Study On The Factors Associated With Timely First Dose Vaccination Of Hepatitis B Among Neonates In Yunnan Province, China,2010

Backgrounds:Hepatitis B is a serious public health problem worldwide, which hepatitis B vaccine immunization can against the infection. Timely first dose of hepatitis B vaccination is recommended to the neonate within24hours after the birth, which could provide immune early and against maternal transmission. In China, by Hepatitis B maternal transmission is the main type of infection. Timely vaccination among neonates is particularly appropriate. By the end of2010,40counties (31.01%) were failed to achieve the gain on Hepatitis B control that is required at least75%of neonates immunizated within24hours after their birth.Objectives:To explore the factors associated with timely first dose vaccination of hepatitis B vaccine among neonates in Yunnan Province, China, which includes the factors comes from mathers, institution of delivering service, institution of vaccination service, and the doctors responsed for delivery.Contents and methods:Using stratified cluster sampling, eighteen counties,and2~3townships in each selected county were randomly selected in this study. The information were collected from the institution of vaccination service, the institution of delivering service, and the doctors reponsed for delivery. All mothers of neonates in2010in the2~3villages randomly selected form each township sampled. The information include the situation of neonate hepatitis B vaccination, the situation of knowledge, attitude, and practice about hepatitis B prevention among mother and the doctors responsed for delivery, and the situation of public health service. Results:The rate of timely first dose vaccination of hepatitis B among neonates who born in hospital (82.72%) is significantly higher than those who born at home (14.29%). Higher timly first dose vaccination appears at the neonates whose mather has more knowledge on hepatitis B preventation. Frequency of training and supervision conducted by county CDC, and the application of muti-type dissemination are shown the strong association with the timeliness of first dose vaccination. The main reasons resulted in miss vaccination at hospital are because of low birth-weight (45.88%), neonatal asphyxia (25.26%), and premature (16.32%).The study also finds that the doctors responsed for vaccination who worked at hogher timeliness vaccination have the higher knowledge level on hepatitis B prevention.Conclusions:This research revealed that the main factors of low timliness of first dose of Hepatitis B in Yunnan province include the knowledge level on hepatitis B preventionamong pregnant woman and the doctors responed for delivery, whether hospital or home where the place of neonate birth, frequency of training and supervision for the local institution. Muti-type of dissemination could help rise the timeliness of vaccination.Recommendations:To increase the timeliness of first dose of hepatitis B vaccination, this study recommends that the efforts should focus on:to rise the percentage of delivering at hospital, to enhance the training for the people and institution responed both for vaccination and delivery, to apply the muti-type dissemination for the public to increase their knowledge awareness of hepatitis B prevention.