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Published in: BMC Infectious Diseases 1/2006

Open Access 01-12-2006 | Research article

Adherence to the screening program for HBV infection in pregnant women delivering in Greece

Authors: Vassiliki Papaevangelou, Christos Hadjichristodoulou, Dimitrios Cassimos, Maria Theodoridou

Published in: BMC Infectious Diseases | Issue 1/2006

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Abstract

Background

Hepatitis B infection (HBV) is a major Public Health Problem.
Perinatal transmission can be prevented with the identification of HBsAg(+) women and administration of immunoprophylaxis to their newborns. A national prevention programme for HBV with universal screening of pregnant women and vaccination of infants is in effect since 1998 in Greece.

Methods

To evaluate adherence to the national guidelines, all women delivering in Greece between 17–30/03/03 were included in the study. Trained health professionals completed a questionnaire on demographic data, prenatal or perinatal screening for HBsAg and the implementation of appropriate immunoprophylaxis.

Results

During the study period 3,760 women delivered. Prenatal screening for HBsAg was documented in 91.3%. Greek women were more likely to have had prenatal testing. HBsAg prevalence was 2.89% (95%CI 2.3–3.4%). Higher prevalence of HBV-infection was noted in immigrant women, especially those born in Albania (9.8%). Other risk factors associated with maternal HBsAg (+) included young maternal age and absence of prenatal testing. No prenatal or perinatal HBsAg testing was performed in 3.2% women. Delivering in public hospital and illiteracy were identifiable risk factors for never being tested. All newborns of identified HBsAg (+) mothers received appropriate immunoprophylaxis.

