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Results from Nationwide Hepatitis B Serosurvey in Cambodia using Simple and Rapid Laboratory Test: Implications for National Immunization Program

Chronic liver infection and cancer in the western Pacific region is disproportionate to the population globally. This study provides the first nationwide estimates of hepatitis B surface antigen (HBsAg) seroprevalence in Cambodia among children five year of age. Using a simple and rapid test for HBsAg and multi-stage stratified cluster sampling design, we estimated HBsAg seroprevalence to be 3.5% (95% confidence interval = 2.4–4.8%) among five-year old children. Triangulating the results with other studies, we demonstrate the importance of interrupting perinatal transmission and one-time catch-up vaccination of older children born before nationwide introduction of vaccination for effective hepatitis B control in Cambodia and for reaching the disease control goal of less than 2% chronic infection rates among children 5 years of age. The results demonstrate the feasibility of conducting nationwide serosurveys using simple and rapid tests to evaluate the impact of hepatitis B vaccination programs in lieu of standard enzyme-linked immunosorbent assays.

Received September 18, 2008. Accepted for publication March 24, 2009.

Acknowledgments: We thank the surveyors and supervisors from National Immunization Program, Cambodia Ministry of Health, and from provincial departments of health; health workers at survey sites; and local authorities and provincial and operational district health departments for assistance. We also thank the children and their caretakers for voluntarily participating in this study.

^* Address correspondence to Manju Rani, Western Pacific Regional Office, World Health Organization, Corner Taft and UN Avenues, Metro Manila-1000, The Philippines. E-mail: ranim{at}wpro.who.int

Authors’ addresses: Sann Chan Soeung, Savay Sarath, and Chea Kimly, Cambodia Ministry of Health, 125–129 Street 134, Veal Vong, 7 Makara, Phnom Penh, Cambodia, E-mails: sann_chansoeung{at}yahoo.com , sv_sarath{at}yahoo.com , and cheak{at}nip.everyday.com . Manju Rani, Western Pacific Regional Office, World Health Organization, Corner Taft and UN Avenues, Metro Manila-1000, The Philippines, E-mail: ranim{at}wpro.who.int . Vu Huong, PATH, Second Floor, Hanoi Towers, 49 Hai Ba Trung Street, Hanoi, Vietnam, E-mail: hvu{at}path.org . Toda Kohei, Expanded Program on Immunization, World Health Organization, No. 177–179, Corner Pasteur 951 and 254, Phnom Penh, Cambodia, E-mail: todak{at}wpro.who.int .