Open AccessHepatitis B sero-prevalence in children under 15 years of age in South Africa using residual samples from community-based febrile rash surveillance
Author(s) -
Nishi Prabdial-Sing,
Lillian Makhathini,
Sheilagh B. Smit,
Morubula Manamela,
Nkengafac Villyen Motaze,
Cheryl Cohen,
Melinda Suchard
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0217415
Subject(s) - medicine , vaccination , hbsag , hepatitis b , hepatitis a vaccine , measles , immunology , immunity , hepatitis a , rash , hepatitis b vaccine , virology , herd immunity , antibody , hepatitis , hepatitis b virus , immune system , virus
and methods Hepatitis B is a vaccine preventable disease and is notifiable in South Africa. Hepatitis B vaccination was incorporated into the Expanded Programme on Immunisation in South Africa in 1995. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. Of samples serologically negative for acute measles infection, 450 samples spanning nine provinces of South Africa were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc). Results Two children (2/450; 0.4%) tested positive for HBsAg. Three hundred and three children (67.3%) had evidence of vaccine induced immunity. Vaccine induced immunity was present in 80.2% of 1–5 year olds, but only 60.3% of 10–14 year olds. Natural immunity, indicating exposure to circulating hepatitis B, was present in 13/450 (2.9%) children. Conclusion Chronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction. Decreased vaccine-induced immunity with increasing age may reflect waning antibody titres over time.