Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?—A Scoping Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Objectives of the Review
- To describe current knowledge on the risk of HBV MTCT in the WHO Africa region;
- To describe the status of HBV MTCT mitigation strategies including hepatitis B birth-dose vaccination programs;
- To explore health systems’ capacity to support hepatitis B birth-dose vaccination programs in the WHO Africa region.
2.2. Methods
3. Results
3.1. Current Knowledge on the Risk of HBV MTCT in the WHO Africa Region
3.1.1. Growing Evidence on the Risk of HBV MTCT
3.1.2. HIV–HBV Co-Infection and the Increased Risk of HBV MTCT
Study No. | Author, Year | Setting | Study Design | Study Period | Population and Population Size | Summary of Key Findings |
---|---|---|---|---|---|---|
1 | Rashid et al., 2014 [12] | Tanzania | Cross-sectional | August–September 2010 | 310 Pregnant women |
|
2 | Bayo et al., 2014 [10] | Uganda | Cross-sectional | September 2012–January 2013 | 397 Pregnant women |
|
3 | Howell et al., 2014 [5] | Sub-Saharan Africa | Literature Review | Publications between 1995–2013 | 60,177 Pregnant women and women of childbearing age |
|
528 Mother–child pairs |
| |||||
4 | Sadoh et al., 2014 [6] | Nigeria | Literature Review | Period not specified. References range from 1988–2013 | Pregnant women and women of childbearing age |
|
Mother–child pairs (Size of population not consistently reported) |
| |||||
5 | Umare et al., 2016 [9] | Ethiopia | Cross-sectional | March–May 2015 | 338 Pregnant women |
|
6 | Breakwell et al., 2017 [2] | WHO AFRO | Literature review | January 1995–October 2016 | Median range 269–2244 Pregnant women across 75 studies |
|
WHO/UNICEF Monitoring data updated to year 2016 | 143 Mother–child pairs |
| ||||
7 | Chotun et al., 2017 [15] | South Africa | Prospective cohort | June–November 2014 | 134 Pregnant women |
|
4 Infants |
| |||||
8 | Kirbak et al., 2017 [11] | South Sudan | Cross-sectional | December 2012–March 2013 | 280 Pregnant women |
|
9 | Seremba et al., 2017 [49] | Uganda | Cross-sectional | July 2012–June 2014 | 612 Mothers |
|
606 Infants |
| |||||
10 | Sone et al., 2017 [7] | Cameroon | Prospective cross-sectional | 10-month period, year not specified. | 298 Pregnant women |
|
Ethical clearance given in 2014 | 20 Infants |
| ||||
11 | Bittaye et al., 2019 [8] | The Gambia | Cross-sectional | May–July 2015 | 424 Pregnant women |
|
12 | Guingané et al., 2020 [13] | Burkina Faso | Prospective cohort | October 2014–February 2016 | 1580 Pregnant women |
|
40 Infants |
| |||||
13 | Thompson et al., 2021 [14] | Democratic Republic of Congo | Cohort | September 2018–February 2019 | 4016 Pregnant women |
|
88 Infants |
|
3.2. Status of HBV MTCT Mitigation Strategies in the WHO Africa Region
3.2.1. Barriers to Adopting Universal Hepatitis B Birth-Dose Vaccination Programs
3.2.2. Challenges Faced by Established Hepatitis B Birth-Dose Vaccination Programs
3.2.3. Poor Adherence to Timely Hepatitis B Birth-Dose Vaccination
3.3. Health Systems’ Capacity to Support Hepatitis B Birth-Dose Vaccination Programs in the WHO Africa Region
3.3.1. Conceptual Models for the Assessment of Health Systems’ Capacity
3.3.2. Complexity as a Characteristic of Hepatitis B Birth-Dose Vaccination Programs
3.3.3. A Systems-Based Logic Model for Assessing Complexity within Hepatitis B Birth-Dose Vaccination Programs
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Section | Item | PRISMA-ScR checklist item | Page number |
Title | |||
Title | 1 | Identify the report as a scoping review. | 1 |
Abstract | |||
Structured summary | 2 | Provide a structured summary that includes (as applicable): background, objectives, eligibility criteria, sources of evidence, charting methods, results, and conclusions that relate to the review questions and objectives. | 1–21 |
Introduction | |||
Rationale | 3 | Describe the rationale for the review in the context of what is already known. Explain why the review questions/objectives lend themselves to a scoping review approach. | 1–3 |
