫管理不完善有关.结论 单纯用上级统计年鉴人口数据进行接种率评估方法值得商榷.     

中小学生甲型H1N1流感疫苗接种率调查及影响因素分析

目的调查深圳市宝安区中小学生甲型H1N1流感疫苗的接种率及影响因素。方法在全区中小学中随机抽取1405名学生进行问卷调查,对一般情况采用描述性分析,组间构成比比较采用χ2检验,探讨多变量影响因素采用多因素Logistic回归分析。结果宝安区中小学生甲型H1N1流感疫苗的接种率为30.4%,甲流疫苗知识的总体知晓率为39.5%;未接种甲流疫苗最主要的原因是怕出现疫苗不良副反应,占38.7%;男性学生、年龄增加、近3年接种过季节性流感的学生更倾向于接种疫苗。结论宝安区中小学生甲流疫苗的知晓率偏低,应加强对学生甲流和甲流疫苗的相关知识宣传,同时加强季节性流感知识的健康教育,疾控部门应利用各种渠道及时对公众传达准确的信息。     

2007年广州部分大学生乙肝疫苗接种与乙肝相关知识态度调查

目的了解大学生乙肝疫苗（HBV）接种情况和大学生对乙型肝炎的认知程度，为制定更好的免疫接种计划提供更为可靠的依据。方法2007年，在广州市抽取4所高等学校的部分大学生进行调查。结果调查191人，HBV接种率为76．44％，其中全程接种的为64．92％。HBV接种率及全程接种率，不同年龄学生间有显著性差异（P〈0．05），不同家庭经济收入的学生有差异（P〈0．05）。有乙肝疫苗接种史者、全程接种者对乙肝是否经日常生活接触传播的知晓率仅为56．16％、60．48％．经唾液传播的知晓率仅为41．78％、45．16％；97．4％的被调查者表示会劝亲人或朋友去接种乙肝疫苗，93．7％的被调查者表示会愿意接受乙肝病人或乙肝携带者赠送的礼物。20．9％的被调查者表示会回避与乙肝病人或乙肝携带者交往，同时86．9％的被调查者也表示不介意与乙肝携带者一起工作或学习。结论广州市大学生HBV接种率较商，对乙肝知识的知晓率较高，对乙肝病人多有正确的态度，但在某些方面存在误区？