Wang et al[21] reported that HBV vaccination program was less effective in socio-economically disadvantaged area and was affected by factors associated with urbanization[22]. among children aged 5 to 10, 10 to 15 and 15 years respectively compared to those 5 years and 1.1 among girls compared to boys with 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and 0.01.The prevalence was higher Rabbit Polyclonal to MC5R among girls (0.48%) than boys (0.29%) with 0.05. CONCLUSION: The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory. QIAgility (QIAGEN, Germany). HBV real-time assays were performed in combination of Artus HBV RG PCR Kit (Artus? GmbH, Hamburg, Germany) and the Real time PCR instrument, Rotor-Gene Q (QIAGEN, Germany). Thermal profile was set according to manufacturers guideline. Detection limit of HBV DNA in the current study assay was 3.8 IU/L assessed by the WHO international standard (97/750)[11]. At least two negative controls, one non template control and four standards (provided by the manufacturer) were added per run. Strict precautions were taken to avoid possible contamination. Only reproducible data that revealed no false positive results in the negative controls was used. Statistical analysis Data entry and statistical analysis were done using SPSS software program version 18.0. Anti-HBs geometric mean titer (GMT) was calculated to estimate the central tendency of anti-HBs level in consideration to its skewed distribution. Children who had an undetectable anti-HBs titer were assigned a titer value of 0.05 IU/L[12]. For qualitative data that presented by numbers and percentages, 2 was done. For comparison between two means, 0.05 was considered statistically significant and 0. 01 was considered statistically highly significant. The statistical methods of this study were performed by first author Iman I Cloxyfonac Salama, professor of public Health and Preventive Medicine at National Research Center and she is a Bio-statistical reviewer in Medical Research J. RESULTS Short and long term HBV sero-protection among the fully vaccinated children The Cloxyfonac present study was carried out on 3600 children and adolescents from six Egyptian governorates, 1909 (53%) from urban and 1691 (47%) from rural areas. There were 1743 (48.4%) boys and 1857 (51.6%) girls with a mean age of 9.1 5.5 years. Overall sero-protection rate among the studied children was 57.2% (95%CI: 55.6% to 58.8%). Figure ?Figure1A1A shows anti-HBs level among all the studied Cloxyfonac children, while Figure ?Figure1B1B shows anti-HBs level among children 1 year representing the primary response to HBV vaccine 3-6 mo after receiving the 3 compulsory doses. The GMT of the anti-HBs was significantly lower among children 5 years compared to younger, among girls than boys, in lower socioeconomic status, in Assuit and Red Sea compared to other governorates and in rural compared to urban areas ( 0.05), Table ?Table1.1. The table also showed that the distribution of anti-HBs levels was significantly different as regards all studied socio-demographic characteristics, 0.05. Antibody concentrations decline more quickly during the first 4 years after vaccination than they do later on (Figure ?(Figure2).2). There was no significant difference between boys and girls in the different governorates except Cloxyfonac in Gharbeya and Assuit, where males had significantly higher sero-protection rate.