Journal Article

Impact of Four Urban Perinatal Hepatitis B Prevention Programs on Screening and Vaccination of Infants and Household Members

Gary L. Euler, John Copeland and Walter W. Williams

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 157, issue 8, pages 747-753
Published in print April 2003 | ISSN: 0002-9262
Published online April 2003 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwg034
Impact of Four Urban Perinatal Hepatitis B Prevention Programs on Screening and Vaccination of Infants and Household Members

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During 1992–2000, the authors studied compliance with perinatal hepatitis B prevention recommendations, including vaccination of household contacts, at four metropolitan sites in Connecticut, Georgia, Texas, and Michigan. Demographic and hepatitis B-related knowledge, attitudes, practices, and barrier data were collected on pregnant women testing positive for hepatitis B surface antigen and on their infants, children, and household and sexual contacts. Generalized estimating equations with repeated measures in a multivariable model were used to obtain adjusted relative risks of household noncompliance. In 1,458 households studied, 1,490 infants and 3,502 other contacts were identified. Among infants, vaccination start/finish rates were 92%/72%, and 73% were serotested postvaccination. Prevaccination serotesting rates among contacts were 22% preenrollment and 47% postenrollment. Among 2,519 contacts whose immunity status was susceptible or unknown, the vaccination start/finish rate was 45%/41%. Site-specific adjusted relative risks of household noncompliance compared with Texas were 2.14 (Michigan), 1.96 (Georgia), and 1.30 (Connecticut). Mother’s birth in the United States increased the relative risk of household noncompliance (1.32). Home visits, implemented only in Texas, most likely account for higher compliance rates in that state. Findings may indicate that many perinatal programs could achieve higher overall rates of infant and contact identification; pre- and postvaccination serologic testing in contacts and infants, respectively; and contact hepatitis B vaccination.

Keywords: hepatitis B; hepatitis B surface antigens; patient compliance; perinatal care; prenatal care; serologic tests; vaccination; Abbreviations: CI, confidence interval; ESPHB, Enhanced Surveillance–Perinatal Hepatitis B Prevention Program; HBIG, hepatitis B immunoglobulin; HBsAg, hepatitis B surface antigen.

Journal Article.  5007 words. 

Subjects: Public Health and Epidemiology

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