Seroprevalence of Chronic Hepatitis B among 6-8 Year-old Children in Kwajalein Atoll, Republic of the Marshall Islands A Mixed Method Study

Background:
Hepatitis B, a serious public health challenge, caused by Hepatitis B Virus (HBV) that causes both acute and chronic disease. MTCT is a major mode of transmission in HBV endemic countries including RMI where less is known about the prevalence of the disease and the knowledge and attitude of the parents towards the disease.
Objective
To estimate the prevalence of chronic HBV infection among children of Kwajalein Atoll and to assess the level of knowledge and attitude of parents towards HBV infection and vaccine
Methodology
A mixed method study involving two components. The first is the cross- sectional analysis of the sero-survey of grade 1 students (6-8 years old) and the sero-survey of biological mothers of grade 1 students of the 2016. The second is a knowledge-attitude survey designed for parents
Result
Prevalence of hepatitis B amongst children on KA was found to be 0.3%. Hepatitis B vaccine timely birth dose was found to be 91.3% of those surveyed; 57.7% received 3-dose vaccine at 6 months of age, and 91% had received three dose coverage before 12 months of age; mothers of grade 1 students with prevalence of 6.8% HBsAg-positive, lower education was found to be significantly associated with maternal hepatitis B infection (OR =2.6). Survey of mothers/guardians revealed that 47% of the respondents had good knowledge of hepatitis B infection and vaccination and 96.4% had positive attitudes towards hepatitis B infection .
Conclusion
Kwajalein Atoll has achieved a milestone of regional target for reducing HBV in children <1%. The low level in knowledge of hepatitis B among mothers & guardian (53%) has demonstrated the need to further develop Hepatitis B public health education package.