Objectives | 4 | Provide an explicit statement of the questions and objectives being addressed with reference to their key elements (e.g., population or participants, concepts, and context) or other relevant key elements used to conceptualize the review questions and/or objectives. | 2–3 |
Methods | |||
Protocol and registration | 5 | Indicate whether a review protocol exists; state if and where it can be accessed (e.g., a Web address); and if available, provide registration information, including the registration number. | N/A |
Eligibility criteria | 6 | Specify characteristics of the sources of evidence used as eligibility criteria (e.g., years considered, language, and publication status), and provide a rationale. | 3 |
Information sources | 7 | Describe all information sources in the search (e.g., databases with dates of coverage and contact with authors to identify additional sources), as well as the date the most recent search was executed. | 3 |
Search | 8 | Present the full electronic search strategy for at least 1 database, including any limits used, such that it could be repeated. | 1–2 (Table S1) |
Selection of sources of evidence | 9 | State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review. | 3 |
Data charting process | 10 | Describe the methods of charting data from the included sources of evidence (e.g., calibrated forms or forms that have been tested by the team before their use, and whether data charting was done independently or in duplicate) and any processes for obtaining and confirming data from investigators. | 3 |
Data items | 11 | List and define all variables for which data were sought and any assumptions and simplifications made. | 3 |
Critical appraisal of individual sources of evidence | 12 | If done, provide a rationale for conducting a critical appraisal of included sources of evidence; describe the methods used and how this information was used in any data synthesis (if appropriate). | N/A |
Synthesis of results | 13 | Describe the methods of handling and summarizing the data that were charted. | 3 |
Results | |||
Selection of sources of evidence | 14 | Give numbers of sources of evidence screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally using a flow diagram. | 5 |
Characteristics of sources of evidence | 15 | For each source of evidence, present characteristics for which data were charted and provide the citations. | 7–8 &3–19 (Table S2) |
Critical appraisal within sources of evidence | 16 | If done, present data on critical appraisal of included sources of evidence (see item 12). | N/A |
Results of individual sources of evidence | 17 | For each included source of evidence, present the relevant data that were charted that relate to the review questions and objectives. | 3–18 |
Synthesis of results | 18 | Summarize and/or present the charting results as they relate to the review questions and objectives. | 3–18 |
Discussion | |||
Summary of evidence | 19 | Summarize the main results (including an overview of concepts, themes, and types of evidence available), link to the review questions and objectives, and consider the relevance to key groups. | 20–21 |
Limitations | 20 | Discuss the limitations of the scoping review process. | 21 |
Conclusions | 21 | Provide a general interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps. | 21 |
Funding | |||
Funding | 22 | Describe sources of funding for the included sources of evidence, as well as sources of funding for the scoping review. Describe the role of the funders of the scoping review. | 21 |
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Solomon-Rakiep, T.; Olivier, J.; Amponsah-Dacosta, E. Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?—A Scoping Review. Trop. Med. Infect. Dis. 2023, 8, 474. https://doi.org/10.3390/tropicalmed8100474
Solomon-Rakiep T, Olivier J, Amponsah-Dacosta E. Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?—A Scoping Review. Tropical Medicine and Infectious Disease. 2023; 8(10):474. https://doi.org/10.3390/tropicalmed8100474
Chicago/Turabian StyleSolomon-Rakiep, Tasneem, Jill Olivier, and Edina Amponsah-Dacosta. 2023. "Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?—A Scoping Review" Tropical Medicine and Infectious Disease 8, no. 10: 474. https://doi.org/10.3390/tropicalmed8100474