Euroasian Journal of Hepato-Gastroenterology

Register      Login

VOLUME 9 , ISSUE 2 ( July-December, 2019 ) > List of Articles

RESEARCH ARTICLE

A Dynamic Mathematical Modeling Revelation about the Impact of Vaccination on Hepatitis B Virus-induced Infection and Death Rate in Bangladesh

Sajib Chakraborty, Rajib Chakravorty, Saruar Alam, Yearul Kabir, Musarrat Mahtab, Md Atikul Islam, Md Abul Khair Yusuf, Ruksana Raihan, Sheikh Mohammad Fazle Akbar

Keywords : Hepatitis B virus, Immunization, Mathematical model, Target

Citation Information : Chakraborty S, Chakravorty R, Alam S, Kabir Y, Mahtab M, Islam MA, Yusuf MA, Raihan R, Akbar SM. A Dynamic Mathematical Modeling Revelation about the Impact of Vaccination on Hepatitis B Virus-induced Infection and Death Rate in Bangladesh. Euroasian J Hepatogastroenterol 2019; 9 (2):84-90.

DOI: 10.5005/jp-journals-10018-1303

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: Attainment of sustainable development goal (SDG) targets requires reducing the rate of new hepatitis B virus (HBV)-induced infection and mortality rate to 90% and 65%, respectively, by 2030. Therefore, it is important to investigate the feasibility of reducing the required rates of HBV-induced infection and death incidents at the current rate of vaccination coverage in Bangladesh. Moreover, factors influencing vaccination coverage like negative bias toward girls during immunization can affect the current vaccination program and ultimately hinder the efforts to reduce HBV-induced infection and death rates. To investigate the possibility of reducing HBV-induced infection and death rates with current vaccination coverage, we adopted mathematical molding-based approach. Materials and methods: We developed a mathematical model based on the susceptible–infectious–recovered model to simulate the HBV-induced infection in children under the age of five at three different vaccination rates: 80, 90, and 95%. Additionally the impact of current vaccination coverage was assessed on HBV-induced death rates in the future. Moreover, we took advantage of the mathematical model to investigate the impact of negative bias toward girls in vaccination program on HBV-induced infection and death rates. Results: The model simulations revealed that 10% increase in the vaccination rate from 80 to 90% can potentially contribute to the significant lowering (around 40%) of HBV-induced infection rate among children. When increased by 5% of vaccination rate from 90 to 95%, the HBV-infection rate is likely to be decreased by another 22%. Likewise, 44% reduction in HBV-induced death rate in the future (2050 onward) can potentially be achieved by 10% increase in the current vaccination rate from 80 to 90%, whereas 5% increase in the current vaccination rate (90–95%) may lead to 24% further reduction of death rate. These results underscored the significant impact of vaccination in reducing HBV-induced infection among children and future death rates in adults. Moreover, at 90% vaccination coverage, the negative bias of vaccination toward girls contributes to an increase of 15 and 12% of HBV-induced infection and death rates, respectively, in female subjects compared to their male counterparts. Conclusion: The current vaccination coverage (80–90%) is further aggravated by untimely vaccination, dropouts from vaccination program, and negative bias toward girls in vaccination program. Therefore, if the current situation persists, it will not be possible to accomplish the required reduction in HBV-induced infection and death rates by 2030, according to the SDG guidelines. Moreover negative bias in the vaccination program may intensify the HBV-induced infection and death rates in the future. Clinical significance: In light of the mathematical model, we suggest that the vaccination coverage should be increased to 95% without any negative bias toward girls. To accomplish this, the concerning authorities must ensure timely and full completion of the HBV vaccine schedules, reducing dropouts from vaccination program, and lastly preventing negative bias toward girls to uplift vaccination coverage to more than 95% with gender equality. Without these strategies, the necessary reduction in the HBV-induced infection and death rates in Bangladesh may not be attained per SDG directives.


