Abstract

PIP: Rumi et al. conducted a study to estimate the economic rationale for introducing routine prenatal hepatitis B surface antigen (HBsAg) screening and prescribing combined passive-active immunization to at-risk babies in Bangladesh. They concluded that universal hepatitis B virus (HBV) immunization may be more cost-effective than selective immunization in developing countries such as Bangladesh and India, and have therefore called for the replacement of selective vaccination with universal vaccination in Bangladesh. Given the limited available facilities in Bangladesh for antenatal checkup and laboratory tests, the universal vaccination of newborns is the more simple logistical option to control HBV infection. The Global Advisory Group of the Expanded Program on Immunization and World Health Assembly has recommended that countries with higher than a 2% prevalence of HBV carriers add hepatitis B vaccine to their routine infant immunization schedules. In the Southeast Asian region, however, only Indonesia, Mongolia, Thailand, and the Maldives have begun such routine hepatitis B immunization. Economic constraints have prevented other countries in the region from following suit.