Children have an increased likelihood of becoming carriers of the chronic
hepatitis B virus. A total of 1,381 children and adolescents were assessed in
five municipalities of Maranhao State, Brazil, for detection of anti-HBc, HBsAg
and anti-HBs serologic markers and sociodemographic and behavioral features.
Among those who were HBsAg negative and anti-HBc negative, the proportion of
anti-HBs positives was calculated after the individuals had completed the
vaccination schedule. The robust variance of the Poisson’s regression model was
used in order to have adjusted tables and calculate the prevalence ratio.
Multivariate analysis was performed to identify the factors associated with the
prevalence of anti-HBc with or without HBsAg and the vaccine response. It was
observed that 163 children were anti-HBc positive and nine individuals were
HBsAg positive. The factors associated with the infection were: municipality of
residence (residing in Morros municipality or Humberto de Campos municipality),
residence in a rural area, aged between 13 and 15 years old, and illicit drug
use. The percentage of individuals who were anti-HBc negative and received all
three doses of the vaccine was 48.5%. Among these, only 276 (38.9%) had
antibodies at protective concentrations. In an adjusted analysis, Morros
municipality presented an increased positivity of vaccine response (p <
0.001), and the age ranging between 6 and 10 years old presented a reduced
frequency of response. This study reveals a high prevalence of current and past
HBV infection within the targeted age group which, in addition to the low
vaccination coverage and serological responses, raises concerns about the
management of prevention measures, especially the quality of vaccination in
these locations.
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