An effectiveness of Hepatitis B intervention to prevent transmission of Hepatitis B virus to the infants. John A, Orisasona, MPP., M.P.H. Walden University School of Health Science Saturday, May 07 2011

Purpose The following are the study focus: To determine the effectiveness of hepatitis B vaccine administered to prenatal women diagnosed with hepatitis B. virus To preventing the transmission to the infants or to evaluate the ongoing level of immunity in previously vaccinated infants. Also to measure whether there are immunity differences based on vaccination status, ethnic origin, healthcare availability, or geographical area

Statement of the Problem Pregnant women diagnosed with positive HBsAg infection became reportable infectious diseases by law when the prevalence was empirically established. In United States approximately 1.25 million people are infected with chronic hepatitis B while a total of 4000 to 5000 people die from chronic liver diseases annually. In Virginia, 130 cases of acute Hepatitis B was reported in 2008 (Centers for Disease Control and Prevention, 2006; Virginia Department of Health, 2008). There is a tendency for infants born to infected parents with positive hepatitis B virus not to get immune with the virus despites administration of HBs immunoglobulin (HBIG) and a 3 dose series of hepatitis B.vaccine. The purpose of this study is to determine the effectiveness of hepatitis B. vaccine administered to prenatal women diagnosed with hepatitis B. Virus and HIBG and 3 dose of HB Vaccine intervention to the infants to prevent the transmission of the virus through evaluation of the ongoing level of immunity in previously vaccinated parents and infants.

Research Questions and/or Hypothesis Is there a relationship between immunity levels and the number of vaccine received based on ethnic origin, healthcare availability, or geographical area? What is the proportion of HBs immunoglobulin (HBIG) and a 3 dose series of hepatitis B. vaccine have on the level of infant immunity?

Research Methodology The research study will be a quasi-experimental design using a non equivalent control group design. The experimental group would be pregnant women positive for hepatitis surface antigen (HBsAg), the infants have received HBIG within 12 hours after birth, and have consistently completed a 3 dose series of hepatitis B. vaccine. Testing between ages 9 and 18 months showing a magnitude of 1.0 Level index value of anti-HBs. The control group will be from the same population with or without HBIG within 12 hours of birth, which are not consistent for the series of 3 doses of hepatitis B. vaccine, received no treatment or refuse the treatment or having level of index value < 0.99.

Research Design Pre-Test Post-Test Treatment with Nonequivalent Group Design. (NEGD) Pre-Test: N O X O Post-Test: N O O A. Administration of HBIG and 3 dose series of hepatitis B. vaccine represents the treatment. B. Comparable group are without HBIG and 3 dose series of hepatitis B. vaccine

References: Centers for Disease Control and Prevention. (1982). Recommendation of the immunization practices Advisory Committee (ACIP) Inactivated hepatitis B vaccine. MMWR, 31(24), 317-328. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/0000111 6.htm Centers for Disease Control and Prevention. (2006). A comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States. Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: Immunization of Adults. MMWR, 55(RR16), 1-25. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1 .htm

References Cont: Derso, A., Boxall, E. H., Tarlow, M. J., & Flewett, T. H. (1978). Transmission of HBsAg from mother of infant in four ethnic groups. British Medical Journal 1 (6118), 949-952 Gish, R. G., & Gadano, A.C. (2006). Chronic hepatitis B: Current epidemiology in the Americas and implication for management. Journals of Viral Hepatitis, 13(12), 787-798 Nguyen, T. T., Taylo, V., Chen, M. S., Jr., Bastani, R., Maxwell, A. E., & McPhee, S. J. (2007). Hepatitis B awareness, knowledge, & screening among Asian Americans. Journal of cancer Education, 22(4), 266-272 Virginia Department of Health, (2008). Diseases Surveillance Data. Annual Reports. Retrieved from http://www.vdh.virginia.gov/Epidemiology/Surveillance/Surv eillanceData/AnnualReports/index.htm