Hepatitis B birth vaccination, cohort study, Tunisia 2000–2017

Figures & data

Table 1. Effectiveness of hepatitis B vaccine according to the two protocols, Monastir, Tunisia 2000–2017.

	Cases	Population	Absolute risk per 100,000 PY (95% CI)	Absolute risk reduction per 100,000 PY	Relative risk	Relative risk reduction	Number Needed to vaccine	p
First dose at 3 months	23	405,011	5.67 (3.36;7.99)	19.73	0.22 (0.14–0.34)	0.77 (0.66–0.85)	5067 (4044–6783)	<0.0001
NVC	664	2,612,173	25.42 (23.4–27.3)
HepB-BD	2	1,812,887	0.11 (0.001–0.26)	19.85	0.005 (0.001–0.022)	0.994 (0.978–0.999)	5037.1 (4563 − 5620.0)	<0.0001
NVC	837	4,192,827	19.96 (18.6–21.31)
HepB-BD	2	1,812,887	0.11 (0.04–0.02)	5.56	0.019 (0.005;0.082)	0.981 (0.918;0.995)		<0.0001
First dose at 3 months	23	405,011	5.67 (3.36;7.99)

NVC: Not Vaccinated cohort

Table 2. Effectiveness of HB vaccine (Monastir (2000–2017)).

Years		Cases	Population	Absolute risk per 100,000 PY (95% CI)	Absolute risk reduction per 100,000 PY	Relative Risk	Relative Risk reduction	number needed to treat	p
2000–2017	VC	25	2,246,551	1.11 (0.68;1.55)	20.94	0.050 (0.034,0.075)	0.95 (0.925; 0.966)	4775 (4367;5268)	< 0.0001
	NVC	1501	6,805,000	22.06 − 20.94;23.17)
2000	VC	1	43,624	2.29 (0; 6.8)	22.08	0.094(0.01; 0.67)	0.905 (0.33; 0.99	4526 (2716; 13,564)	0.0186
	NVC	112	459,240	24.38 (1.9; 28.9)
2001	VC	1	53,175	1.88 (1.81;5.57)	23.91	0.0729 (0.010; 0.522)	0.927 (0.478;0.990)	4181 (2675; 9797)	0.0091
	NVC	116	449,689	24.90 (20.29;29.51)
2002	VC	0	62,726	0	24.38	0.0333(0.0021;0.5353)	0.9667 (0.4647; 0.9979)	4316 (2832;9070)	0.0164
	NVC	105	440,138	24.385 (19.72; 29.04)
2003	VC	2	72,277	2.767 (1.0; 6.660)	21.16	0.1135 (0.028;0.459)	0.8865 (0.541;0.972)	4626 (3020;9878)	0.0023
	NVC	105	430,587	23.943 (19.35; 28.512)
2004	VC	1	81,828	1.222 (0;3.62)	24.19	0.048 (0.006;0.344)	0.951 (0.655;0.993)	4134 (2844;7567)	0.0025
	NVC	117	421,036	25.413 (20.599;30.228)
2005	VC	0	91,380	0	25.88	0.0267 (0.0017; 0.4296)	0.9733 (0.5704; 0.9983)	5003 (3412; 9374)	0.0106
	NVC	109	411,484	25.888 (21.029–30.7480)
2006	VC	0	100,931	0	20.89	0.0236 (0.0015;0.3799)	0.9764 (0.6201;0.9985)	4872 (3390;8655)	0.0082
	NVC	84	401,933	20.899 (16.43; 25.36)
2007	VC	2	110,482	1.18 (0; 4.32)	18.32	0.089 (0.022;0.366)	0.910 (0.634;0.978)	5458(3732;10,153)	0.0008
	NVC	79	392,382	20.13 (15.69; 24.57)
2008	VC	3	120,033	2.49 (0;5.33)	30.41	0.076 (0.024;0.238)	0.92 (0.76;0.97)	3289 (2451;4994)	< 0.0001
	NVC	126	382,831	32.91 (27.16;38.65)
2009	VC	0	129,584	0	17.68	0.217 (0.001;0.350)	0.783 (0.65;0.999)	5738 (4045;9868)	0.0069
	NVC	66	373,280	17.68 (13.41;21.94)
2010	VC	1	139,135	0.71 (0;2.13)	18.80	0.036 (0.005;0.265)	0.964 (0.735;0.995)	5319 (3818;8767)	0.0010
	NVC	71	363,729	19.52 (14.98;24.06)
2011	VC	1	148,686	0.675 (0;19.9)	17.39	0.037(0.005;0.268)	0.963 (0.732; 0.995)	5749 (4118;9515)	0.0011
	NVC	64	354,178	18.07 (13.64;22.49)
2012	VC	1	158,237	0.63 (0;1.87)	21.71	0.028 (0.003;0.203)	0.972 (0.797;0.997)	4607 (3434;6995)	0.0004
	NVC	77	344,627	22.34 (17.35;27.33)
2013	VC	0	167,788	0	19.99	0.014 (0.0009;0.239)	0.986 (0.761;0.9991)	5039 (3751;7676)	0.0030
	NVC	67	335,076	19.99 (15.20;24.78)
2014	VC	2	177,340	1.13 (0.44;2.69)	13.00	0.079 (0.019;0.328)	0.921 (0.672;0.981)	7691 (5361;13,604)	0.0004
	NVC	46	325,524	14.13 (9.78;17.86)
2015	VC	2	186,891	1.07 (0.41;2.55)	15.38	0.065 (0.015;0.267)	0.935 (0.733;0.985)	6500 (4692;10,572)	0.0001
	NVC	52	315,973	16.45 (11.98;20.93)
2016	VC	5	196,442	2.54 (0.31;4.78)	15.07	0.144 (0.057;0.361)	0.856 (0.639;0.943)	6633 (4714;11,186)	<0.0001
	NVC	54	306,422	17.62 (12.92;22.32)
2017	VC	3	205,993	1.46 (0.20;3.26)	15.65	0.085 (0.027;0.272)	0.915 (0.728;0.973)	6361 (4641;10,104)	<0.0001
	NVC	51	296,871	17.18 (12.46;21.89)

