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Protektem Pikinini Blong Yu

Protektem Pikinini Blong Yu: Preventing mother-to-child transmission of hepatitis B in Vanuatu

WHO recommends pregnant women with a high hepatitis B viral load receive tenofovir during pregnancy to prevent mother-to-child transmission, however there is limited access to viral load testing across Vanuatu and other Pacific Island Countries. This field trial compares the effectiveness of WHO-based guidelines to an alternative model of care, in which all hepatitis B-infected pregnant women receive tenofovir without requiring viral load testing, to prevent mother-to-child transmission of hepatitis B.

Objective

The project aims to:

  • evaluate if the treat-all approach to managing hepatitis B-infected pregnant women leads to a reduction in hepatitis B among infants compared to a guideline-based care approach
  • evaluate and compare the acceptability, cost-effectiveness and safety of the treat-all and guideline-based care approaches to management of hepatitis B-infected pregnant women. 

Timeline

2023–2025.

Approach

A two-arm, parallel group, randomised trial with hepatitis B-infected pregnant women attending antenatal clinics in Port Vila, Vanuatu. Infants will be tested 6-12 months after birth. 

Community impact

The treat-all approach is highly novel and will facilitate a major paradigm shift in prevention of mother-to-child transmission of hepatitis B in low and low-middle income countries including Pacific Island Countries. 

Pacific regional stakeholders will be consulted to determine the best strategy for regional roll-out of updated guidance. 

The impact of the intervention will be immediate in terms of averting hepatitis B infections in infants in Vanuatu. Scale-up of the intervention across the Pacific could avert hundreds of infections each year. 

Partners

Funding partners

  • Thrasher Research Fund

Collaborators

  • Vanuatu Ministry of Health
  • Doherty Institute
  • VIDRL

Project contacts

Dr Caroline  van Gemert

Dr Caroline van Gemert

Co-Head, Pacific Infectious Diseases (Operational Research, Surveillance and Resilience) Working Group
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Project team

Kali Ameara

Kali Ameara

Country Representative, Vanuatu; Vanuatu Research Coordinator
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Leila Bell

Leila Bell

PhD student
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Professor Margaret Hellard AM

Professor Margaret Hellard AM

Deputy Director, Programs; Adjunct Professor, Monash University, DEPM.
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Stephanie Levy

Stephanie Levy

Global Health Emergencies Specialist & Pacific Projects Manager
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Dr Caroline  van Gemert

Dr Caroline van Gemert

Co-Head, Pacific Infectious Diseases (Operational Research, Surveillance and Resilience) Working Group
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