Seroprotección para virus de hepatitis B en estudiantes universitarios de atención prehospitalaria en Cali, Colombia / Seroprotection for hepatitis B virus in university students of prehospital care in Cali, Colombia

Introducción: El personal de salud se encuentra expuesto a contraer enfermedades infecto contagiosas en el ejercicio de su labor, una de ellas es la hepatitis B. Los estudiantes de atención prehospitalaria no se encuentran exentos de sufrir esta enfermedad, sobre todo por el contexto de las emergencias y desastres donde se desenvuelven. Objetivo: Determinar la prevalencia de seroprotección para el virus de hepatitis B en estudiantes de atención prehospitalaria en una universidad en Colombia. Métodos: Estudio descriptivo de corte transversal realizado a estudiantes de atención prehospitalaria en el periodo febrero-junio de 2017. No se utilizó ninguna técnica de muestreo porque se incluyó la totalidad de los estudiantes en práctica. Se aplicó un cuestionario con preguntas de datos sociodemográficos, registro del esquema de vacunación para hepatitis B y el resultado de los anticuerpos (Anti-HBs). Para el análisis estadístico se utilizó Microsoft Excel 2010, se construyeron estadísticas descriptivas. Las variables numéricas se describieron con base en medidas de tendencia central y variabilidad, las variables categóricas se describieron con base en prevalencias y distribuciones porcentuales. Resultados: En la caracterización de los 103 estudiantes evaluados se encontró que el 98 por ciento obtuvo títulos de anticuerpos (Anti-HBs) mayores a 10 UI/ml, considerándose como reactivos a las dosis de las vacunas, alcanzando títulos protectores. Sin embargo, el 93 por ciento no cumplió con el esquema de vacunación establecido. Conclusiones: Los resultados obtenidos evidencian la efectividad de las dosis aplicadas de vacuna para el virus de hepatitis B para obtener los títulos de anticuerpos a estudiantes de atención prehospitalaria en una universidad en Colombia. Pero existen incumplimientos en los tiempos recomendados para la aplicación de cada una de las dosis y en el tiempo de toma de los títulos(AU)

Introduction: Health personnel are at risk of infectious diseases when doing their job. One of them is hepatitis B. Prehospital care students are not free from suffering this disease, especially due to the emergencies and disasters context in which they work. Objective: To determine the prevalence of seroprotection for the hepatitis B virus in prehospital care students at a university in Colombia. Methods: Descriptive cross-sectional study carried out on prehospital care students during the period February-June 2017. No sampling technique was used because all the students in practice were included. A questionnaire was applied with questions of social-demographic data, registration of the vaccination schedule for hepatitis B and result of (Anti-HBs) antibodies. For statistical analysis, Microsoft Excel 2010 was used and descriptive statistics were designed. Numerical variables were described based on measures of central tendency and variability, categorical variables were described based on prevalence and percentage distributions. Results: In the depiction of the 103 students who were evaluated, it was found that 98 percent obtained antibody titers (Anti-HBs) bigger than 10 IU / ml, being considered as reactive to the doses of the vaccines and getting protective titles. However, 93 percent did not fill the established vaccination schedule. Conclusions: It can be concluded that the results obtained show the effectiveness of the applied doses of vaccine for the hepatitis B virus to obtain antibody titers to prehospital care students at a university in Colombia. But there are breaches in the recommended times for the application of each of the doses and in the time of taking the antibody titers(AU)

Seroprotección para virus de hepatitis B en estudiantes universitarios de atención prehospitalaria en Cali, Colombia / Seroprotection for hepatitis B virus in university students of prehospital care in Cali, Colombia