AAR: Absolute Risk Reduction; *: per 100,000 PY; NNT: number needed to treat.

Figure 1. Age distribution of cases of hepatitis B according to immunization status (2000–2017; Monastir Tunisia).

Table 3. Absolute risk of developing HB, by delegations (Monastir; Tunisia, 2000–2017).

	Population	Cases	Absolute risk per 100,000 PY (95% CI)
Over all	502,864	1526	16.85
Delegations
Monastir	92,914	386	23.08
Jemmal	60,346	249	22.92
Ksibet Medyouni	31,649	107	18.78
Moknine	82,581	267	17.96
Ksar hellel	44,683	142	17.66
Bembla	29,968	79	14.65
Sayada – Lamta – Bouhjar	23,918	58	13.47
Sahline	24,624	45	10.15
BniHassen	13,259	22	9.22
Zeramdine	27,840	46	9.18
Wardanine	20,333	31	8.47
Teboulba	34,319	50	8.09
Bekalta	15,772	20	7.04

Table 4. Absolute risk and trends of HB, by age groups and gender (Monastir, Tunisia, 2000–2017).

	Population	Cases(%)	Absolute risk per 100,000 PY	Slope (b)	CI 95% (b)	p
Age groups (Years)
0–19	186,890	109 (7.1)	3.24	−0.145	−0.10;-0.18	<0.0001
20–39	171,046	1121 (73.5)	36.40	−0.063	−0.05;-0.07	<0.0001
40–59	101,466	278 (18.2)	15.22	0.029	0.006–0.011	0.012
$\ge$60	43,460	18 (1.2)	2.30	0.012	-	<0.785
Gender
Men	252,757	1213 (79.5)	26.66	−0.037	−0.02;-0.04	<0.0001
Women	250,106	313 (20.5)	6.95	−0.105	−0.08; −0.12	<0.0001

Slope (b) calculated by Log-linear Poisson regression model,

Figure 2. Trends of hepatitis B crude incidence rate/100,000 inh according to immunization status (2000–2017; Monastir Tunisia).

Figure 3. Prediction to 2030 of cases of hepatitis B according to age group.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Competing interests No Competing interests for all authors.