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

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  • 1 Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 2 Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 3 Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti;
  • | 4 Expanded Program on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti;
  • | 5 Centers for Disease Control and Prevention, Port-au-Prince, Haiti;
  • | 6 Institut Haïtien de l’Enfance, Pétion-Ville, Haiti;
  • | 7 Pan American Health Organization, Washington, District of Columbia
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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) (P = 0.1), gender (males: 0.7%, 95% CI: 0.2–2.4; females: 0.2%, 95% CI: 0.05–1.1) (P = 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.

Author Notes

Address correspondence to Anna A. Minta, Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS H24-3, Atlanta, GA 30329. E-mail: aminta@cdc.gov

Financial support: This survey was supported by a cooperative agreement between the CDC and the Haiti Ministry of Public Health and Population.

Disclosure: Valery Blot works for Institut Haitien de L’Enfance, the institution that was funded through a cooperative agreement between CDC and the Haiti Ministry of Health and Population to implement the survey.

Disclaimer: The findings and conclusions in this study are those of the authors and do not necessarily reflect the official position of the CDC nor the Pan American Health Organization.

Authors’ addresses: Lana Childs, Anna A. Minta, Jodi L. Vanden Eng, and Rania A. Tohme, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: lana.cristina.childs@emory.edu, aminta@cdc.gov, jodi.vandeneng@gmail.com, and ihb1@cdc.gov. Paul Adrien, Directorate of Epidemiology, Laboratory and Research, Haiti Ministry of Public Health and Population, Port-au-Prince, Haïti, E-mail: padrien2004@yahoo.fr. Jeannot François, Expanded Program on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti, E-mail: francoisjeannot@yahoo.fr. Nadia Phaïmyr Jn Charles, Centers for Disease Control and Prevention (CDC), Port-au-Prince, Haiti, E-mail: xfg6@cdc.gov. Valery Blot, Institut Haïtien de l’Enfance, Pétion-Ville, Haiti, E-mail: valeryblot@yahoo.fr. Gloria Rey-Benito, Pan American Health Organization, Washington, DC, E-mail: reyglori@paho.org.

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