RESUMEN Introducción: El personal de salud se encuentra expuesto a contraer enfermedades infecto contagiosas en el ejercicio de su labor, una de ellas es la hepatitis B. Los estudiantes de atención prehospitalaria no se encuentran exentos de sufrir esta enfermedad, sobre todo por el contexto de las emergencias y desastres donde se desenvuelven. Objetivo: Determinar la prevalencia de seroprotección para el virus de hepatitis B en estudiantes de atención prehospitalaria en una universidad en Colombia. Métodos: Estudio descriptivo de corte transversal realizado a estudiantes de atención prehospitalaria en el periodo febrero-junio de 2017. No se utilizó ninguna técnica de muestreo porque se incluyó la totalidad de los estudiantes en práctica. Se aplicó un cuestionario con preguntas de datos sociodemográficos, registro del esquema de vacunación para hepatitis B y el resultado de los anticuerpos (Anti-HBs). Para el análisis estadístico se utilizó Microsoft Excel 2010, se construyeron estadísticas descriptivas. Las variables numéricas se describieron con base en medidas de tendencia central y variabilidad, las variables categóricas se describieron con base en prevalencias y distribuciones porcentuales. Resultados: En la caracterización de los 103 estudiantes evaluados se encontró que el 98 % obtuvo títulos de anticuerpos (Anti-HBs) mayores a 10 UI/ml, considerándose como reactivos a las dosis de las vacunas, alcanzando títulos protectores. Sin embargo, el 93 % no cumplió con el esquema de vacunación establecido. Conclusiones: Los resultados obtenidos evidencian la efectividad de las dosis aplicadas de vacuna para el virus de hepatitis B para obtener los títulos de anticuerpos a estudiantes de atención prehospitalaria en una universidad en Colombia. Pero existen incumplimientos en los tiempos recomendados para la aplicación de cada una de las dosis y en el tiempo de toma de los títulos.

ABSTRACT Introduction: Health personnel are at risk of infectious diseases when doing their job. One of them is hepatitis B. Prehospital care students are not free from suffering this disease, especially due to the emergencies and disasters context in which they work. Objective: To determine the prevalence of seroprotection for the hepatitis B virus in prehospital care students at a university in Colombia. Methods: Descriptive cross-sectional study carried out on prehospital care students during the period February-June 2017. No sampling technique was used because all the students in practice were included. A questionnaire was applied with questions of social-demographic data, registration of the vaccination schedule for hepatitis B and result of (Anti-HBs) antibodies. For statistical analysis, Microsoft Excel 2010 was used and descriptive statistics were designed. Numerical variables were described based on measures of central tendency and variability, categorical variables were described based on prevalence and percentage distributions. Results: In the depiction of the 103 students who were evaluated, it was found that 98% obtained antibody titers (Anti-HBs) bigger than 10 IU / ml, being considered as reactive to the doses of the vaccines and getting protective titles. However, 93% did not fill the established vaccination schedule. Conclusions: It can be concluded that the results obtained show the effectiveness of the applied doses of vaccine for the hepatitis B virus to obtain antibody titers to prehospital care students at a university in Colombia. But there are breaches in the recommended times for the application of each of the doses and in the time of taking the antibody titers.

Single Hepatitis B Booster Dose in High-risk Children with Suboptimal Surface Antigen Antibody Responses After 3-dose Primary Vaccine Series

This was a descriptive study of 30 children born to HBsAG positivemothers between June 2009 and December 2013. All childrenhad anti-HBs response ≤100 IU/L after 3 doses of hepatitis Bvaccine primary series. A single booster dose led to hepatitis Bsurface antibody titers ≥100 IU/L in (85%) of children.

Seroprevalence of measles, mumps & rubella antibodies among 5-10 years old children in north India

Background & objectives: Globally, there is an effort to eliminate the measles and control rubella as these diseases lead to considerable morbidity and mortality especially among under-five children and are important public health problems. This study was aimed to estimate the seroprevalence of measles, mumps and rubella (MMR) antibodies among children of age 5-10 yr in Chandigarh, north India, to provide evidence on prevalent immunity levels. Methods: This cross-sectional study was conducted in Chandigarh, among 196 randomly selected healthy children (5-10 yr), who received either one or two doses of measles or MMR combination vaccine. Socio-economic background and immunization history were recorded. Blood sample (2 ml) was collected to estimate the MMR IgG antibody titres by using ELISA kits. Results: Protective seroprevalence of MMR antibodies was 40.8, 75.5 and 86.2 per cent, respectively. The geometric mean titres of MMR IgG antibodies in the study children were 11.3, 50.6 and 54.3 international units (IU)/ ml, respectively. The proportion of seroprotected children for measles was significantly higher among those who had received two or more doses (46.4%) of measles vaccine compared to those who had received single dose (35.6%) ( P <0.001). About 16 per cent of children had received single dose of MMR vaccine. Among these, 71.4 and 100 per cent were seroprotected against mumps and rubella, respectively. Interpretation & conclusions: A large proportion of children aged 5-10 yr lacked protective immunity against measles (60%); about one-fourth (15-25%) were susceptible to infection with mumps and rubella virus. Mumps vaccination may be considered to be included in National Immunization Schedule for children with periodic serosurveillance.

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.

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.

