Review of hepatitis B surveillance in China: Improving information to frame future directions in prevention and control☆

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Cui, Fuqiang ; Drobeniuc, Jan ; Hadler, Stephen C. ; Hutin, Yvan J. ; Ma, Fubao ; Wiersma, Steve ; Wang, Fuzhen ; Wu, Jiang ; Zheng, Hui ; Zhou, Liwei ; Zuo, Shuyan
• Description:
  Background
  
  As the WHO verified that China reached the target of 1% prevalence of chronic hepatitis B infection among children targeted by universal hepatitis B immunization of newborns, the country considered new options for hepatitis B prevention and control. We reviewed hepatitis B surveillance in the broader context of viral hepatitis surveillance to propose recommendations to improve the system.
  
  Methods
  
  We described surveillance for viral hepatitis in China with a specific focus on hepatitis B. We assessed critical attributes of the system, including data quality, predictive positive value and usefulness.
  
  Results
  
  While remarkable progress in hepatitis B immunization of infants and children has likely almost eliminated transmission in younger age groups, reported rates of hepatitis B increased steadily in China between 1990 and 2008, probably because of a failure to distinguish acute from chronic infections. Elements that prevented a clearer separation between acute and chronic cases included (1) missed opportunity to report cases accurately among clinicians, (2) low availability and use of tests to detect IgM against the hepatitis B core antigen (IgM anti-HBc) and (3) lack of systems to sort, manage and analyze surveillance data.
  
  Conclusions
  
  To improve hepatitis B surveillance, China may consider (1) training clinicians to diagnose acute cases and to use IgM anti-HBc to confirm them, (2) improving access and use of validated IgM anti-HBc tests and (3) developing data management and analysis techniques that sort out acute from chronic cases.
  
  
• Subjects:
  Communicable Disease Control Education, Professional Epidemiological Monitoring Hepatitis B Antibodies Humans Immunoassay Immunoglobulin M Statistics As Topic
• Source:
  Vaccine. 31(Suppl 9):J79-J84
• Pubmed ID:
  23770336
• Pubmed Central ID:
  PMC5942228
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Place as Subject:
  China
• Volume:
  31
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:dee56a102868c5bd82cddc79626c85aeabae0f4e1fd41eee4c37155029ecc96a
• Download URL:
  https://stacks.cdc.gov/view/cdc/53982/cdc_53982_DS1.pdf
• File Type:
  [PDF - 417.59 KB ]