Conclusion

The prevalence of HBsAg in Greek pregnant women is low and comparable to other European countries. However, immigrant women composing almost 20% of our childbearing population, have significant higher prevalence rates. There are still women who never get tested. Universal vaccination against HBV at birth and reinforcement of perinatal testing of all women not prenatally tested should be discussed with Public Health Authorities.
Literature
1.
go back to reference Evans AA, London WT: Epidemiology of hepatitis B. Viral Hepatitis. Edited by: Zuckerman AJ, Thomas HC. 1998, London: Harcout, 107-114. Evans AA, London WT: Epidemiology of hepatitis B. Viral Hepatitis. Edited by: Zuckerman AJ, Thomas HC. 1998, London: Harcout, 107-114.
2.
go back to reference American Academy of Pediatrics: Hepatitis B. Red Book: Report of the Committee on Infectious Diseases. Edited by: Pickering LK. 2003, Elk Grove Village, IL: American Academy of Pediatrics, 331-334. 26 American Academy of Pediatrics: Hepatitis B. Red Book: Report of the Committee on Infectious Diseases. Edited by: Pickering LK. 2003, Elk Grove Village, IL: American Academy of Pediatrics, 331-334. 26
3.
go back to reference Hyams KC: Risks of chronicity following acute hepatitis B virus infection;a review. Clin Infect Dis. 1995, 20: 992-1000.CrossRefPubMed Hyams KC: Risks of chronicity following acute hepatitis B virus infection;a review. Clin Infect Dis. 1995, 20: 992-1000.CrossRefPubMed
4.
go back to reference McMahon BJ, Alward WLM, Hall DB, Heyward WL, Bender TR, Francis DP, Maynard JE: Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 1985, 151: 599-603.CrossRefPubMed McMahon BJ, Alward WLM, Hall DB, Heyward WL, Bender TR, Francis DP, Maynard JE: Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 1985, 151: 599-603.CrossRefPubMed
5.
go back to reference Hsu HY, Chang MH, Ni YH, Lee PI: Cytokine release of peripheral blood mononuclear cells in children with chronic hepatitis B virus infection. JPGN. 1999, 29: 540-545.PubMed Hsu HY, Chang MH, Ni YH, Lee PI: Cytokine release of peripheral blood mononuclear cells in children with chronic hepatitis B virus infection. JPGN. 1999, 29: 540-545.PubMed
6.
go back to reference Hsu HY, Chang MH, Hsieh KH, Lee CY, Lin HH, Hwang LH, Chen PJ, Chen DS: Cellular Immune response to HBcAg in mother-to-infant transmission of hepatitis B virus. Hepatology. 1992, 14: 770-776.CrossRef Hsu HY, Chang MH, Hsieh KH, Lee CY, Lin HH, Hwang LH, Chen PJ, Chen DS: Cellular Immune response to HBcAg in mother-to-infant transmission of hepatitis B virus. Hepatology. 1992, 14: 770-776.CrossRef
7.
go back to reference Beasley RP, Hwang L-Y, Epidemiology of hepatocellular carcinoma: Viral hepatitis and liver disease. Edited by: Vyas GN, Dienstag JL, Hoofnagle JH. 1984, New York: Grune & Stratton, 209-24. Beasley RP, Hwang L-Y, Epidemiology of hepatocellular carcinoma: Viral hepatitis and liver disease. Edited by: Vyas GN, Dienstag JL, Hoofnagle JH. 1984, New York: Grune & Stratton, 209-24.
8.
go back to reference Beasley RP, Hwang L-Y: Postnatal infectivity of hepatitis B surface antigen-carrier mothers. J Infect Dis. 1983, 147: 185-90.CrossRefPubMed Beasley RP, Hwang L-Y: Postnatal infectivity of hepatitis B surface antigen-carrier mothers. J Infect Dis. 1983, 147: 185-90.CrossRefPubMed
9.
go back to reference Stevens CE, Toy PT, Tong MJ, Taylor PE, Vyas GN, Nair PV, Gudavalli M, Krugman S: Perinatal hepatitis B virus trans- mission in the United States: prevention by passive-active immunization. JAMA. 1985, 253: 1740-5. 10.1001/jama.253.12.1740.CrossRefPubMed Stevens CE, Toy PT, Tong MJ, Taylor PE, Vyas GN, Nair PV, Gudavalli M, Krugman S: Perinatal hepatitis B virus trans- mission in the United States: prevention by passive-active immunization. JAMA. 1985, 253: 1740-5. 10.1001/jama.253.12.1740.CrossRefPubMed
10.
