| Titre : | A mathematical model to estimate global hepatitis B disease burden and vaccination impact. (2005) |
| Auteurs : | Susan-T GOLDSTEIN ; Beth-P BELL ; . FANGJUN ZHOU ; Stephen-C HADLER ; Harold-S MARGOLIS ; Eric-E MAST ; Centers for Disease Control and Prevention. Division of Viral Hepatitis. Atlanta. GA. USA |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 34, n° 6, 2005) |
| Pagination : | 1329-1339 |
| Langues: | Anglais |
| Mots-clés : | Hépatite virale B ; Virose ; Infection ; Prévention santé ; Vaccination ; Facteur risque ; Morbidité [épidémiologie] ; Epidémiologie ; Mortalité ; Morbidité ; Homme ; Appareil digestif [pathologie] ; Foie [pathologie] ; Cancer |
| Résumé : | [BDSP. Notice produite par INIST-CNRS kx3R0x3n. Diffusion soumise à autorisation]. Background : Limited data are available regarding global hepatitis B virus (HBV) - related morbidity and mortality and potential reduction in disease burden from hepatitis B vaccination. Methods : A model was developed to calculate the age-specific risk of acquiring HBV infection, acute hepatitis B (illness and death), and progression to chronic HBV infection. HBV-related deaths among chronically infected persons were determined from HBV-related cirrhosis and hepatocellular carcinoma (HCC) mortality curves, adjusted for background mortality. The effect of hepatitis B vaccination was calculated from vaccine efficacy and vaccination series coverage, with and without administration of the first dose of vaccine within 24 h of birth (i.e. birth dose) to prevent perinatal HBV infection. Results : For the year 2000, the model estimated 620000 persons died worldwide from HBV-related causes : 580000 (94%) from chronic infection-related cirrhosis and HCC and 40000 (6%) from acute hepatitis B. In the surviving birth cohort for the year 2000, the model estimated that without vaccination, 64.8 million would become HBV-infected and 1.4 million would die from HBV-related disease. Infections acquired during the perinatal period, in early childhood (<5 years old), and>=5 years of age accounted for 21,48, and 31% of deaths, respectively. Routine infant hepatitis B vaccination, with 90% coverage and the first dose administered at birth would prevent 84% of global HBV-related deaths. Conclusion : Globally, most HBV-related deaths result from the chronic sequelae of infection acquired in the perinatal and early childhood periods. Inclusion of hepatitis B vaccine into national infant immunization programs could prevent>80% of HBV-related deaths. |
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