Progress towards hepatitis B control and elimination of mother-to-child transmission of hepatitis B virus -- WHO African Region, 2016-2021.

Chronic hepatitis B virus (HBV) infection is one of the leading causes of cirrhosis and liver cancer. In 2019, approximately 1.5 million people newly acquired chronic HBV infection; of these, 990 000 (66%) were in the WHO African Region (AFR). Most chronic HBV infections are acquired through mother-to-child transmission (MTCT) or during early childhood, and about two thirds of the infections occur in the AFR. In 2016, the World Health Assembly endorsed the goal of eliminating MTCT of HBV demonstrated by ≥90% coverage with both a timely hepatitis B vaccine (HepB) birth dose (HepB-BD) and 3 infant doses of HepB (HepB3), and ≤0.1% seroprevalence of hepatitis B surface antigen (HBsAg) among children aged ≤5 years. In 2016, the AFR Regional Committee endorsed targets of a 30% reduction in incidence (≤2% HBsAg seroprevalence in children aged ≤5 years) and ≥90% HepB3 coverage by 2020. By 2021, all 47 countries in the Region provided HepB3 to infants from age 6 weeks, and 14 countries (30%) provided HepB-BD. By December 2021, 16 (34%) countries had achieved ≥90% HepB3 coverage; only 2 (4%) had achieved ≥90% timely HepB-BD coverage. Eight countries (17%) conducted nationwide serosurveys among children born after the introduction of HepB to assess HBsAg seroprevalence: 6 countries had achieved ≤2% seroprevalence, but none had achieved ≤0.1% seroprevalence. Development of immunization recovery plans following the COVID-19 pandemic provides an opportunity to accelerate progress towards hepatitis B control and elimination of MTCT, including introduction of HepB-BD and increasing coverage with timely HepB-BD and HepB3 vaccination. Representative HBsAg serosurveys among children and a regional body for verifying elimination of MTCT of HBV will be necessary to monitor progress. [ABSTRACT FROM AUTHOR]