Lauren Périères1, Aldiouma Diallo1, Fabienne Marcellin2, Marie Libérée Nishimwe2, El Hadji Ba1, Marion Coste2,3, Gora Lo4, Philippe Halfon5, Coumba Touré Kane4, Gwenaëlle Maradan2,6, Patrizia Carrieri2, Assane Diouf1, Yusuke Shimakawa7, Cheikh Sokhna8, Sylvie Boyer2. 1. Vecteurs-Infections Tropicales et Méditerranéennes (VITROME), Campus Institut de Recherche pour le Développement (IRD)-Universite Cheikh Anta Diop, Dakar, Senegal. 2. Institut National de la Santé et de la Recherche Médicale, IRD, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Institut des Sciences de la Santé Publique - ISSPAM, Aix-Marseille University, Marseille, France. 3. Centre National de la Recherche Scientifique, École des Hautes Études en Sciences Sociales, Centrale Marseille, Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France. 4. Institut de Recherche en Santé de Surveillance Epidémiologique et de Formation, Dakar, Senegal. 5. Laboratoire Alphabio, Hôpital Européen, Marseille, France. 6. Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. 7. Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France. 8. IRD, Service de santé des armées, VITROME, Aix-Marseille University, Marseille, France.
Abstract
Senegal introduced the infant hepatitis B virus (HBV) vaccination in 2004 and recently committed to eliminating hepatitis B by 2030. Updated epidemiological data are needed to provide information on the progress being made and to develop new interventions. We estimated the prevalence of hepatitis B surface antigen (HBsAg) in children and adults living in rural Senegal and assessed hepatitis B treatment eligibility. A cross-sectional population-based serosurvey of HBsAg was conducted in 2018-2019 in a large sample (n = 3,118) of residents living in the Niakhar area (Fatick region, Senegal). Individuals positive for HBsAg subsequently underwent clinical and biological assessments. Data were weighted for age and sex and calibrated to be representative of the area's population. Among the 3,118 participants, 206 were HBsAg positive (prevalence, 6.9%; 95% confidence interval [CI], 5.6-8.1). Prevalence varied markedly according to age group in individuals aged 0-4, 5-14, 15-34, and ≥35 years as follows: 0.0% (95% CI, 0.00-0.01); 1.5% (95% CI, 0.0-2.3); 12.4% (95% CI, 9.1-15.6); and 8.8% (95% CI, 6.1-11.5), respectively. Of those subsequently assessed, 50.9% (95% CI, 41.8-60.0) had active HBV infection; 4 (2.9%; 95% CI, 0.9-9.4) were eligible for hepatitis B treatment. Conclusion: In this first population-based serosurvey targeting children and adults in rural Senegal, HBsAg prevalence was very low in the former, meeting the World Health Organization's (WHO) < 1% HBsAg 2020 target; however, it was high in young adults (15-34 years old) born before the HBV vaccine was introduced in 2004. To reach national and WHO hepatitis elimination goals, general population testing (particularly for adolescents and young adults), care, and treatment scale-up need to be implemented.
Senegal introduced the infant hepatitis B virus (HBV) vaccination in 2004 and recently committed to eliminating hepatitis B by 2030. Updated epidemiological data are needed to provide information on the progress being made and to develop new interventions. We estimated the prevalence of hepatitis B surface antigen (HBsAg) in children and adults living in rural Senegal and assessed hepatitis B treatment eligibility. A cross-sectional population-based serosurvey of HBsAg was conducted in 2018-2019 in a large sample (n = 3,118) of residents living in the Niakhar area (Fatick region, Senegal). Individuals positive for HBsAg subsequently underwent clinical and biological assessments. Data were weighted for age and sex and calibrated to be representative of the area's population. Among the 3,118 participants, 206 were HBsAg positive (prevalence, 6.9%; 95% confidence interval [CI], 5.6-8.1). Prevalence varied markedly according to age group in individuals aged 0-4, 5-14, 15-34, and ≥35 years as follows: 0.0% (95% CI, 0.00-0.01); 1.5% (95% CI, 0.0-2.3); 12.4% (95% CI, 9.1-15.6); and 8.8% (95% CI, 6.1-11.5), respectively. Of those subsequently assessed, 50.9% (95% CI, 41.8-60.0) had active HBV infection; 4 (2.9%; 95% CI, 0.9-9.4) were eligible for hepatitis B treatment. Conclusion: In this first population-based serosurvey targeting children and adults in rural Senegal, HBsAg prevalence was very low in the former, meeting the World Health Organization's (WHO) < 1% HBsAg 2020 target; however, it was high in young adults (15-34 years old) born before the HBV vaccine was introduced in 2004. To reach national and WHO hepatitis elimination goals, general population testing (particularly for adolescents and young adults), care, and treatment scale-up need to be implemented.
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