Prevalence of Chronic Hepatitis B Virus Infection among Children in Haiti, 2017

• Published in: The American journal of tropical medicine and hygiene 2019-01, Vol.101 (1), p.214-219
• Main Authors: Childs, Lana, Adrien, Paul, Minta, Anna A, François, Jeannot, Phaïmyr Jn Charles, Nadia, Blot, Valery, Rey-Benito, Gloria, Vanden Eng, Jodi L, Tohme, Rania A
• Format: Article
• Language: English
• Subjects: Adult; Caregivers; Child; Child, Preschool; Cross-Sectional Studies; Female; Haiti - epidemiology; Hepatitis; Hepatitis B; Hepatitis B Surface Antigens - blood; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - immunology; Hepatitis B, Chronic - epidemiology; Hepatitis B, Chronic - prevention & control; Humans; Immunization; Infections; Interferon; Male; Prevalence; Seroepidemiologic Studies; Socioeconomic Factors; Vaccination
• ISSN: 0002-9637; 1476-1645; 1476-1645
• DOI: 10.4269/ajtmh.19-0117

In 2016, the World Health Assembly endorsed the Global Health Sector Strategy on Viral Hepatitis, which calls for elimination of hepatitis B virus (HBV) by 2030 (definition: ≤ 0.1% hepatitis B surface antigen [HBsAg] prevalence among children aged 5 years). The burden of chronic HBV infection among children in Haiti is unknown. We conducted a nationally representative cross-sectional serological survey among 5- to 7-year-old children based on a two-stage cluster design with two strata: West (includes metropolitan Port-au-Prince) and non-West (all other departments). We collected demographic, socioeconomic, and vaccination history data and tested for HBsAg using a rapid point-of-care test. We estimated HBsAg prevalence and evaluated the association of HBV infection with vaccination history, demographics, and socioeconomic characteristics. Of the 1,152 children, seven (0.5%, 95% CI: 0.2-1.2) were HBsAg positive. The HBsAg prevalence varied by region (West: 0.1%, 95% CI: 0.01-0.9; non-West: 0.7%, 95% CI: 0.2-1.9) ( = 0.1), gender (males: 0.7%, 95% CI: 0.2-2.4; females: 0.2%, 95% CI: 0.05-1.1) ( = 0.3), and caregiver's education level (none: 0.8%, 95% CI: 0.2-3.1; some or completed primary: 0.5%, 95% CI: 0.1-1.8; some secondary: 0.4%, 95% CI: 0.1-1.8; secondary and higher: 0.0%, 95% CI: 0-0), although the differences were not statistically significant. None of the HBsAg-positive children had documented vaccination with hepatitis B vaccine (HepB). Haiti's chronic HBV infection prevalence among children is low; however, it is above the elimination target. To reach elimination, Haiti needs to achieve high coverage with the three HepB doses and introduce a HepB birth dose.