PDF Share
  1. Liang TJ. Hepatitis B: the virus and disease. Hepatology 2009; 49(5 Suppl):S13–S21. DOI: 10.1002/hep.22881.
  2. Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 2015;386(10003):1546–1555. DOI: 10.1016/S0140-6736(15)61412-X.
  3. Ott JJ, Stevens GA, Groeger J, et al. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 2012;30(12):2212–2219. DOI: 10.1016/j.vaccine.2011.12.116.
  4. Wait S, Kell E, Hamid S, et al. Hepatitis B and hepatitis C in southeast and southern Asia: challenges for governments. Lancet Gastroenterol Hepatol 2016;1(3):248–255. DOI: 10.1016/S2468-1253(16) 30031-0.
  5. Mahtab MA, Rahman S, Karim MF, et al. Epidemiology of hepatitis B virus in Bangladeshi general population. Hepatobiliary Pancreat Dis Int 2008;7(6):595–600.
  6. Franco E, Bagnato B, Marino MG, et al. Hepatitis B: epidemiology and prevention in developing countries. World J Hepatol 2012;4(3):74–80. DOI: 10.4254/wjh.v4.i3.74.
  7. Zanetti AR, Van Damme P, Shouval D. The global impact of vaccination against hepatitis B: a historical overview. Vaccine 2008;26(49): 6266–6273. DOI: 10.1016/j.vaccine.2008.09.056.
  8. Borgia G, Carleo MA, Gaeta GB, et al. Hepatitis B in pregnancy. World J Gastroenterol 2012;18(34):4677–4683. DOI: 10.3748/wjg.v18.i34. 4677.
  9. Di Bisceglie AM. Hepatitis B and hepatocellular carcinoma. Hepatology 2009;49(5 Suppl):S56–S60. DOI: 10.1002/hep.22962.
  10. Bixler D, Zhong Y, Ly KN, et al. Mortality among patients with chronic hepatitis B infection: the chronic hepatitis cohort study (CHeCS). Clin Infect Dis 2019;68(6):956–963. DOI: 10.1093/cid/ciy598.
  11. Wang T. Model of life expectancy of chronic hepatitis B carriers in an endemic region. J Epidemiol 2009;19(6):311–318. DOI: 10.2188/jea.JE20090039.
  12. Meireles LC, Marinho RT, Van Damme P. Three decades of hepatitis B control with vaccination. World J Hepatol 2015;7(18):2127–2132. DOI: 10.4254/wjh.v7.i18.2127.
  13. WHO Publication. Hepatitis B vaccines: WHO position paper–recommendations. Vaccine 2010;28(3):589–590. DOI: 10.1016/j.vaccine.2009.10.110.
  14. Paul RC, Rahman M, Wiesen E, et al. Hepatitis B surface antigen seroprevalence among prevaccine and vaccine era children in Bangladesh. Am J Trop Med Hyg 2018;99(3):764–771. DOI: 10.4269/ajtmh.17-0721.
  15. Sheikh N, Sultana M, Ali N, et al. Coverage, timelines, and determinants of incomplete immunization in Bangladesh. Trop Med Infect Dis 2018;3(3):E72. DOI: 10.3390/tropicalmed3030072.
  16. Boulton ML, Carlson BF, Power LE, et al. Socioeconomic factors associated with full childhood vaccination in Bangladesh, 2014. Int J Infect Dis 2018;69:35–40. DOI: 10.1016/j.ijid.2018.01.035.
  17. Omori R, Cowling BJ, Nishiura H. How is vaccine effectiveness scaled by the transmission dynamics of interacting pathogen strains with cross-protective immunity? PLoS One 2012;7(11):e50751. DOI: 10.1371/journal.pone.0050751.
  18. Baussano I, Franceschi S, Plummer M. Infection transmission and chronic disease models in the study of infection-associated cancers. Br J Cancer 2014;110(1):7–11. DOI: 10.1038/bjc.2013.740.
  19. Morris SE, Pitzer VE, Viboud C, et al. Demographic buffering: titrating the effects of birth rate and imperfect immunity on epidemic dynamics. J R Soc Interface 2015;12(104):20141245. DOI: 10.1098/rsif.2014.1245.
  20. Navabakhsh B, Mehrabi N, Estakhri A, et al. Hepatitis B virus infection during pregnancy: transmission and prevention. Middle East J Dig Dis 2011;3(2):92–102.
  21. Uz-Zaman MH, Rahman A, Yasmin M. Epidemiology of hepatitis B virus infection in Bangladesh: prevalence among general population, risk groups and genotype distribution. Genes (Basel) 2018;9(11):E541. DOI: 10.3390/genes9110541.
  22. Merten S, Martin Hilber A, Biaggi C, et al. Gender determinants of vaccination status in children: evidence from a meta-ethnographic systematic review. PLoS One 2015;10(8):e0135222. DOI: 10.1371/journal.pone.0135222.
  23. Salmon DA, Dudley MZ, Glanz JM, et al. Vaccine hesitancy: causes, consequences, and a call to action. Vaccine 2015;33(Suppl 4): D66–D71. DOI: 10.1016/j.vaccine.2015.09.035.
  24. Khan MN, Rahman ML, Awal Miah A, et al. Vaccination coverage survey in Dhaka district. Bangladesh Med Res Counc Bull 2005;31(2):46–53.
  25. Quaiyum MA, Gazi R, Khan AI, et al. Programmatic aspects of dropouts in child vaccination in Bangladesh: findings from a prospective study. Asia Pac J Public Health 2011;23(2):141–150. DOI: 10.1177/1010539509342119.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.