Title
Estimating the burden of hepatitis B virus infection in Laos between 2020 and 2021: A cross-sectional seroprevalence survey
Date Issued
01 October 2022
Access level
open access
Resource Type
journal article
Author(s)
Sitbounlang P.
Deharo E.
Latthaphasavang V.
Marchio A.
Soukhsakhone C.
Soinxay V.
Mayxay M.
Steenkeste N.
Vincelot P.
Palamy S.
Paboriboune P.
Pineau P.
Université de Toulouse
Publisher(s)
Elsevier Ltd
Abstract
Background: Laos is considered highly endemic for persistent infection with hepatitis B virus (HBV). To eliminate this burden, it has gradually implemented universal anti-hepatitis B immunisation of newborns over the past two decades. Methods: Using VIKIA® HBsAg, a rapid test for the qualitative detection of the HBV surface antigen, we conducted between Sep 1st, 2020 and Aug 31st, 2021 the largest prospective prevalence survey ever in Laos. This survey included blood donors (BD, n = 42,277), patients attending care in capital and provincial hospitals (n = 37,347) including attending mothers (n = 20,548), HIV-infected patients (n = 7439, recruited from 2009 to 2020), students from the Health Sciences University (n = 609), and outpatients (n = 350) coming for diagnosis at the Center Infectiology Lao-Christophe Mérieux in Vientiane. In total, 88,022 persons were tested, representing approximately 1.22% of the national population. To reach a reasonable estimate of HBsAg prevalence in Laos, we segmented the population according to three variables, age (≤20 years as a cut-off), sex, and geographical origin. BD values were used to estimate HBsAg prevalence in patients aged <20 while hospital survey prevalence was used to estimate the prevalence in those aged older than 20 years. Findings: We observed an HBsAg seroprevalence ranging from 2.6% in blood donors to 8.0% in HIV-infected patients. In BD, men were significantly more at risk to be carriers than women (RR = 1.2, P = 0.00063). For BD, attending mothers, or HIV-infected patients, HBsAg was significantly more prevalent in northern Laos (5.1–8.4%) than in central (2.0–8.1%) or southern parts of the country (2.2–6.9%), thereby delineating a North-to-South gradient. Interpretation: We considered that HBsAg prevalence probably ranges between 5.0% and 6.0% of the total population. Thus, we consider that Laos may no longer be highly endemic for chronic HBV infection but rather a country with intermediate endemicity. Funding: The funding sources were the Agence Universitaire de la Francophonie, the French Government, the French Institute for Sustainable Development (IRD), and European Union's Horizon 2020 Marie Sklodowska-Curie Actions (MSCA) – Research and Innovation Staff Exchange - (RISE) under grant agreement N° 823935.
Volume
52
Language
English
OCDE Knowledge area
Hematología
Oncología
Subjects
Scopus EID
2-s2.0-85135120689
Source
eClinicalMedicine
ISSN of the container
25895370
Source funding
H2020 Marie Skłodowska-Curie Actions
Sponsor(s)
The funding sources were the Agence Universitaire de la Francophonie, the French Government, the French Institute for Sustainable Development (IRD), and European Union's Horizon 2020 Marie Sklodowska-Curie Actions (MSCA) – Research and Innovation Staff Exchange - (RISE) under grant agreement No. 823935. VIKIA kits were generously offered by the Fondation Mérieux, France. We would like to thank the Vientiane branch of the Agence Universitaire de la Francophonie (AUF). PS was recipient of a Bourse du Gouvernement Français (BGF) and of the French Institute for Sustainable Development (IRD). PS also received support from the European Union's Horizon 2020 Marie Sklodowska-Curie Actions (MSCA) – Research and Innovation Staff Exchange (RISE) under grant agreement No. 823935. We would like to thank Johnny Khammixay for technical assistance. We also would like to thank all collaborating sites in Laos, including the University of Health Sciences (UHS), the Mother and Child Health Center, blood centres in 18 provinces, and five central and eight provincial hospitals, including the Children's Hospital of Luang Prabang. The authors are grateful to Miss Vatsana Prabong (NTPC), who facilitated the distribution of tests in Khammouane province. We are grateful to David Wharton and Kurt A. McKean for editing the manuscript.
VIKIA kits were generously offered by the Fondation Mérieux, France. We would like to thank the Vientiane branch of the Agence Universitaire de la Francophonie (AUF). PS was recipient of a Bourse du Gouvernement Français (BGF) and of the French Institute for Sustainable Development (IRD). PS also received support from the European Union's Horizon 2020 Marie Sklodowska-Curie Actions (MSCA) – Research and Innovation Staff Exchange (RISE) under grant agreement No. 823935. We would like to thank Johnny Khammixay for technical assistance. We also would like to thank all collaborating sites in Laos, including the University of Health Sciences (UHS), the Mother and Child Health Center, blood centres in 18 provinces, and five central and eight provincial hospitals, including the Children's Hospital of Luang Prabang. The authors are grateful to Miss Vatsana Prabong (NTPC), who facilitated the distribution of tests in Khammouane province. We are grateful to David Wharton and Kurt A. McKean for editing the manuscript.
The funding sources were the Agence Universitaire de la Francophonie, the French Government, the French Institute for Sustainable Development (IRD), and European Union's Horizon 2020 Marie Sklodowska-Curie Actions (MSCA) – Research and Innovation Staff Exchange - (RISE) under grant agreement No. 823935 .
Sources of information:
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