Journal of Pediatric Gastroenterology & Nutrition:
ABSTRACTS: Poster Session Abstracts
1Section of Pediatric Gastroenterology, National Institute of Gstroenterology, 2National Dept of Epidemiology, Ministry of Public Health, Havana, Cuba
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Introduction: After several decades of having an effective vaccine for the prevention of hepatitis B, this disease is still a world health problem, especially in developing countries. In Cuba, the universal vaccination of newborns was included since 1992 in the National Immunization Program, achieving a more than 95% coverage. The immunization of 8- and 14-year-old children was begun in 1994 at their schools, completing a group of less than 20 year olds in 2000. In addition, other risk groups previously identified by epidemiological studies were vaccinated through campaigns. Our work presents the impact of this strategy.
Methods: The hepatitis B Heberbiovac recombinant vaccine was used. It is produced by the Genetic Engineering and Bio-technology Center of Havana, Cuba (Heber Biotech, Havana) and has a high and effective immunogenic level. The scheme for newborns is three doses at the moments, 0, in maternity, 1 and 6 months, with an average annual national coverage of more than 95%. The 0–1-2–12-month scheme was used for the children of infected mothers detected by tests during pregnancy, without using the hyperimmune B gamma globulin. The criteria of notification is through the System of Diseases of Obligatory Declaration, diagnosed by the Outpatient Care System or the Family Doctor. The criteria are clinical evidence of acute viral hepatitis and HbsAg positive. Statistical data is obtained by the national health system.
Results: Ten years after the application of this strategy we have seen a reduction in the acute disease of 93.9% in the general population, 99.3% in children under 15 years of age and there were no reported cases in children under 5 years of age since 2000, representing a 100% reduction.
This chart shows the impact of the Vaccination Program with elimination of acute cases of hepatitis B in that age group.
Conclusion: These results demonstrate that it is possible to eliminate hepatitis B in infancy, provided adequate immunization is achieved. AS the group of vaccinated subjects gets older, the protected age groups will increase. This raises the possibility of eliminating acute disease, as well as reduce the mortality from cirrhosis and cancer of the liver. The continuity of this program will make it possible for Cuba to be one of the first countries to be close to eliminating hepatitis B.