Book Review. - Literatur

Book Review. - Literatu

Does Nigeria need the birth dose of the hepatitis B vaccine?

The control of hepatitis B infection involves several strategies of which the most effective is vaccination. Schedules which include a birth dose (which can prevent vertical transmission when administered within 24 hours of birth) are recommended for use in countries with a high rate of vertical transmission. Nigeria is highly endemic for hepatitis B infection. Nigeria had hitherto utilized the monovalent HBV vaccine in the three dose schedule that includes a birth dose, the recent introduction of an HBV containing pentavalent vaccine (which cannot be administered at birth) calls to question whether there should be continued use of the birth dose of HBV (using the monovalent vaccine) in addition to three doses of the pentavalent vaccine given subsequently. This is given the fact that most infections in Nigeria are reportedly acquired in childhood through horizontal rather than vertical transmission. There is also the question of cost- effectiveness of the four dose schedule compared to the three dose schedule in the setting of Nigeria’s hepatitis B epidemiologic profile.A review of the available evidence indicates that a significant proportion of Nigerian women of child bearing age and pregnant women are seropositive for HBsAg and HBeAg. Maternal to child transmission rates of HBsAg of 47-53.3% have been documented while a significant proportion of newborns were noted to have serological markers for HBV infection before receiving their first immunization. These data indicate that there is a significant potential for vertical transmission of HBV in Nigerian infants providing a compelling reason for the continued use of the birth dose of the HBV vaccine. Cost-effectiveness was not examined in this review.There are, however, challenges to the universal delivery of the birth dose in a timely fashion. Encouraging institutional delivery, routine screening of pregnant women (with the administration of HBV within 24 hours of birth to infants of seropositive mothers), retraining of health care workers on ensuring the timely receipt of the birth dose of HBV vaccine and health education of mothers and the community on the need for immunization within 24 hours of birth are suggested strategies to improve the timely uptake of the birth dose of HBVKeywords: Birth dose, Hepatitis Bvaccine, Nigeria, Infant

Risk factors for hepatitis B surface antigenaemia among secondary school students in Abakaliki, South Eastern Nigeria

Background: Majority of secondary school students are adolescents; an age group with a tendency to engage in health compromising risky behaviours in order to deal with anxiety and gain admission to peer groups. This exposes them to risk of Hepatitis B virus infection which is a major public health concern globally and in Nigeria.Objectives: This study focuses on some common risky behavioural practices that characterize the lifestyle of contemporary adolescent subculture; with a view to determining their effect on HBsAg seroprevalence.Method: Using multi-stage sampling method, 266 students were selected from 5 secondary schools in Abakaliki. Each subject first filled a questionnaire regarding biodata and history of exposure to risk factors. Subsequently, they were screened for HBsAg using enzyme immunoassay-based chromatographic test kit.Results: Nine students out of 266 tested positive giving a prevalence value of 3.38%. There was no significant association between gender (p = 0.31) or socioeconomic status (p = 0.81) and the seroprevalence of HBsAg among the subjects. Similarly, none of the risk factors studied, including previous history of jaundice (p = 0.26), blood transfusion (p = 0.24), past history of surgery (p = 0.47), scarification marks (p = 0.17), sharing of sharp objects (p = 0.74), drug injections (p = 0.32), unprotected sex (p = 0.64) and family history of hepatitis (p = 0.79), was significantly associated with HBV infection.Conclusion: None of the risk factors assessed played significant role in the transmission of HBV among secondary school students in Abakaliki.Keywords: Hepatitis B surface antigen, Risk factors, Adolescent

Prevention of mother to child transmission of hepatitis B virus infection in Nigeria: A call to action

