Results from nationwide hepatitis B serosurvey in Cambodia using simple and rapid laboratory test: implications for National Immunization Program

Abstract

Chronic liver infection and cancer in the western Pacific region is disproportionate to the population globally. This study provides the first nationwide estimates of hepatitis B surface antigen (HBsAg) seroprevalence in Cambodia among children five year of age. Using a simple and rapid test for HBsAg and multi-stage stratified cluster sampling design, we estimated HBsAg seroprevalence to be 3.5% (95% confidence interval = 2.4-4.8%) among five-year old children. Triangulating the results with other studies, we demonstrate the importance of interrupting perinatal transmission and one-time catch-up vaccination of older children born before nationwide introduction of vaccination for effective hepatitis B control in Cambodia and for reaching the disease control goal of less than 2% chronic infection rates among children > or = 5 years of age. The results demonstrate the feasibility of conducting nationwide serosurveys using simple and rapid tests to evaluate the impact of hepatitis B vaccination programs in lieu of standard enzyme-linked immunosorbent assays.