Evidence map›Paper›PMID 36575515›Full record

ArticleInternational journal for equity in health2022

Preventing early childhood transmission of hepatitis B in remote aboriginal communities in Northern Australia.

Richard P Sullivan, Jane Davies, Paula Binks, Melita McKinnon, Roslyn Gundjirryiir Dhurrkay, Kelly Hosking, Sarah Mariyalawuy Bukulatjpi, Stephen Locarnini, Margaret Littlejohn, Kathy Jackson and 2 more

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in International journal for equity in health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 1 country.

Richard P SullivanMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia. richie.sullivan@menzies.edu.au.
Jane DaviesMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Paula BinksMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Melita McKinnonMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Roslyn Gundjirryiir DhurrkayMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Kelly HoskingMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Sarah Mariyalawuy BukulatjpiMiwatj Health Aboriginal Corporation, Nhulunbuy, Northern Territory, Australia.
Stephen LocarniniVictorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia.
Margaret LittlejohnVictorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia.
Kathy JacksonVictorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia.
Steven Y C TongMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Joshua S DavisMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Menzies School of Health Research · AUCharles Darwin University · AUMaari Ma Health · AURoyal Darwin Hospital · AUThe Royal Melbourne Hospital · AUUniversity of Melbourne · AUVictorian Infectious Diseases Reference Laboratory · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic hepatitis B is a public health concern in Aboriginal communities in the Northern Territory of Australia with prevalence almost four times the non-Aboriginal population. Infection is suspected to mainly occur in early life, however, the mode of transmission and vaccine effectiveness is not known in this population. WHO has set a target for hepatitis B elimination by 2030; elimination in this disproportionately affected population in Australia will require understanding of the modes of transmission and vaccine effectiveness.

methodsWe conducted the study at four very remote Aboriginal communities. We approached mothers who had chronic hepatitis B and had given birth between 1988 and 2013 for consent. We obtained hepatitis B serology, immunisation and birth details from the medical record. If both mother and child had hepatitis B viral DNA detected, we performed viral whole genome sequencing.

resultsWe approached 45 women for consent, of whom 23 agreed to participate. We included 20 mothers and 38 of their children. Of the 20 included mothers, 5 (25%) had children who were hepatitis B immune by exposure and 3 (15%) had children with evidence of chronic hepatitis B infection at the time of assessment. Hepatitis B immunoglobulin (HBIg) had been given at birth in 29/38 (76.3, 95% CI 59.8-88.6) children, and 26 children (68.4, 95% CI 51.3-82.5) were fully vaccinated. Of the 3 children who had chronic hepatitis B, all had received HBIg at birth and two were fully vaccinated. Of the 5 who were immune by exposure, 4 had received HBIg at birth and one was fully vaccinated. Whole genome sequencing revealed one episode of definite mother to child transmission. There was also one definite case of horizontal transmission.

conclusionsChronic hepatitis B in this context is a sensitive issue, with a high proportion of women refusing consent. Although uncommon, there is ongoing transmission of hepatitis B to Aboriginal children in remote northern Australia despite vaccination, and this is likely occurring by both vertical and horizontal routes. Prevention will require ongoing investment to overcome the many barriers experienced by this population in accessing care.

Indexed as

Hepatitis BHepatitis B, ChronicChildChild, PreschoolFemaleHepatitis B VaccinesHumansInfant, NewbornInfectious Disease Transmission, VerticalNorthern TerritoryHepatitis B VaccinesHepatitis BInfectious disease transmissionPrevention

Identifiers

PMID36575515
PMCPMC9795589
OpenAlexW4313250611

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.