Assessment of hepatitis B vaccine-induced seroprotection among children 5-10 years old in Ulaanbaatar, Mongolia.

Abstract

Hepatitis B virus infection is a serious public health problem. Mongolia is one of the countries with the highest rates of hepatitis B virus infection in the world. The routine immunization with the hepatitis B vaccine began nationwide in 1991. The purpose of this study was to determine the persistence of seroprotection (anti-HBs >or= 10 mlU/mL) in children 5-10 years old that were immunized with the hepatitis B vaccine as infants. In total, 438 children were selected from six health facilities in Ulaanbaatar through a multistage random sampling method. Vaccination information was confirmed by checking the vaccination records kept in the health facilities. A blood sample was obtained from each child for anti-HBs, HBsAg and anti-HBc. Of 438 children, five (1.1%) were HBsAg positive and 58 (13.2%) were anti-HBc positive. Sixty infected children were excluded and a total of 378 (86.3%) sera were evaluated. The seroprotective antibodies were detected in only one-fourth of the children at the age of ten. Titres of anti-HBs decreased significantly with age (Linear regression p = 0.01). This decrease is primarily due to the rapid decrease in children living in ger areas (p < 0.001) compared to children living in apartment areas (p = 0.152). On the other hand, children living with higher socio-economic status had more exposure to blood-borne pathogens, probably due to inappropriate health-seeking behaviors.