Conceptual medical abstract, rainbow coloured. Binary code and wave lengths. Credit: AdobeStock

Strengthening prevention of Hep B in children in Papua New Guinea Project

The challenge

Hepatitis B virus (HBV) is one of the most prevalent chronic infections globally. Mother-to-Child Transmission (MTCT) is the most common route of HBV transmission. Early prevention of MTCT is key reducing the burden of chronic HBV. Papua New Guinea (PNG) has a high burden of HBV with an estimated prevalence of 14.6% in the general population. In PNG there are significant knowledge gaps relating to socio-cultural understanding of HBV, acceptability of vaccination to bolster current immunisation efforts and addressing prevention across the mother-infant care cascade, including antenatal HBV screening and management of pregnant women with HBV.

The project

The first guidelines on the triple elimination of MTCT (HIV, syphilis and hepatitis B) was developed in PNG in 2023. The guidelines acknowledge the need to establish HBV testing and prophylaxis of pregnant women. However, currently priority actions for the primary prevention of HBV in PNG focus on improving routine immunisation of infants and children. This study will seek to identify socio-ecological understandings relating to uptake and acceptability of HBV vaccination to help inform national policy to strengthen prevention of hepatitis B in children across the maternal infant care cascade.

The method

This study will use qualitative, quantitative, and biomedical approaches to identify socio-ecological factors as well as system barriers and preparedness that affect uptake and acceptability of HBV vaccination. Among women attending for antenatal care we will screen 2000 women in two sites for current HBV infection. We will provide health education reinforcing the importance of facility base birth, birth dose and subsequent HBV vaccinations. A cost effective analysis will be conducted to identify the cost of scaling up this program countrywide.

The results

This study will commence in mid- 2025, once all ethics approvals have been received.

The impact

This study will inform Papua New Guinea policy and programmatic efforts in the elimination of mother-to-child transmission hepatitis B virus (HBV). It will do this by curating local epidemiological evidence on the burden of chronic HBV in pregnant women, determine the proportion of pregnant women in need of prophylaxis therapy and the health budget impacts of scaling up testing and treatment. It will also provide molecular evidence of the HBV genotypes circulating and what impact this may have on vaccination efficacy as well as critical socio-cultural understandings of HBV including its cause, and acceptability of vaccination and treatment.

Project collaborators