go back to reference Stevens CE, Taylor PE, Tong MJ, Toy PT, Vyas GN, Nair PV, Weissman JY, Krugman S: Yeast-recombinant hepatitis B vaccine: efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission. JAMA. 1987, 257: 2612-6. 10.1001/jama.257.19.2612.CrossRefPubMed Stevens CE, Taylor PE, Tong MJ, Toy PT, Vyas GN, Nair PV, Weissman JY, Krugman S: Yeast-recombinant hepatitis B vaccine: efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission. JAMA. 1987, 257: 2612-6. 10.1001/jama.257.19.2612.CrossRefPubMed
11.
go back to reference World Health Organization: Progress in the control of viral hepatitis: memorandum from a WHO meeting. Bull WHO. 1988, 66: 443-55. World Health Organization: Progress in the control of viral hepatitis: memorandum from a WHO meeting. Bull WHO. 1988, 66: 443-55.
12.
go back to reference CDC: Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991, 40: (No. RR-13) CDC: Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991, 40: (No. RR-13)
13.
go back to reference Stamouli M, Gizaris V, Totos G, Papaevangelou G: Decline of hepatitis B infection in Grece. Eur J Epidemiol. 1999, 15: 447-9. 10.1023/A:1007539517341.CrossRefPubMed Stamouli M, Gizaris V, Totos G, Papaevangelou G: Decline of hepatitis B infection in Grece. Eur J Epidemiol. 1999, 15: 447-9. 10.1023/A:1007539517341.CrossRefPubMed
14.
go back to reference Kyriakis KP, Foudoulaki LE, Papoulia EI, Sofroniadou KE: Seroprevalence of hepatitis B surface antigen (HbsAg) among first time and sporadic blood donors in Greece 1991–1996. Transfusion Med. 2000, 10: 175-80. 10.1046/j.1365-3148.2000.00257.x.CrossRef Kyriakis KP, Foudoulaki LE, Papoulia EI, Sofroniadou KE: Seroprevalence of hepatitis B surface antigen (HbsAg) among first time and sporadic blood donors in Greece 1991–1996. Transfusion Med. 2000, 10: 175-80. 10.1046/j.1365-3148.2000.00257.x.CrossRef
15.
go back to reference Papaevangelou G, Farmaki G, Kada H: Hepatitis B maternal-fetal transmission in Southern Europe. Intervirology. 1998, 41: 197-200. 10.1159/000024936.CrossRefPubMed Papaevangelou G, Farmaki G, Kada H: Hepatitis B maternal-fetal transmission in Southern Europe. Intervirology. 1998, 41: 197-200. 10.1159/000024936.CrossRefPubMed
16.
go back to reference Progress in development of immunisation registries-United States 1999. MMWR. 2000, 49: 274-8. Progress in development of immunisation registries-United States 1999. MMWR. 2000, 49: 274-8.
17.
go back to reference COVER programme: October to December 1999 vaccination coverage statistics for children up to 5 years of age in the United Kingdom. Commun Dis Rep CDR Wkly. 2000, 10: 109-10. COVER programme: October to December 1999 vaccination coverage statistics for children up to 5 years of age in the United Kingdom. Commun Dis Rep CDR Wkly. 2000, 10: 109-10.
18.
go back to reference Jonas MM, Schiff ER, O'Sullivan MJ, de Medina M, Reddy KR, Jeffers LJ, Fayne T, Roach KC, Steele BW: Failure of the Centers for Disease Control criteria to identify hepatitis B infection in a large municipal obstetrical population. Ann Intern Med. 1987, 107: 335-7.CrossRefPubMed Jonas MM, Schiff ER, O'Sullivan MJ, de Medina M, Reddy KR, Jeffers LJ, Fayne T, Roach KC, Steele BW: Failure of the Centers for Disease Control criteria to identify hepatitis B infection in a large municipal obstetrical population. Ann Intern Med. 1987, 107: 335-7.CrossRefPubMed
19.
go back to reference Kumar ML, Dawson NV, McCullough AJ, Radivoyevitch M, King KC, Hertz R, Kiefer H, Hampson M, Cassidy R, Tavill AS: Should all pregnant women be screened for hepatitis B?. Ann Intern Med. 1987, 107: 273-7.CrossRefPubMed Kumar ML, Dawson NV, McCullough AJ, Radivoyevitch M, King KC, Hertz R, Kiefer H, Hampson M, Cassidy R, Tavill AS: Should all pregnant women be screened for hepatitis B?. Ann Intern Med. 1987, 107: 273-7.CrossRefPubMed
20.
