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Use of multiple reporting sources for perinatal hepatitis B surveillance and follow-up
R M Ikeda1, G S Birkhead, M K Flynn
1Bureau of Communicable Disease Control, New York State Department of Health, Albany, USA.
Insights
The New York State Perinatal Hepatitis B Prevention Program effectively identifies mothers with hepatitis B surface antigen (HBsAg) and ensures their infants receive timely vaccination. This surveillance program achieved nearly 100% case-ascertainment, improving infant health outcomes.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- Hepatitis B infection poses a significant risk to newborns.
- The New York State Perinatal Hepatitis B Prevention Program was established in 1988 to address this public health concern.
- Effective surveillance and timely intervention are crucial for preventing perinatal hepatitis B transmission.
Purpose of the Study:
- To describe and evaluate the New York State Perinatal Hepatitis B Prevention Program.
- To assess the program's effectiveness in identifying hepatitis B surface antigen (HBsAg)-positive mothers and ensuring infant vaccination.
- To analyze data from 1991 regarding HBsAg-positive births and subsequent infant vaccination status.
Main Methods:
- Utilized existing surveillance and data collection systems for program implementation.
- Employed the Chandra Sekar-Deming method to estimate case-ascertainment completeness.
- Validated reporting accuracy through hospital medical record audits and local health department follow-up.
Main Results:
- In 1991, 363 (0.2%) of 158,273 live births were to confirmed HBsAg-positive mothers.
- Case-ascertainment completeness was estimated at 96%, increasing to nearly 100% with multiple reporting sources.
- 83% of infants born to HBsAg-positive mothers received hepatitis B immune globulin and three vaccine doses within one year.
Conclusions:
- The program effectively identifies infants at risk for perinatal hepatitis B.
- Leveraging existing systems facilitated rapid program establishment with simplified requirements.
- The program demonstrates success in ensuring prompt vaccination for infants of HBsAg-positive mothers, thereby preventing disease transmission.
Abstract:
The New York State Perinatal Hepatitis B Prevention Program was implemented in New York State (excluding New York City) as a surveillance and control program in 1988. This report describes and evaluates the program and provides data from 1991 regarding hepatitis B surface antigen (HBsAg)-positive mothers and their infants' subsequent hepatitis B vaccination. The program was created using multiple existing surveillance and data collection systems. Completeness of case-ascertainment was estimated by means of the Chandra Sekar-Deming method (J Am Stat Assoc 1949; 44:101-15). An audit of hospital medical records and follow-up by local health departments were used to validate reporting accuracy. Of 158,273 live births in 1991, 363 (0.2%) were born to confirmed HBsAg-positive mothers. Estimated completeness of case-ascertainment was 96%. Thirty-five percent of HBsAg-positive mothers did not report risk factors for hepatitis B, confirming the need for universal testing. Of the infants, 83% received hepatitis B immune globulin and three doses of vaccine within one year of birth. By using existing data collection systems, the program was established quickly, and start-up funding and training requirements were simplified. Multiple reporting increased case-ascertainment to almost 100%. The program effectively identifies and ensures prompt vaccination of infants born to HBsAg-positive mothers.