RESUMO
Background: Hepatitis B is a major public health problem. The efficiency of the vaccine decreases as the time period between the birth and first dose increases. “WHO recommends that all infants should receive their first dose of Hep B vaccine as soon as possible after birth, preferably within 24 hrs. In India the birth dose/ 0 dose coverage was 45% on 2015. Prior to initiation of “Delivery Point Immunization” the birth dose Hep B was 35%. During the course of this programme the challenges and problems faced has been addressed in this study.Methods: It is a prospective observational study for a period of 15 months conducted by postpartum programme department in O&G department. It includes all the babies delivered in the department.Results: After the integration of delivery point immunization with JSY (Janani Surakhya Yojana) programme, the 0 dose hep B coverage was 72%.The coverage of BCG and 0dose OPV remained 89.48%.The most modifiable cause due to which babies were not received 0 dose Hep B vaccine was due to ignorance 36.19% and babies not received due to SNCU (Sick Newborn Care Unit) admission was 36.06%.Conclusions: Initiation of delivery point immunization has definitely increased the 0 dose hep B vaccine coverage. Integration with other maternal and child health programme had further increased the coverage. Though significant percentage of people know about the at birth immunization but are ignorant about the timing of 0 dose hep B vaccine
RESUMO
Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences. Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.