Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy

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Vaccine, Vol. 21 (11-12) (2003) pp. 1246-1249
© 2002 Elsevier Science Ltd. All rights reserved.
PII: S0264-410X(02)00439-5
 

Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy

Tommaso Stroffolini a,b * , Elvira Bianco a, Andrè Szklo a, Rossana Bernacchia a, Crescenzo Bove c, Mario Colucci d, Rosa Cristina Coppola e, Paolo D'Argenio f, Pierluigi Lopalco g, Antonino Parlato h, Pietro Ragni i, Andrea Simonetti h, Carla Zotti j and Alfonso Mele a

a Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanità, Rome, Italy
b San Giacomo Hospital, Liver Unit, Rome, Italy
c Epidemiology Unit, Health District of Caserta, Caserta, Italy
d Infectious Diseases Unit, San Giovanni di Dio e Ruggi D'Aragona Hospital, Salerno, Italy
e Department of Public Health, University of Cagliari, Caserta, Italy
f Epidemiology Unit, Health District of Benevento, Benevento, Italy
g Department of Public Health, University of Foggia, Foggia, Italy
h Health Regional Service, Emilia Romagna, Italy
i Epidemiology Unit, Health District of Naples, Naples, Italy
j Department of Public Health, University of Turin, Turin, Italy

Received 25 April 2002; received in revised form 15 August 2002; accepted 2 September 2002

Abstract

The effectiveness in the prevention of perinatally transmitted HBV infection was assessed in 11858 pregnant women consecutively recruited in public and private hospitals in six Italian regions during a 2 months period in 2001. Of them 10881 (91.8%) attended HBsAg antenatal screening. The overall HBsAg prevalence was 1.7% (CI 95%: 1.4-1.9); it was 1.4% (CI 95%: 1.2-1.7) in pregnant women born in Italy but 5.9% (CI 95%: 4.1-8.1) in those born in Asia, Africa, central and south America, and eastern Europe. Results of multiple logistic regression analysis indicate that birth in foreign countries (OR 2.0; CI 95%: 1.3-3.0), family size with more than 4 members in the household (OR 3.5; CI 95%:2.7-4.6), and birth in a private hospital (OR 1.9; CI 95%: 1.3-2.8) were all independent predictors of lack of adherence to HBsAg screening. Out of the 182 new-borns of HBsAg positive mothers 172 (95.0%) were given active plus passive immunisation; this figure was 100% in new-borns of foreign mothers.

These findings evidence a good effectiveness in the prevention of perinatally transmitted HBV in Italy. More efforts should be addressed to improve the effectiveness of the programme among foreign pregnant women who have high rate of HBsAg and more likely escape HBsAg screening than Italian pregnant women.

Keywords: Effectiveness; HBV; Perinatal transmission

*Corresponding author. Tel.: +39-6-49902982; fax: +39-6-49387173.

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