225453 Perinatal hepatitis B prevention practices in Texas - 2008

Monday, November 8, 2010 : 12:50 PM - 1:05 PM

Virginia L. Headley, PhD , Perinatal Hepatitis B Project, The Litaker Group, Austin, TX
John R. Litaker, PhD MSc MMedSc , Perinatal Hepatitis B Project, The Litaker Group, Austin, TX
Sandra A. Morris, MPH , Communicable Disease Control, Texas Department of State Health Services, Austin, TX
Health department personnel in Texas have implemented targeted strategies to improve perinatal hepatitis B surface antigen (HBsAg) screening and newborn hepatitis B vaccination rates. To measure effectiveness, the Department of State Health Services contracted The Litaker Group to review 24,956 total medical records from 12,324 live birth events in 119 hospitals in Texas in calendar year 2008. Mothers were screened for HBsAg either prenatally or on hospital admission 99.7% of the time, 89.4% both prenatally and on admission. For the 25 mothers who had non-negative screening results for HBsAg, one baby born was not vaccinated with hepatitis B vaccine prior to discharge from the hospital. Fifteen (62.5%) of the remaining 24 received hepatitis B immunoglobulin (HBIG) in addition to vaccine. When documented, the average time after birth to vaccinate was 7.6 hours (range 1-36h); average time to administer HBIG was 10.7 hours (range 1-30h); five babies were documented to have received both in less than 12 hours after birth. About 10% of the mothers (1302, 10.6%) arrived at the hospital with unknown HBsAg status , but only 56 mothers remained unknown by time of discharge. Vaccination rate of babies born to these mothers was 94.6%, with 45.5% receiving within 12 hours of birth. Only 7.1% also received HBIG. Total newborn vaccination rates statewide were 90.5%, showing marked improvement over the National Immunization Survey rate published for 2008 (66.6+/-5.5%). Reasons for lack of vaccination included guardian refusal (2.6% of all newborns) and pediatrician choice to not vaccinate before hospital discharge (2.1%).

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
1. Describe levels of hepatitis B prevention practices demonstrated by medical chart review in Texas hospitals in 2008 2. Compare rate of newborn hepatitis B vaccination demonstrated by medical chart review to rate published by the National Immunization Survey 3. Assess opportunities for future strategies for improvement in hepatitis B prevention practices

Keywords: Hepatitis B, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I personally collected data for the project, managed the collection of data by others, and performed the analysis of the data that will be presented as per the abstract submitted
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
The Litaker Group Public Health Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.