Najma Javed, Sumaira Naz.
Determination of HBsAg and anti HBS in mothers and their children between 6 months and 3 years of age in Islamabad.
Pak J Med Res Jan ;50(2):46-9.

Aims: To determine the presence of hepatitis B surface antigen and antibodies in mothers and their children aged between 6 months-3 years and assess if vaccination at 6 weeks is preventing maternal to child transmission. Study design, settings and duration: Sero-epidemiological cross-sectional community-based study conducted in district Islamabad from Dec. 2008- Dec. 2009 in six clusters (Bani gala, Kuri shehr, Bara kahu, Karachi company, I-sector and Koral town). About 50 paired samples (Maternal and child) were collected from each cluster making a total of 300 mothers and their children. Subjects and Methods: In each cluster, a door to door survey was done to locate houses that had a child between 6 months to 3 years of age and whose mother was willing to participate in the study. Informed written consent was taken from parents (mother/ father) of the enrolled child. Two ml of blood was taken from mother and child and information regarding the HBV vaccination of child and mother was entered in a questionnaire apart from other risk factors for disease transmission. The sera were stored and later analysed for presence of Hepatitis B surface antibodies (anti HBs), Hepatitis B surface antigen (HBsAg) and Hepatitis e antigen (HBeAg). Anti HBs was run on all samples, only those samples that were negative for anti HBs were run for HBsAg and those found positive were run for HBeAg. Results: A total of 277 mothers and their 304 children were enrolled in the study which lasted for 6 months. Out of 277 mothers, 39(14%) were anti HBs positive, 29(11.4%) were positive for HBsAg and out of these three (10.3%) were also HBeAg positive. Out of 304 children who were tested for anti HBs, 239(77%) showed protective levels. Eight children (2.6%) were positive for HBsAg and 02(25%) were also positive for HBeAg. Out of 261 vaccinated children 89% showed, antibodies while 11% did not have antibodies. Five (2%) children were HBsAg positive despite taking the vaccination. Of the 29 mothers who were HBsAg positive, their 03 Children were also positive for the virus. Of the 3 mothers that were HBeAg positive, 2 children were also positive showing the possibility of maternal to child infection in 66% cases. Five children were HBsAg positive but their mothers were negative for this virus indicating other routes of viral transmission or a paternal transmission. Conclusions: Vertical transmission of HBsAg was seen from HBsAg positive mothers to their newborns. HBV infection is seen in 2% vaccinated children indicating that vaccination at 6 weeks are not protecting these children to this deadly virus. Policy Message: Vaccination of Hepatitis B should be done at birth.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com