Perinatal Hepatitis B in Texas Rachel Wiseman, MPH Overview CDC - - PowerPoint PPT Presentation

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Perinatal Hepatitis B in Texas Rachel Wiseman, MPH Overview CDC - - PowerPoint PPT Presentation

Sep 23, 2022 305 likes •513 views

Perinatal Hepatitis B in Texas Rachel Wiseman, MPH Overview CDC Estimates PHBPP Demographics PHBPP Performance Measures NOTE: All 2017 data is provisional. Babies born in 2017 may not be old enough to have completed the series or

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Perinatal Hepatitis B in Texas

Rachel Wiseman, MPH

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Overview

  • CDC Estimates
  • PHBPP Demographics
  • PHBPP Performance

Measures

NOTE: All 2017 data is provisional. Babies born in 2017 may not be old enough to have completed the series or be tested for infection/immunity. Data for San Antonio and Houston is not included in any of the data presented.

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CDC Estimates of Births to Hepatitis B-infected Women

Source of HBsAg prevalence estimates:

  • National Health and Nutrition Examination Survey 2009-2014
  • 2009-2014 Annual Reports
  • Walker TY, Smith EA, Fenlon N, et al. Characteristics of Pregnant Women with

Hepatitis B Virus Infection in Five U.S. Public Health Jurisdictions, 2008–2012. Public Health Reports. 2016 Aug 2016.

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CDC Estimates & Texas PHBPP

  • Point:1194
  • Low: 882

CDC

  • 2015: 648 (54%)
  • 2016: 654 (55%)

Texas

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Questions We Need to Answer

Who are these missing moms? Where are these missing moms? How do we find them or get them reported to us?

1194 Moms

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Drilling Down the Estimate

2015

CDC TX

East Asia

237

Africa

186

Southeast Asia

167

East Asia: China, Hong Kong, Japan, North Korea, South Korea, Macau, Mongolia, Taiwan, Southern Ryukyu Islands Southeast Asia: Burma, Brunei, Cambodia, Indonesia, Laos, Malaysia, Paracel Islands, Spratly Islands, Papua New Guinea, Timor, Philippines, Singapore, Thailand, East Timor, Vietnam

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Maternal Country of Birth, Texas PHBPP, 2016

Country Number of Moms (%) VIETNAM 129 (18%) UNKNOWN 101 (14%) USA 79 (11%) CHINA 74 (10%) NIGERIA 68 (9%) BURMA 24 (3%) CONGO 24 (3%) INDIA 18 (3%) TAIWAN 14 (2%) MEXICO 12 (2%) TOTAL 716

An additional 57 countries are represented in the 2016 enrollment.7

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Infants Born to Foreign-Born and US-Born Moms, 2015

100 200 300 400 500 600 700 800 US-Born Foreign-Born Number of Infants CDC Estimate PHBPP Reported

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Maternal Age, Texas PHBPP, 2016-17*

1 1 2 3 3 50 100 150 200 250 <19 19-24 25-29 30-34 35-39 40-44 45-49 50+

  • No. of Mothers

Age by Year 2016 2017*

*Data is provisional as of 5/1/18

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Infants Born to HBV-infected Moms, Texas PHBPP, 2013-17*

562 632 655 654 568 603 765 736 716 607

100 200 300 400 500 600 700 800 900

2013 2014 2015 2016 2017* Number of Infants Infants Identified Mothers Identified

1 2% 2/3 47% 4/5N 1% 6/5S 34% 7 10% 8 1% 9/10 3% 11 2%

2016 Births

*Data is provisional as of 5/1/18

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Perinatal Infection in Infants, Texas, 2003-18*

5 7 1 5 6 2 3 1 3 4 3 1 1 2 1

1 2 3 4 5 6 7 8 9 10 Peri Hep B Cases

*Data is provisional as of 5/1/18

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Infants with Birth Dose/HBIG within 1 Day of Birth, 2013-17*

96.0% 98.0% 98.8% 98.0% 96.0%

80% 82% 84% 86% 88% 90% 92% 94% 96% 98% 100% 2013 2014 2015 2016 2017* % of Infant Cases 2015 National Average= 96%

*Data is provisional as of 5/1/18

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Infants with Birth Dose/HBIG within 1 Day of Birth by PHR, 2016

100.0% 98.3% 100.0% 98.5% 98.5% 100.0% 94.0% 93.0% 80% 82% 84% 86% 88% 90% 92% 94% 96% 98% 100% PHR 1 PHR 2/3 PHR 4/5M PHR 6/5S PHR 7 PHR 8 PHR 9/10 PHR 11 2016 Texas Average= 98%

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Infants that Completed the Series, 2013-17*

92.1% 90.4% 85.9% 87.5% 63.9%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2013 2014 2015 2016 2017* % of Infant Cases 2015 National Average= 77%

*Data is provisional as of 5/1/18

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Infants that Completed the Series by PHR, 2016

87.5% 89.8% 77.8% 80.5% 94.0% 100.0% 76.5% 85.7% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% PHR 1 PHR 2/3 PHR 4/5N PHR 6/5S PHR 7 PHR 8 PHR 9/10 PHR 11 2016 Texas Average= 87.5%

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Infants with Post-Vaccine Serological Testing, 2013-17*

54.5% 57.6% 55.8% 60.5% 30.2%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2013 2014 2015 2016 2017* % of Infant Cases 2015 National Average= 72%

*Data is provisional as of 5/1/18

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Infants with Post-Vaccine Serological Testing by PHR, 2016

80.0% 69.7% 50.0% 63.5% 69.5% 100.0% 55.0% 53.0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% PHR 1 PHR 2/3 PHR 4/5N PHR 6/5S PHR 7 PHR 8 PHR 9/10 PHR 11 2016 Texas Average= 60.5%

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Summary

Areas for improvement

  • Identifying all pregnant women with

hepatitis B infection

  • Ensuring PHBPP infants are tested for

immunity and infection after vaccination Areas of success

  • Vaccination of all infants at birth
  • Prophylaxing exposed infants with

HBV/HBIG at birth

  • Completing the 3-dose HBV series

Suzy Wiseman getting Hep B shot at 1 hour old

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Thank you!

Questions?

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