go back to reference Jensen L, Heilmann C, Smith E, Wantzin P, Peitersen B, Weber T, Krogsgaard K: Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?. Scand J Infect Dis. 2003, 35: 378-82. 10.1080/00365540310010921.CrossRefPubMed Jensen L, Heilmann C, Smith E, Wantzin P, Peitersen B, Weber T, Krogsgaard K: Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?. Scand J Infect Dis. 2003, 35: 378-82. 10.1080/00365540310010921.CrossRefPubMed
21.
go back to reference Margolis HS, Alter MJ, Hadler SC: Hepatitis B: evolving epidemiology and implications for control. Semin Liver Dis. 1991, 11: 84-92.CrossRefPubMed Margolis HS, Alter MJ, Hadler SC: Hepatitis B: evolving epidemiology and implications for control. Semin Liver Dis. 1991, 11: 84-92.CrossRefPubMed
22.
go back to reference Papaevangelou G, Farmaki G, Kada H: Hepatitis B maternal-fetal transmission in Southern Europe. Intervirology. 1998, 41: 197-200. 10.1159/000024936.CrossRefPubMed Papaevangelou G, Farmaki G, Kada H: Hepatitis B maternal-fetal transmission in Southern Europe. Intervirology. 1998, 41: 197-200. 10.1159/000024936.CrossRefPubMed
23.
go back to reference Malamitsi-Puchner A, Papacharitonos S, Sotos D, Tzala L, Psichogiou M, Hatzakis A, Evangelopoulou A, Michalas S: Prevalence study of different hepatitis markers among pregnant Albanian refugees in Greece. Eur J Epidemiol. 1996, 12: 297-301. 10.1007/BF00145420.CrossRefPubMed Malamitsi-Puchner A, Papacharitonos S, Sotos D, Tzala L, Psichogiou M, Hatzakis A, Evangelopoulou A, Michalas S: Prevalence study of different hepatitis markers among pregnant Albanian refugees in Greece. Eur J Epidemiol. 1996, 12: 297-301. 10.1007/BF00145420.CrossRefPubMed
24.
go back to reference Dalekos GN, Zervou E, Karabini F, Tsianos EV: Prevalence of viral markers among refugees from southern Albania: increased incidence of infection with hepatitis A, B and D viruses. Eur J Gastroenterol Hepatol. 1995, 7: 553-8.PubMed Dalekos GN, Zervou E, Karabini F, Tsianos EV: Prevalence of viral markers among refugees from southern Albania: increased incidence of infection with hepatitis A, B and D viruses. Eur J Gastroenterol Hepatol. 1995, 7: 553-8.PubMed
25.
go back to reference Stroffolini T, Bianco E, Szklo A, Bernacchia R, Bove C, Colucci M, Cristina Coppola R, D'Argenio P, Lopalco P, Parlato A, Ragni P, Simonetti A, Zotti C, Mele A: Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy. Vaccine. 21: 1246-9. 10.1016/S0264-410X(02)00439-5. 2003 Mar 7 Stroffolini T, Bianco E, Szklo A, Bernacchia R, Bove C, Colucci M, Cristina Coppola R, D'Argenio P, Lopalco P, Parlato A, Ragni P, Simonetti A, Zotti C, Mele A: Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy. Vaccine. 21: 1246-9. 10.1016/S0264-410X(02)00439-5. 2003 Mar 7
26.
go back to reference Baldo V, Floreani A, Menegon T, Grella P, Paternoster DM, Trivello R: Hepatitis C virus, hepatitis B virus and human immunodeficiency virus infection in pregnant women in North-East Italy: a seroepidemiological study. Eur J Epidemiol. 2000, 16: 87-91. 10.1023/A:1007600532105.CrossRefPubMed Baldo V, Floreani A, Menegon T, Grella P, Paternoster DM, Trivello R: Hepatitis C virus, hepatitis B virus and human immunodeficiency virus infection in pregnant women in North-East Italy: a seroepidemiological study. Eur J Epidemiol. 2000, 16: 87-91. 10.1023/A:1007600532105.CrossRefPubMed
27.
go back to reference Niesert S, Messner U, Tillmann HL, Gunter HH, Schneider J, Manns MP: Prevalence of hepatitis B in pregnancy and selective creening. Geburtshilfe Frauenheilkd. 1996, 56: 283-6.CrossRefPubMed Niesert S, Messner U, Tillmann HL, Gunter HH, Schneider J, Manns MP: Prevalence of hepatitis B in pregnancy and selective creening. Geburtshilfe Frauenheilkd. 1996, 56: 283-6.CrossRefPubMed
Metadata
Title
Adherence to the screening program for HBV infection in pregnant women delivering in Greece
Authors
Vassiliki Papaevangelou
Christos Hadjichristodoulou
Dimitrios Cassimos
Maria Theodoridou
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2006
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-6-84

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