Application of sero- epidemiology data to inform interventions for HBV in Africa: should diagnosis and treatment replace catch-up vaccination?

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dc.contributor.authorMcNaughton, Anna L.
dc.contributor.authorLourenço, José
dc.contributor.authorArmand Bester, Phillip
dc.contributor.authorMokaya, Jolynne
dc.contributor.authorLumley, Sheila F.
dc.contributor.authorForde, Donall
dc.contributor.authorMaponga, Tongai G.
dc.contributor.authorKatumba, Kenneth R.
dc.contributor.authorGoedhals, Dominique
dc.contributor.authorGupta, Sunetra
dc.contributor.authorSeeley, Janet
dc.contributor.authorNewton, Robert
dc.contributor.authorOcama, Ponsiano
dc.contributor.authorMatthews, Philippa C.
dc.date.accessioned2022-05-01T20:57:25Z
dc.date.available2022-05-01T20:57:25Z
dc.date.issued2018
dc.description.abstractInternational goals for hepatitis B virus (HBV) infection set ambitious targets for elimination by 2030. In populations with a high prevalence of infection, catch-up HBV vaccination of adults is sometimes deployed. An alternative approach of ‘test and treat’ could be applied as a population intervention for HBV. Methods: We used a systematic approach to determine the relationship between prevalence of HBV infection (HBsAg) and exposure (anti-HBc) in Africa. We applied a mathematical model to compare the impact of catch-up vaccination with a ‘test and treat’ strategy in a high prevalence setting. Findings: There is a strong relationship between the prevalence of HBsAg and anti- HBc (p<0·0001) across Africa, but the pattern differs between regions. Our data can be interactively visualised at https://hbv-geo.shinyapps.io/oxafricahbv/. In settings with high prevalence of infection, catch-up vaccination may have a transient effect. However, this intervention does not contribute to a sustained decline in prevalence, because a high proportion of adults are either already infected or immune as a result of prior exposure. In contrast, diagnosing and treating infection has a marked impact on reducing prevalence, equivalent to that of neonatal vaccination. Interpretation: We have developed a high-resolution picture of HBV epidemiology across Africa. In combination with robust neonatal vaccination programmes, testing and treating infection is likely to be of more benefit than catch-up vaccination. This alternative not only benefits the infected individual, but also has impact on transmission, thus contributing to sustained reductions in population prevalence.en_US
dc.identifier.citationMcNaughton, A., Lourenço, J., Bester, P. A., Mokaya, J., Lumley, S. F., Forde, D., ... & Matthews, P. C. (2018). Application of Sero-Epidemiology Data to Inform Interventions for HBV in Africa: Should Diagnosis and Treatment Replace Catch-Up Vaccination?.en_US
dc.identifier.urihttps://papers.ssrn.com/sol3/papers.cfm?abstract_id=3260787
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3098
dc.language.isoenen_US
dc.publisherGlobal Healthen_US
dc.subjectHBVen_US
dc.subjectVaccinationen_US
dc.subjectEpidemiologyen_US
dc.subjectPrevalenceen_US
dc.subjectCatch-upen_US
dc.subjectBoosteren_US
dc.subjectEliminationen_US
dc.subjectImmunizationen_US
dc.subjectSustainable development goalsen_US
dc.subjectAfricaen_US
dc.subjectUgandaen_US
dc.titleApplication of sero- epidemiology data to inform interventions for HBV in Africa: should diagnosis and treatment replace catch-up vaccination?en_US
dc.typeArticleen_US
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