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- Title
Hepatitis B immunization for indigenous adults, Australia.
- Authors
Wattiaux, Andre Louis; Yin, J. Kevin; Beard, Frank; Wesselingh, Steve; Cowie, Benjamin; Ward, James; Macartney, Kristine
- Abstract
Objective To quantify the disparity in incidence of hepatitis B between indigenous and non-indigenous people in Australia, and to estimate the potential impact of a hepatitis B immunization programme targeting non-immune indigenous adults. Methods Using national data on persons with newly acquired hepatitis B disease notified between 2005 and 2012, we estimated incident infection rates and rate ratios comparing indigenous and non-indigenous people, with adjustments for underreporting. The potential impact of a hepatitis B immunization programme targeting non-immune indigenous adults was projected using a Markov chain Monte Carlo simulation model. Findings Of the 54 522 persons with hepatitis B disease notified between 1 January 2005 and 31 December 2012, 1953 infections were newly acquired. Acute hepatitis B infection notification rates were significantly higher for indigenous than non-indigenous Australians. The rates per 100 000 population for all ages were 3.6 (156/4 368 511) and 1.1 (1797/168 449 302) for indigenous and non-indigenous people respectively. The rate ratio of age-standardized notifications was 4.0 (95% confidence interval: 3.7-4.3). If 50% of non-immune indigenous adults (20% of all indigenous adults) were vaccinated over a 10-year programme a projected 527-549 new cases of acute hepatitis B would be prevented. Conclusion There continues to be significant health inequity between indigenous and non-indigenous Australians in relation to vaccine-preventable hepatitis B disease. An immunization programme targeting indigenous Australian adults could have considerable impact in terms of cases of acute hepatitis B prevented, with a relatively low number needed to vaccinate to prevent each case.
- Subjects
AUSTRALIA; HEPATITIS B prevention; INDIGENOUS Australians; HEALTH services accessibility; DECISION trees; HEALTH status indicators; IMMUNIZATION; STATISTICAL models
- Publication
Bulletin of the World Health Organization, 2016, Vol 94, Issue 11, p826
- ISSN
0042-9686
- Publication type
Article
- DOI
10.2471/BLT.16.169524