About
Chronic infection with hepatitis B virus (HBV) is an important cause of premature adult deaths in sub-Saharan Africa (SSA), due to liver cancer or cirrhosis. To reduce the disease burden, it is critical to interrupt perinatal mother-to-infant transmission: in SSA, an estimated >60% of chronic HBV carriers suffering from liver disease were infected through perinatal transmission. Despite the WHO recommendation, the timely administration of an HBV vaccine within 24 hours of birth to prevent perinatal transmission has rarely been implemented in SSA. First, the pentavalent vaccine (DTP-HepB-Hib) provided by the GAVI cannot be used at birth. Second, a birth dose vaccine poses logistical challenges where many births take place at home. Our study will develop and evaluate a community-based home visit intervention to improve the coverage of a timely birth dose of HBV vaccine and other neonatal care practices that can improve child survival. First, we will conduct a baseline formative study in Senegal, Burkina Faso and Madagascar, in which we develop a locally adapted, sustainable home visit intervention through mixed (epidemiological and anthropological) methods. Subsequently, we will assess the impact of the intervention developed during the formative study on birth dose HBV vaccine coverage and neonatal mortality through a cluster randomized controlled trial. Our results will assist policy makers in SSA and international funders in evaluating the effectiveness of a home visit approach that promotes birth dose vaccine coverage and other neonatal care practices.