Seroprotección para hepatitis B luego de 3 dosis de vacunación en niños colombianos menores de 18 años de edad con infección por VIH / Seroprotection for Hepatitis B after Three Doses of Vaccine in Colombian HIV Patients under the Age of 18

Introducción: la seroprotección (SP) (títulos cuantitativos de anticuerpos para antígeno de superficie [Anti-HBsAg] >10 UI/L) para el virus de la hepatitis B (VHB) en niños con el virus de inmunodeficiencia humana (VIH) es baja. Objetivo: establecer la SP para VHB y los posibles factores asociados en niños con VIH de Cali, Colombia. Metodología: estudio de SP para VHB en 85 niños <18 años de edad luego de 3 dosis de vacunación. Fueron consideradas variables clínicas, paraclínicas, ambientales y sociodemográficas. El análisis estadístico incluyó estimación de proporción por ocurrencia, IC 95%, porcentajes, promedios y desviación estándar, y análisis univariado entre variable exposición y efecto; también se evaluó confusión (tablas de 2 x 2 y estimación de OR con IC 95%). Se utilizó prueba de Chi2 con significancia p <0,05. El modelo multivariado se realizó por el método de eliminación hacia atrás. Se eliminaron variables con p >0,10 por likelihood-ratio test. Resultados: la SP fue del 35,3% (IC 95% 25,2-46,4) (n = 30) en niños con edad promedio 101±44 meses, con predominio del género femenino, raza mestiza, estadio C para VIH según los Centros para el Control y Prevención de Enfermedades (CDC) de los Estados Unidos y promedio de tiempo de tratamiento de 5 años, sin relación entre el tiempo transcurrido entre dosis 1, 2 y 3 de vacunación y SP, ni entre diagnóstico y colocación de dosis 3 de vacunación y SP. En el modelo multivariado, el factor asociado fue la relación temporal entre inicio de tratamiento (0-3 años) y la colocación de la última dosis de vacunación (OR = 4,3 IC 95% 0,96-19,23; p = 0,05) y >3 años de inicio de tratamiento (OR = 9,69 IC 95% 2,37-39,5; p = 0,00). Conclusión: la prevalencia de SP fue del 35,3%, con posible factor de riesgo asociado con la relación temporal entre el inicio del tratamiento y el tiempo de colocación de la última dosis de vacunación.

Introduction: Seroprotection against hepatitis B is defined as anti-hepatitis B surface antigen titer ≥ 10 IU/L), but in children with human immunodeficiency virus (HIV) this is low. Objective: The objective of this study was to establish SP against HBV and potential associated factors in children with HIV in Cali, Colombia. Methodology: This is a study of seroprotection against HBV in 85 children under 18 years of age after receiving three doses of vaccine. Clinical, paraclinical, environmental and sociodemographic variables were considered. Statistical analysis included estimation of proportion per occurrence, 95% confidence intervals, percentages, means, standard deviations, and univariate analysis between variable exposure and effect. Confounding factors were evaluated with 2x2 contingency tables and estimation of odds ratios with 95% confidence intervals. The Chi2 test was used with significance of p <0.05. The multivariate model used backward elimination. Variables with p> 0.10 were eliminated by likelihood-ratio test. Results: SP was 35.3% (95% CI: 25.2 to 46.4, n = 30) in children with a mean age of 101 ± 44 months. Patients were predominantly female gender and mixed race and had Stage C HIV (according to US Centers for Disease Control and Prevention (CDC) standards). Average treatment time was 5 years. No relationship was found between the time between the first, second and third doses of vaccine and SP, nor among diagnosis, time of vaccination, and SP. The multivariate model showed an association of SP with the temporal relationship between start of treatment (0-3 years), last dose of vaccination (OR = 4.3, 95% CI: 0.96 to 19.23; p = 0.05) and more than three years after starting treatment (OR = 9.69, 95% CI: 2.37 to 39.5; p = 0.00). Conclusion: The prevalence of SP was 35.3%, with a possible risk factor associated with the temporal relationship between onset of treatment and time of the last dose of vaccine.

Impact of hepatitis B immunization among the Nicobarese tribe - antibody titres & seroprotection five years after vaccination.

