By Uche Ajene
eHealth Africa (eHA) is supporting data collection on the prevalence of Hepatitis B in the Bo and Bombali districts, and Western Urban area in Sierra Leone, through its Hepatitis B Sero Survey project. U.S. Centers for Disease Control and Prevention (CDC) is funding this project.
A Sero Survey is a test of blood serum from a group of individuals to determine seroprevalence.
The African Regional Committee of the World Health Organization in 2014, endorsed a resolution to reduce chronic Hepatitis B virus (HBV) infection prevalence to <2% in children less than 5 years of age in all member states by 2020. In Sierra Leone, there is no accurate data on Hepatitis B Virus (HBV) infection among children and women of childbearing age. Hence the need for a survey to determine the prevalence of HBV infection among infants, children and women of childbearing age in order to inform the HBV vaccination policy of Sierra Leone.
In 2007, the country introduced the Hepatitis B vaccine as a component of the pentavalent vaccine provided at 6, 10 and 14 weeks of age. However, a birth dose of Hepatitis B vaccine recommended by WHO to prevent mother - to - child HBV transmission is not yet included in the routine immunization schedule.
The Hepatitis B community serosurvey conducted in the 3 districts, targeted some 2,544 infants aged 4- 24 months and their biological mothers to evaluate the risk of mother to child transmission and subsequent need for a Hepatitis B vaccine birth dose; and also 2,332 children aged 5- 9 years to assess the impact of childhood pentavalent vaccine on the prevalence of Hepatitis B virus infection among children.
Prior to collecting data, a five- day classroom and practical field training was conducted to:
build the knowledge of the surveyors
identify households
counsel families ahead of the survey
conduct a rapid diagnostic test on Hepatitis B and the processing and tracking of venous blood specimen
As part of the training, a practical field exercise was also conducted to pretest participants’ knowledge on the classroom training.
eHA is a technology-driven organization. In a drive to discourage potential errors via paper-based methods and to present an automated approach to health data collection, eHA also trained supervisors and phlebotomists on the use of the Open Data Kit (ODK) tool. eHA provided the phones and data for the survey and installed the ODK app (which is used for data collection in the field), the age= app for age calculation, and the ODK dashboard. With ODK, data collection is done easily, and survey activities monitored in near real time.
A total of 3,934 forms were submitted via the ODK tool of which 3,158 (80%) of households visited were willing to participate in the survey. Out of the 2,232 households selected for children aged 2 months - 24 months, 1,704 children were enrolled which is 76% and 1,604 biological mothers of these children were also enrolled.
For the 5-9 year-olds, out of the 2,250 households selected, 80% participated with 1,811 enrolled. For children with vaccination cards, 1,186 were enrolled and 401 for the 5- 9 year- olds. A total of 551 serum samples were collected during the 6-week community serosurvey.
eHA continues to work with the CDC and other partners with a view to increasing the early detection and reporting of government-identified priority diseases, especially when very little is known about HBV prevalence in Sierra Leone.