Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy

• Published in: Vaccine Vol. 21; no. 11; pp. 1246 - 1249
• Main Authors: Stroffolini, Tommaso, Bianco, Elvira, Szklo, Andrè, Bernacchia, Rossana, Bove, Crescenzo, Colucci, Mario, Cristina Coppola, Rosa, D’Argenio, Paolo, Lopalco, Pierluigi, Parlato, Antonino, Ragni, Pietro, Simonetti, Andrea, Zotti, Carla, Mele, Alfonso
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 07.03.2003; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Africa - ethnology; Americas - ethnology; Asia - ethnology; Biological and medical sciences; Compliance; Confidence intervals; Developing countries; Educational Status; Effectiveness; Emigration and Immigration - statistics & numerical data; Europe, Eastern - ethnology; Family Characteristics; Female; HBV; Hepatitis; Hepatitis B - epidemiology; Hepatitis B - prevention & control; Hepatitis B - transmission; Hepatitis B Surface Antigens - analysis; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - therapeutic use; Hepatitis B virus; Hospitals, Private - statistics & numerical data; Hospitals, Public - statistics & numerical data; Human viral diseases; Humans; Immunization; Immunization, Passive - statistics & numerical data; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious diseases; Italy; LDCs; Logistics; Mass Screening - psychology; Mass Screening - statistics & numerical data; Medical sciences; Patient Compliance; Perinatal transmission; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - epidemiology; Prenatal Care - statistics & numerical data; Program Evaluation; Seroepidemiologic Studies; Socioeconomic Factors; Vaccination - statistics & numerical data; Vaccines; Variables; Viral diseases; Viral hepatitis; Italy; Europe; Perinatal transmission; HBV; Effectiveness; Human; Orthohepadnavirus; Hepatic disease; Medical screening; Infection; Virus; Pregnancy; Viral hepatitis B; Prenatal; Hepadnaviridae; Viral disease; Digestive diseases; Female; Hepatitis B virus; Public health
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/S0264-410X(02)00439-5

The effectiveness in the prevention of perinatally transmitted HBV infection was assessed in 11858 pregnant women consecutively recruited in public and private hospitals in six Italian regions during a 2 months period in 2001. Of them 10881 (91.8%) attended HBsAg antenatal screening. The overall HBsAg prevalence was 1.7% (CI 95%: 1.4–1.9); it was 1.4% (CI 95%: 1.2–1.7) in pregnant women born in Italy but 5.9% (CI 95%: 4.1–8.1) in those born in Asia, Africa, central and south America, and eastern Europe. Results of multiple logistic regression analysis indicate that birth in foreign countries (OR 2.0; CI 95%: 1.3–3.0), family size with more than 4 members in the household (OR 3.5; CI 95%:2.7–4.6), and birth in a private hospital (OR 1.9; CI 95%: 1.3–2.8) were all independent predictors of lack of adherence to HBsAg screening. Out of the 182 new-borns of HBsAg positive mothers 172 (95.0%) were given active plus passive immunisation; this figure was 100% in new-borns of foreign mothers. These findings evidence a good effectiveness in the prevention of perinatally transmitted HBV in Italy. More efforts should be addressed to improve the effectiveness of the programme among foreign pregnant women who have high rate of HBsAg and more likely escape HBsAg screening than Italian pregnant women.