African newborn hepatitis B immunization initiatives have recently made progress.

Infection with the hepatitis B virus (HBV) is the most common global cause of cirrhosis and liver cancer. Researchers report progress made toward the elimination of mother-to-child transmission (MTCT) of HBV in the World Health Organization (WHO) African Region (AFR) between 2016 and 2021 in a recent Morbidity and Mortality Weekly Report (MMWR) published by the United States Centers for Disease Control and Prevention (CDC).

• Campaigning for infant HBV vaccination

• 66% of newly acquired HBV infections worldwide in 2019 were located in the WHO AFR. This remained true despite the HBV birth dose (HepB-BD)'s launch in 2016, which enhanced the results of three newborn doses of HepB3 in children aged five or less. Less than 2% hepatitis B surface antigen (HBsAg) seroprevalence in children aged five years or less and more than 90% HepB3 coverage by 2020 were the vaccination initiative's ultimate goals for a 30% decrease in MTCT incidence.

The WHO advises giving all newborns a HepB-BD within 24 hours of delivery, followed by two to three more HepB doses throughout infancy, because roughly two-thirds of MTCT chronic HBV infections take place in AFR.

• Concerning the study

For information on the immunization activity in all 47 AFR nations, researchers reviewed official HBV coverage data that had been sent to WHO in the current study to produce estimates of the annual national vaccine coverage. In order to find HBsAg seroprevalence studies unique to the WHO AFR, a MEDLINE literature research was carried out.

Less than or equal to 0.1% HBsAg seroprevalence in children five years of age or younger demonstrates the complete eradication of HBV following MTCT. The Demographic Health Survey (DHS) and Population-based HIV Impact Assessment (PHIA) surveys provided further population-based information.

• Study findings

By the year 2021, children under the age of six weeks received three doses of the HBV vaccine HepB3 from all 47 AFR countries, in addition to HepB-BD from 14 more nations. As a result, 34% of nations and 4% of countries, respectively, obtained over 90% timely HepB-BD coverage and over 90% HepB3 coverage.

Four nations also achieved HBV control, but none eliminated MTCT, which would happen if less than 0.1% of children aged five and under showed seroprevalence of the HBsAg virus.

Pregnancy-related HBsAg seroprevalence aids in calculating the risk for HBV MTCT. According to this data, which was available for 11 of the 47 AFR nations, Rwanda and Sierra Leone had seroprevalences of HBsAg of 1.2% and 9.8%, respectively.

The 2019 COVID-19 pandemic of the coronavirus illness interfered with immunization efforts. Fewer AFR nations were able to achieve over 90% HepB3 coverage as a consequence, which caused values to decline from their peak of 20 to 16 between 2018 and 2021, respectively.

So, to boost HepB-BD coverage, four AFR nations implemented HepB-BD between 2016 and 2021. However, in Nigeria and Senegal, regional HepB-BD coverage only rose from 10% to 17%.

In AFR nations, about 33 million newborns did not receive timely HepB-BD by 2021. These findings underline the necessity for measures to restart immunization campaigns in AFR nations so that all eligible children who missed the necessary doses of HepB3 vaccine do so.

Training healthcare professionals is essential to ensuring that HepB-BD immunization is included in neonatal care. All 47 AFR nations will receive more timely HepB-BD coverage as a result of these initiatives. Identifying pregnant women with HBV infection who are eligible for treatment with antiviral drugs in addition to early vaccination and improved vaccination coverage may help to further lower the MTCT of HBV.

Only 17 of the 47 AFR nations had national-level regulations for newborn HBsAg testing and therapy as of 2021. Additionally unusual in these nations were national-level serosurveys. Future HBsAg seroprevalence surveys may aid in tracking development and guiding policy choices for HBV control and MTCT of HBV eradication in this WHO area.

• Conclusions

The WHO AFR nations have not yet met the HBV eradication targets established in 2016 by the WHO African Regional Committee and supported by the World Health Assembly.

The implementation of a region-based verification framework for the eradication of MTCT of HBV and disease control in AFR are only two of the authors' several significant proposals for accomplishing these objectives. Additionally, HepB-BD immunization rates must rise in AFR nations to finally stop HBV-related morbidity and fatalities.