Prevalence and factors associated with seroprotection after primary series of hepatitis b vaccination among children seen in the outpatient setting of Philippine Children’s Medical Center

BACKGROUND@#Hepatitis B is a vaccine-preventable condition that could develop into cirrhosis and hepatocellular carcinoma. Identifying patients at risk for Hepatitis B infection despite the universal implementation of Hepatitis B vaccination will help improve the immunization program.@*OBJECTIVE@#To determine the prevalence and factors associated with seroprotection among children 3 months to 18 years old primary Hepatitis B vaccination series.@*METHODOLOGY@#This is a cross-sectional study among children 3 months to 18years old with complete Hepatitis B immunization. Demographic, social and clinical data were correlated with response to HBsAg, Anti-HBs and Total Anti-HBc tests.@*RESULTS@#Among 110 subjects from different age groups, 52% had seroprotective anti-HBs levels (>10 mIU/ml). Seventy four percent seroprotection was seen in subjects with <5 years interval from vaccination, 26% in cases after 5-10 years, and 38% at 10 years after vaccination with significant difference. Other factors such as gender, geographic area, type of vaccine, schedule, age at first dose and place of vaccine were not associated with seroprotection.@*CONCLUSION@#Fifty two percent seroprotection from Hepatitis B infection among different age groups was demonstrated in our study. Interval year after vaccination was the only factor established to have significant association with seroprotection, with < 50% decline of anti-HBs level at 5 years or more after vaccination. @*RECOMMENDATIONS@#Community studies with larger population are needed. Anti-HBs detection 5 years or more post-vaccination may be considered to identify patients at risk for breakthrough infection. Repeat serologic testing among non-seroprotected subjects is recommended.

Clinical profile and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among overweight and obese children: A prospective study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> In the past decades, the prevalence of childhood overweight and obesity has increased worldwide. Childhood obesity has been associated with wide range of serious health complications and increased risk of premature adult illnesses. Non-alcoholic Fatty Liver Disease (NAFLD) was of concern because of limited data among children. The study aims to determine the prevalence and demographic /clinical factors associated with NAFLD among overweight and obese children.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The study was a cross-sectional study among overweight and obese participants aged 2-18 years old. A total of 96 subjects were included. Frequencies and percentages of clinical characteristics were determined. Chi-square, linear correlation and logistic regression analysis for different factors were performed.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Among the 92 subjects, 26 (28%) were overweight while 66 (72%) were obese. The M:F ratio was 1.8:1 and majority belonged to 6-10 years old (44%). As to socioeconomic class, the rity (59%) were from the low-income group. The overall prevalence of NAFLD among overweight and obese subjects was 29.3%. None of the clinical factors (age, gender, socioeconomic status, BMI, waist circumference, actual caloric intake, and dietary fat consumption) were significantly associated with NAFLD. Analysis of biochemical factors revealed that alanine aminotransferase, aspartate aminotransferase, serum triglycerides and total cholesterol were found to be associated with NAFLD. Among which AST and ALT were identified predictors of NAFLD.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was high prevalence of NAFLD among overweight and obese children. Screening among the pediatric population may aid on early identification and prevent its progression. ALT, AST, serum triglycerides and total cholesterol were independently related wih NAFLD. AST and ALT were identified predictors of NAFLD.</p>

Clinical profile and factors affecting outcome of children with Hepatic Abscess: 19 year study

Objectives@#To describe the clinical profile of children with hepatic abscess, determine their laboratory & imaging findings, medical and surgical treatments and study factors affecting its outcome.@*Methodology@#A retrospective cohort study done in December 2016 on children 0 to Demographic, clinical and diagnostic data were correlated with the outcome and presence of complications.@*Results@#Thirty cases were identified in 19 years but only 25 charts were available for review. Mean age in years was 5.27 +/- 4.80 SD with male predominance. Fever (96%) and abdominal pain (60%) were common symptoms.Only 9 patients had hepatic abscess culture with Staphylococcus aureus (56%) as the most frequent growth. Anemia (76%) and leukocytosis (96%), and solitary (76%), large abscess >5 cms (60%) involving the right lobe (72%), were the common diagnostic findings. Most were treated with antibiotics alone (60%).All patients improved with no mortality noted, while pleural effusion was seen in 8 out of 12 patients with complications. Only male gender was significantly associated with complications both on chi-square (p0.004) and logistic regression (p 0.008). @*Conclusion@#Hepatic abscess is a liver infection usually seen among young and male population, manifesting as fever with anemia and leucocytosis. Most were complicated by pleural effusion with no deaths reported. Male gender had significant association with complications.

A prospective cross-sectional study on the prevalence and factors associated with Seroprotection after primary series of Hepatitis B vaccination

Objectives@#To determine the prevalence and factors associated with seroprotection among children 3 months to 18 years old with primary Hepatitis B vaccination series@*Methodology@#This is a prospective cross-sectional study done among children 3 months to 18 years old with complete primary series of Hepatitis B vaccination. Demographic, social and clinical data were correlated with reactivity to antibody to Hepatitis B surface antigen (antiHBs) (>10 IU/L),total antibody to Hepatitis B core antigen (total anti-HBc) and Hepatitis B surface antigen (HBsAg) serologic tests.@*Results@#Among 110 subjects from different age groups,52% had seroprotective anti-HBs levels, with the highest noted among infants (3 months-2 years) at 82%, followed by 41% from the childhood group (3-9 years) and 26% from adolescent group (10-18 years). Seventy-four percent of subjects with <5 years interval from vaccination were seroprotected, 26% in subjects after 5-10 years, and 38% at more than 10 years after vaccination with significant difference on multi-logistic regression (p value 0.000/0.020). None of the other factors including gender, geographic area, age at first dose, vaccination schedule, type and place of vaccination were significantly associated with seroprotection.@*Conclusion@#Fifty-two percent of patients among different age groups were seroprotected. Seroprotection was significantly associated with the interval year after vaccination demonstrated at < 50% 5 years and beyond post-vaccination.

Vitamin D status of Filipino high school students in selected schools in Quezon City

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Vitamin D deficiency has been documented as a frequent problem in almost every region of the world even in the tropical countries and its health consequences are enormous. Infancy and adolescence are age groups particularly at risk of developing vitamin D deficiency. However, there are no data on the Vitamin D status of Filipino adolescents.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine the serum 25-hydroxyvitamin D levels in Filipino high school students in selected schools in Quezon City</p><p style="text-align: justify;"><strong>METHODS:</strong> A cross-sectional study of Filipino high school students was undertaken. A total of 97 boys and girls aged 11- 18 years old, attending selected private and public secondary schools in Quezon City participated in the study after parents' consent and students' assent were taken. Serum 25(OH)D levels were determined by electrochemiluminescence immunoassay (ECLIA) using Roche HITACHI Cobas e immunoassay analyzer.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The total serum 25-hydroxyvitamin D levels of the students ranged from 19.92 nmol/L to 88.63 nmol/L with a mean of 52.43 nmol/L. Among the 97 high school students, there was a prevalence of hypovitaminosis D (serum 25 (OH)D <50nmol/L) of 41.2% with 20.6% having deficient (</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Hypovitaminosis D is highly prevalent among Filipino adolescents in secondary school despite abundance of sunlight. Appropriate interventions are needed to address the problem of poor vitamin D status in schoolchildren.</p>