Background & objectives: A total of 237 Nicobarese subjects who had received hepatitis B vaccination as part of mass vaccination project during 2000-2001 were screened for anti-HBsAg titres by quantitative ELISA five years after vaccination. Methods: Anti-HBsAg antibody was estimated using quantitative ELISA. Proportion of the subjects with protective levels of antibody and geometric mean antibody titres were calculated. Results: Among the 237 study subjects, 213 had received three doses of vaccine, 17 had received two doses and seven had received one dose. The geometric mean titres of anti-HBs antibodies were 201.7, 31.9 and 23.1 mIU/ml among those who received three, two and one dose of vaccine, respectively. Among those who received three doses of vaccination, 85.9 per cent had anti-HBs antibody levels of 10 mIU/ml or more, indicating seroprotection. The difference in the seroprotection rates among those who received three doses of vaccination (85.9%) and those who received less than three doses (58.3%) was significant. Seroprotection rates one month after the first, second and third dose of vaccination were 49.1, 86.9 and 96.7 per cent, respectively. It then declined to 89 per cent by the end of the second year and to 85.5 per cent by the end of the third year, but there was no decline thereafter. Interpretation & conclusions: Seroprotection rate reached at the maximum one month after the third dose of HBV vaccine. Although about 15 per cent of the vaccinated persons lost seroprotection by the end of the third year, no further loss in seroprotection was observed between the third year and the fifth year.

Immune response to second dose of MMR vaccine in Indian children.

Background & objectives: MMR vaccine in a two dose schedule has successfully eliminated measles, mumps and rubella from many developed countries. In India, it is not a part of national immunization programme but is included in the State immunization programme of Delhi as a single dose between 15-18 months. This prospective study was carried out to assess the extent of seroprotection against these three diseases in immunized children and to study the immune response to a second dose of MMR. Methods: Consecutive children aged 4-6 yr, attending the immunization clinic of a tertiary care hospital in Delhi for routine DT vaccination, were enrolled. Second dose of MMR was given and pre- and post-vaccination antibody levels were compared. Results: The pre-vaccination percentage seropositivity observed in the 103 children recruited, was 20.4 per cent for measles, 87.4 per cent for mumps and 75.7 per cent for rubella. Amongst the 84 children who were followed up after the second dose, the percentage seroprotection for measles rose from 21.4 (18/84) to 72.6 per cent (61/84) and 100 per cent became seroprotected to mumps and rubella. Interpretation & conclusions: The percentage of children protected against measles was found to be alarmingly low which needs to be investigated. Though the observed protection against mumps and rubella was adequate, its durability was not known. The need for re-appraisal of the current MMR immunization policy is called for by carrying out longitudinal studies on a larger sample.

Immunogenicity of Single Dose Live Attenuated Hepatitis A Vaccine.

A long-term immunogenicity study of a single dose live attenuated H2 strain hepatitis A vaccine is being conducted in healthy Indian children at KEM Hospital, Pune. 131 of the original 143 children vaccinated in 2004, were evaluated for anti- HAV antibodies 30 months post vaccination (2007). Seroprotective antibody levels ≥20 mIU/mL were demonstrated in 87.8% subjects with an overall GMT of 92.02mIU/mL. No hepatitis like illness was recorded in any of the subjects since vaccination

La atención primaria en el control de un brote de hepatitis en un círculo infantil / Primary health care in the control of an outbreak of hepatitis in a day care center

Se realizó un control de foco de hepatitis aguda en un círculo infantil, estudiando 118 niños y 37 trabajadores, mediante encuestas epidemiológicas, exámenes físicos y toma de muestras para: transaminasa glutámico pirúvico; dosificaciones de inmunoglobulinas M y total antivirus de la hepatitis A; antígeno de superficie contra el virus de la hepatitis B; y de anticuerpos contra los virus de la hepatitis B, C y E. El virus de hepatitis A fue el causante del brote, el caso índice se pudo ubicar. Todos los infectados por el virus de la hepatitis A eran menores de 4 años. La mayoría de los susceptibles eran niños (96 %); 78 % de los adultos estaban protegidos, demostrando evidencias de contactos anteriores, fuera del brote. Los menores de 5 años vacunados de acuerdo con el Programa Nacional contra el virus de la hepatitis B tenían valores altos de seroprotección, más de 94 %.

A study was undertaken among 118 children and 37 workers at a day care center to control an acute hepatitis focus by epidemiological surveys, physical examinations and the taking of samples for glutamic piruvic transaminase, immunoglobulin M dosages, total hepatitis A antivirus, and surface antigen against the virus of hepatitis B, C and E. The hepatitis A virus was the cause of the outbreak. It was possible to locate the index case. All the infected by the hepatitis A virus were under 4. Most of the susceptible were children (96 %). 78 % of the adults were protected, showing evidences of previous contacts out of the outbreak. Those under 5 that were vaccinated according to the National Program Against the Hepatitis B Virus had high values of seroprotection (over 94 %).