ArticleBMC public health2025
Optimizing the prevention of mother-to-child transmission of hepatitis B through integrated care models: a pilot study in Jiangsu Province, China.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreventing mother-to-child transmission of hepatitis B (PMTCT) is crucial for reducing the incidence of new hepatitis B virus (HBV) infections. However, the current PMTCT interventions including maternal screening, antiviral prophylaxis, infant immunoprophylaxis, and post-vaccination serological testing, fail to reach a broader population, especially those in rural areas. This pilot study aimed to optimize the PMTCT strategy by integrating existing medical resources, with the goal of achieving high coverage of the complex intervention services.
methodsThis real-world pilot study was conducted from March 4, 2019, to May 27, 2020, in Zhangjiagang, a county under the jurisdiction of Suzhou, Jiangsu Province. We collaborated with multiple healthcare institutions to establish a comprehensive PMTCT strategy that combines decentralized and centralized service delivery. The intervention rate at each healthcare service related to PMTCT was the primary endpoint of the evaluation.
resultsA total of 11,181 pregnant women accepted HBV screening during their first antenatal care (ANC) visit. Among the 272 hepatitis B surface antigen (HBsAg) positive individuals, 64 (23.5%) were hepatitis B e antigen (HBeAg) positive. All 64 HBeAg-positive pregnant women (including one case of twin pregnancy) accepted the referral, of whom 53 met the criteria for antiviral prophylaxis, and 51 (96.2%) received the treatment. All 65 infants born to HBeAg-positive mothers completed post-vaccination serological testing (PVST) in designated institutions or others selected by their parents. The PVST results indicated complete success of the PMTCT strategy.
conclusionsBy integrating centralized and decentralized healthcare services through collaboration among multiple healthcare institutions, it is feasible to establish a whole-process service that provides pregnant women with more timely and comprehensive services. This strategy can improve the rate of antiviral prophylaxis for high-risk pregnant women with HBV MTCT, which is of great significance for eliminating MTCT of HBV.
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