Sibling status, home birth, tattoos and stitches are risk factors for chronic hepatitis B virus infection in Senegalese children: A cross‐sectional survey

Abstract

Sub‐Saharan Africa's hepatitis B virus (HBV) burden is primarily due to infection in infancy. However, data on chronic HBV infection prevalence and associated risk factors in children born post‐HBV vaccination introduction are scarce. We estimated hepatitis B surface antigen (HBsAg) prevalence and risk factors in Senegalese children born during the HBV vaccination era. In 2018–2019, a community‐based cross‐sectional survey was conducted in Senegal among children born between 2004 and 2015 (ie after the three‐dose HBV vaccine series was introduced (2004) but before the birth dose's introduction (2016)). HBsAg‐positive children were identified using dried blood spots. A standardized questionnaire collected socioeconomic information. Data were age‐sex weighted and calibrated to be representative of children living in the study area. Risk factors associated with HBsAg positivity were identified using negative binomial regression. Among 1,327 children, 17 were HBsAg‐positive (prevalence = 1.23% (95% confidence interval [CI] 0.61–1.85)). Older age (adjusted incidence‐rate ratio [aIRR] 1.31 per one‐year increase, 95% CI 1.10–1.57), home vs healthcare facility delivery (aIRR 3.55, 95% CI 1.39–9.02), stitches (lifetime) (aIRR 4.79; 95% CI 1.84–12.39), tattoos (aIRR 8.97, 95% CI 1.01–79.11) and having an HBsAg‐positive sibling with the same mother (aIRR 3.05, 95% CI 1.09–8.57) were all independently associated with HBsAg positivity. The low HBsAg prevalence highlights the success of the Senegalese HBV vaccination program. To further reduce HBV acquisition in children, high‐risk groups, including pregnant women and siblings of HBsAg‐positive individuals, must be screened. Vital HBV infection prevention measures include promoting delivery in healthcare facilities, and increasing awareness of prevention and control procedures.

Screening for Hepatitis B in partners and children of women positive for surface antigen, Burkina Faso

“…This finding could be explained by a higher risk of horizontal transmission between children in larger households, as has been reported in Gambia and Senegal. 29 , 30 There is also a greater chance of having an elder sibling born before the introduction of hepatitis B vaccination into the expanded programme of immunization, who is less likely to have been protected by immunization. Finally, there could be a higher frequency of maternal HBeAg carriage at the first childbirth due to the younger age of the women.…”

The First Assessments of Pediatric HBV Immunization Coverage in Mauritania and Persistence of Antibody Titers Post Infant Immunizations

“…In the present study, no active HBV infection was detected in fully immunized children, further demonstrating the potency of the HBV vaccine. The HBsAg prevalence observed in children from the capital Nouakchott was lower than in children from other part of Mauritania [ 21 ], in healthy Indonesian children (3.1%) [ 25 ] and in Senegalese children (1.23%) [ 26 ].The difference observed with other African countries is probably associated with several factors including different vaccination coverage and malnutrition.…”