About
Project overview
The purpose of this project, implemented by PATH in collaboration with Nghe An Province CDC and with support from the City of Geneva, is to demonstrate the impact of introducing screening and treatment of hepatitis B in pregnant women within the Maternal & Child Healthcare system as part of Vietnam’s 2030 triple elimination goal (HIV, Syphilis & HBV).
Context
In the Asia-Pacific Region, mother-to-child transmission (MTCT) at birth plays a significant role in hepatitis B epidemiology. Approximately 3% to 5% of infants born in this region will acquire chronic hepatitis B infection at birth if not immunized immediately after delivery. Each year, over 180,000 newborn babies in the region are newly infected by hepatitis B through mother-to-child transmission.
According to WHO, Vietnam has one of the highest HBV prevalence in the world at more than 10%. Viral hepatitis is the third cause of death in the country, and HBV claims over 25,000 lives annually (Polaris Observatory, 2016). Chronic carriers of hepatitis B are at risk of developing liver diseases such as cirrhosis and liver cancer. HBV causes 45% of all liver cancer cases.
To prevent MTCT of HBV, WHO recommends that all children be vaccinated against hepatitis B as soon as possible, including a first dose of the vaccine within 24 hours after birth. Timely diagnosis and treatment of women living with chronic hepatitis B during pregnancy and hepatitis B vaccination for newborns can reduce and prevent MTCT of HBV by more than 95% and thus break the cycle of transmission across generations. While the national birth dose of hepatitis B vaccination rate is at 82.2%, the proportion of pregnant women screened for HBV is very low (55%), and the prophylactic treatment for pregnant women is not yet dispensed in district hospitals in Vietnam.
Action
The project aims to implement a scalable pilot model towards a hepatitis-free future for newborn babies in Nghe An Province through the following objectives:
- Provide testing for hepatitis B in pregnant women receiving antenatal care (ANC) or delivery services at district health facilities in Dien Chau and Thai Hoa, Nghe An.
- Facilitate linkage to HBV prophylaxis or treatment for pregnant women living with hepatitis B to prevent mother-to-child transmission of HBV.
- Promote newborn HBV birth dose vaccination.
- Provide clinical and operational evidence for policy formulation at the provincial and national levels.
Nghe An is Vietnam’s largest province, located in the North Central Coast region of the country, with 3,547,247 people living in 21 districts.
Expected results
The project aims to screen 90% of pregnant women receiving antenatal care, treat 80% of eligible pregnant women with Tenofovir (TDF) prophylaxis or treatment, and vaccinate up to 98% of newborns with a birth dose HBV vaccine at the project sites.
Catalytic impact
PATH expects this pilot project to demonstrate promising results, which will be endorsed and expanded by the Vietnamese government. The project will also build capacity for healthcare workers and local health authorities in Nghe An province to better screen and treat HBV among pregnant women toward reducing MTCT of HBV beyond the project duration.
This project was made possible by support from the City of Geneva.
Photo credit: PATH.