[Pilot program of immunization against viral hepatitis B, integrated in the extended immunization program in Abancay (peru)].

BACKGROUND

Abancay is located at 2,395 m.a.s.l. in the Peruvian Andean Region. It is a hyperendemic area for Hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection, where 7% of the deaths are caused by acute and chronic hepatitis infections. In 1991, a pilot immunization program against HBV infection was started to control the incidence of VHB-VHD, and as a strategy to improve the EPI coverage in general.

METHODS

Vaccination population was programmed to include 1,301 children under 1 year old and 3,488 children between 1-4 years old. A total of 3 doses of DNA recombinant vaccine against HBV per child were administered. The vaccination schedule fit within the EPI immunization schedule. For children under one year old, the program includes: Newborn: BCG, Polio 1, HBV1; 2-month old: Polio 2, DPT1, HBV2; 3-month old: DPT2, Polio 3; 4-month old: polio 4, HBV 3 and; 9 month old: Measles. For children aged between 1 and 4 years old, the program includes: HBV1, HBV2 one month after HBV1, and HBV six months after HBV1.

RESULTS

One year after the immunization program started, 1,262 (97.0%) children under one year old and 2,529 (72.5%) between 1-4 years old were immunized. No relevant adverse effects have been reported. There were 8 deaths due to acute respiratory infection and acute diarrhea diseases, which are the main causes of death in this area. One of the objectives achieved was an improvement in the EPI vaccination coverage for children younger than 1 year old, with a DPT coverage of 97.0% in 1991 compared to 63.0% in 1988, 26.9% in 1989, and 61.9% in 1990.

CONCLUSIONS

The inclusion of HVB vaccination in the EPI for a HBV and HDV endemic area improves the total EPI coverage and it is safe an effective.