Volume 141, Issue 1 p. 126-132
CLINICAL ARTICLE

A decision analytic model for prevention of hepatitis B virus infection in Sub-Saharan Africa using birth-dose vaccination

Sarah Anderson

Corresponding Author

Sarah Anderson

Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, The University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence

Sarah Anderson, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.

Email: [email protected]

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Lorie M. Harper

Lorie M. Harper

Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, The University of Alabama at Birmingham, Birmingham, AL, USA

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Jodie Dionne-Odom

Jodie Dionne-Odom

Division of Infectious Diseases, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA

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Gregory Halle-Ekane

Gregory Halle-Ekane

Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, Buea, Cameroon

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Alan T.N. Tita

Alan T.N. Tita

Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, The University of Alabama at Birmingham, Birmingham, AL, USA

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First published: 08 January 2018
Citations: 13
Presented at the 37th Annual Meeting of the Society for Maternal Fetal Medicine: The Pregnancy Meeting; January 23–28, 2017; Las Vegas, NV, USA.

Abstract

Objective

To compare prenatal maternal hepatitis B virus (HBV) screening and infant vaccination strategies to inform policy on HBV prevention in Sub-Saharan Africa.

Methods

A decision analytic model was created using previously published data to assess the ability of three intervention strategies to prevent HBV infection by age 10 years. Strategy 1 comprised of universal vaccination with a pentavalent vaccine (HBV, diphtheria, tetanus, pertussis, and Haemophilus influenzae) at age 6 weeks. Strategy 2 comprised of universal HBV vaccine at birth plus pentavalent vaccine. Strategy 3 comprised of maternal prenatal HBV screening and targeted HBV vaccine at birth for all exposed infants plus pentavalent vaccine. The reference strategy provided neither maternal screening nor infant vaccination. Rates of HBV infection and costs were compared.

Results

The reference strategy had an HBV infection rate of 2360 per 10 000 children. The HBV infection rate for strategy 1 was 813 per 10 000 children vaccinated (1547 cases prevented). Strategies 2 and 3 prevented an additional 384 cases and 362 cases, respectively. Inclusion of HBV vaccination at birth was the preferred approach at a willingness-to-pay threshold of US$150.

Conclusion

Including a birth-dose HBV vaccine in the standard schedule was both cost-effective and prevented additional infections.

CONFLICTS OF INTEREST

The authors have no conflicts of interest.