According to the study data, Nepal is determining with major reporting of Hepatitis B infections; were according to estimates from the WHO; viral hepatitis caused 1.34 million deaths globally in 2015. In India, it is estimating that there are four crore people suffering from hepatitis B; and 0.6-1.2 crore people suffering from hepatitis C.
But as Hepatitis B coverage receiving a shot in the arm after the introduction of a pentavalent vaccine; on a pilot basis in Kerala and Tamil Nadu in December 2011 and its national roll-out in 2014-2015. According to the study Bangladesh, Bhutan, Nepal and Thailand have become the first four countries in the World Health Organisation’s (WHO) Southeast Asia region to successfully control hepatitis B as the prevalence of the disease has been reduced to less than 1% among children below five.
Hepatitis B infections
Preventing hepatitis B infection in infancy would reduce chronic infections and cases of liver cancer and cirrhosis (scarring of the liver) in adulthood. According to a report by the ministry of health and family welfare, there was only 45% coverage of the health dose in 2015 and 60% in 2016. Despite the fact that 80% of deliveries are in healthcare institutions in India, the coverage for the birth dose vaccine has been low with 55% in 2015 and 67% in 2016.
The coverage amongst institutional deliveries for the birth dose was reported to be 71% as of March 2017. Several patients remain asymptomatic for a long period of time; and since prenatal testing is not very common, the virus tends to go undetected in children and they do not know they have it until much later in adulthood. The hepatitis B birth dose, rolled out in the national programme in 2008; prevents vertical transmission from the mother to child if administered in the first 24 hours after birth.
Administering the birth dose to cut vertical transmission is needing as about 70-90% newborns infecting; this way become chronic carriers of hepatitis B, and about 20-30% carriers in India are due to vertical transmission. A factor that contributes to the low coverage of the birth dose in healthcare facilities; is the fear of wasting vaccines when a ten-dose vial is using.
However, most workers are unaware that WHO recommendations allow for a hepatitis B; open vial policy for the vaccine which can be keeping for a maximum duration; of 28 days for use in other children. But Hepatitis coverage received a shot in the arm after the introduction of a pentavalent vaccine in Nepal.