Hepatitis B virus infection on Kwajalein Atoll, Marshall Islands: a seroprevalence, knowledge and attitudes study

Authors

  • Melaia Lawanivalu Ebeye Public Health Department, Leroij Kitlang Memorial Health Center – Ministry of Health and Human Services, Majuro, Marshall Islands
  • Anaseini Ratu School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
  • Glorine A Jeadrik Kwajalein Atoll Health Care Bureau, Leroij Kitlang Memorial Health Center – Ministry of Health and Human Services, Majuro, Marshall Islands
  • Masoud Mohammadnezhad School of Nursing and Healthcare Leadership, University of Bradford, Bradford, United Kingdom of Great Britain and Northern Ireland
  • Aneley Getahun Strobel School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji; Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia

DOI:

https://doi.org/10.5365/wpsar.2024.15.1.1042

Keywords:

hepatitis B, seroprevalence, vaccination, Marshall Islands, Pacific Islands

Abstract

Objective: A study was conducted to determine the seroprevalence of chronic hepatitis B virus (HBV) infection among children and their mothers on Kwajalein Atoll in the Marshall Islands two decades after routine vaccination was introduced in the 1990s. Mothers’ knowledge and attitudes towards HBV disease and vaccination were also assessed.

Methods: Results of a national seroprevalence survey conducted in 2016–2017 and antenatal records were used to determine the prevalence of HBV seropositivity in children aged 6–8 years and their biological mothers. The associations between demographic, social and vaccination-related factors and seropositivity were explored using Fisher’s exact tests.

Results: HBV seroprevalence was 0.3% in children and 6.8% in their mothers (during pregnancy). Coverage of timely HBV vaccination was 90.3% for the birth dose and was significantly associated with factors related to place of residence (P < 0.001), place of birth (P < 0.001) and number of antenatal visits (P < 0.001). Maternal attitudes towards infant vaccination and antenatal screening were largely positive (95.8% and 96.7%, respectively) despite low vaccination rates (20.9%) among mothers. Knowledge levels were low for disease complications, treatment and transmission.

Discussion: Prevalence of HBV in children and mothers residing on Kwajalein Atoll in 2016–2017 was lower than the national average for the Marshall Islands. Timely birth dose administration appears to have been effective in preventing mother-to-child transmission of HBV in this setting and should be promoted in remote settings where antiviral therapy is not available. Provision of out-of-cold-chain HBV vaccines should be considered to improve access in remote settings.

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Published

21-02-2024

How to Cite

1.
Lawanivalu M, Ratu A, Jeadrik GA, Mohammadnezhad M, Getahun Strobel A. Hepatitis B virus infection on Kwajalein Atoll, Marshall Islands: a seroprevalence, knowledge and attitudes study. Western Pac Surveill Response J [Internet]. 2024 Feb. 21 [cited 2026 Mar. 24];15(1). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1042

Issue

Vol. 15 No. 1 (2024): January ‒ March

Section

Original Research

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