Background: Sub- Sahara Africa including Nigeria has the second largest global burden of chronic carriers of hepatitis B virus (HBV) infection after Asia. Mother-to-child transmission (MTCT) of HBV is the most commonroute of transmission in high endemic areas .MTCT of hepatitis B virus infection continues to occur despite the interventions of hepatitis B vaccinations and immunoglobulins in settings where it is practiced. Infants most at risk are those whose mothers have high HBV DNA viral loads and produce the protein HBeAg. Various Nigerian studies have reported high HBV infection rates as well as HBeAg positivity among pregnant women. These HBV infections usually occur intrapartum and rarely inutero. Mothers with HBeAg positivity known to be associated with higher HBV DNA viral loads have been linked with higher chances of MTCT as HBeAg is the only structural HBV protein that can cross into the placental circulation. In the absence of post exposure prophylaxis about 40 percent of infants delivered by HBV infected mothers could develop HBV infections, and about 25% of them may come down with chronic hepatitis and resulting possible complications including liver cirrhosis and hepatocellular cancer later in life. The prevention of transmission of retroviral infection from motherto- child has been a success story of the 21st century and such feat could be replicated for HBV infection. The standard PMTCT of HBV currently will comprise: timely prenatal screening, starting anti-viral therapy for pregnant women with HBeAg positivity and high viral load, infant postexposure prophylaxis and followup of infants of HBsAg positive mothers. There is no co-ordinated PMTCT of HBV programme in place in our setting despite the huge burden of the disease in Nigeria. Hence the need therefore to develop a home grown PMTCT programme of HBV to help tackle the burden of the disease in our country. An evidence based review of current best practice guidelines for the prevention of mother-to-child transmission of HBV for use in low and medium resource income settings with hepatitis B hyperendemicity will be quiet apt in this circumstance. This document therefore will be useful as a quick guide to Paediatricians, Obstetricians, Family Physicians, General Practice Doctors and other allied health workers charged with the care of pregnant mothers and their young children.Methods: Relevant literatures published in English language or translated into English were searched manually and electronically in PUBMED and SCOPUS for the period between 1990 and 2016 on the subject. Keywords searched included: epidemiology of HBV infection, MTCT of HBV, and its preventive strategies including prenatal screening, antiviral agents in pregnancy, infant post exposure prophylaxis and follow-up of infected children.Results: Over 35 scholarly articles on HBV epidemiology, MTCT, and preventive measures as well as follow –up models were retrieved and analyzed.Conclusion: Universal screening of all pregnant women for HBV infection is the most effective strategy for the prevention of MTCT of HBV, as effective preventive measures could be applied starting from pregnancy to delivery while infants of HBsAg positive mothers should receive timely post exposure prophylaxis and followed up for possible development of chronic hepatitis B infection.Key words: Prevention of mother to child transmission; Hepatitis B virus infection; Resource limited settings

Justice (Vol. 14, Iss. 10)

Justice was the official publication of the International Ladies’ Garment Workers’ Union ILGWU from 1919 to 1995. Editions of Justice were published in English, Italian, Spanish, and Yiddish. When compared side by side, the content of some of these different editions of Justice shows significant differences. This is the English-language edition of Justice.Justice_14_10__2_.pdf: 104 downloads, before Oct. 1, 2020

Persistent expression of microRNA-125a targets is required to induce murine hematopoietic stem cell repopulating activity

MicroRNAs (miRs) are small noncoding RNAs that regulate gene expression posttranscriptionally by binding to the 30 untranslated regions of their target mRNAs. The evolutionarily conserved microRNA-125a (miR-125a) is highly expressed in both murine and human hematopoietic stem cells (HSCs), and previous studies have found that miR-125 strongly enhances self renewal of HSCs and progenitors. In this study we explored whether temporary overexpression of miR-125a would be sufficient to permanently increase HSC self-renewal or, rather, whether persistent overexpression of miR-125a is required. We used three complementary in vivo approaches to reversibly enforce expression of miR-125a in murine HSCs. Additionally, we interrogated the underlying molecular mechanisms responsible for the functional changes that occur in HSCs on overexpression of miR-125a. Our data indicate that continuous expression of miR-125a is required to enhance HSC activity. Our molecular analysis confirms changes in pathways that explain the characteristics of miR-125a overexpressing HSCs. Moreover, it provides several novel putative miR-125a targets, but also highlights the complex molecular changes that collectively lead to enhanced HSC function. (c) 2020 ISEH - Society for Hematology and Stem Cells. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/