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Biomedical subjects

H M Inskip

Publications and source records attributed to H M Inskip.

11 recordsLinked to original sources
PubMed1994

Do bedbugs transmit hepatitis B?

An intervention study was done over two years in seven Gambian villages to determine the contribution of bedbugs to hepatitis B transmission. In addition, fortnightly questionnaires were completed for each child to assess other possible routes of transmission. The intervention, insecticide spraying of the child's dwelling, was highly effective in reducing exposure to bedbugs but there was no effect on hepatitis B infection. No other risk factor for transmission was identified despite a consistent village-to-village variation in the rate of childhood infection. The major mode of transmission of hepatitis B in childhood remains unknown.

Animals↗
PubMed1993

Efficacy of hepatitis B vaccine in the Gambian expanded programme on immunisation.

Because of the high prevalence of hepatitis B virus (HBV) infection in The Gambia, HBV vaccination has been incorporated into the national expanded programme on immunisation. We have assessed the efficacy of the vaccine against HBV infection and chronic carriage by examining 720 3-4-year-old children who had received the vaccine in infancy and 816 who had not received it. The vaccine was 84% (95% CI 78-89%) effective against infection and 94% (84-98%) effective against chronic carriage. Vaccinated infants of mothers positive for hepatitis B surface and e antigens were at greater risk of breakthrough infection and chronic carriage than infants of uninfected mothers. The high vaccine efficacy against the HBV carrier state, the main risk factor for the development of chronic liver disease and liver cancer, offers hope that the prevalence of these diseases may be reduced in the future.

Carrier State↗
PubMed1992

The Gambia Hepatitis Intervention Study: follow-up of a cohort of children vaccinated against hepatitis B.

Hepatitis B vaccine has been introduced into The Gambia's national Expanded Programme on Immunization, with the aim of evaluating the impact on chronic liver diseases and in particular on hepatocellular carcinoma. As part of the project, a cohort of 1000 children was recruited to assess the long-term protection induced by the vaccine. The first 3 years of follow-up are described. By the age of 3 years, 95% of the children had protective antibody levels; 4 (0.6%) are known to be carriers in contrast to the 90-140 that would be expected in the absence of vaccination. The protective effectiveness of vaccine in preventing chronic carriage in the first 3 years of life is thus estimated as 95%. Since the risk of becoming a carrier is highest in those infected early in life, these results are encouraging.

Antigens, Viral↗
PubMed1991

Hepatitis B vaccine in the Gambian Expanded Programme on Immunization: factors influencing antibody response.

Data on over a thousand Gambian children have been analysed to examine factors influencing their antibody levels following immunization with hepatitis B vaccine administered during the first year of life. The dominant effect was the time between the last dose of vaccine and taking the blood sample. There was considerable variation in vaccine response by area of residence which could not be explained by any other factor. The hepatitis B surface antigen (HBsAg) status of the mother and the age at vaccination did not appear to have an effect, but there was some indication that a delay in receiving the second dose of vaccine led to a marginally lower response.

Antibodies, Viral↗
PubMed1991

Response to hepatitis B vaccine in relation to the hepatitis B status of family members.

The influence of the hepatitis B status of family members on the response to hepatitis B vaccine of an infant has been examined in 395 families. The presence of one or more HBsAg-positive family members did not appear to have any effect on the vaccine response. This is an encouraging finding as children born into carrier families are at an increased risk of becoming carriers themselves. That the vaccine response of such children is as good as for those born into non-carrier families means that they are likely to be protected against the carrier state by the vaccine.

Family↗
PubMed1991

Accuracy of answers obtained using a one-year recall period compared to a series of fortnightly recalls.

In a study to examine factors influencing transmission of hepatitis B virus, a comparison has been made between answers obtained about events occurring over a one-year period and the summation of the results from fortnightly questionnaires administered over the same period. Complete data were available for 532 children and the results showed that for an estimate of rates within the population, the results from both methods were similar. At the individual level, however, the differences between the one-year recall and fortnightly questions were large. Thus it appears that for population estimates longer recall periods may be satisfactory, but in any study requiring accurate data at the individual level shorter recall periods are required.

Child, Preschool↗
PubMed1990

Risk factors for transmission of hepatitis B virus to Gambian children.

Risk factors for hepatitis B virus transmission were examined in 973 Gambian children aged 6 months to 5 years. 33% had evidence of infection with hepatitis B virus and a third of these were carriers. A significant association was found between infection and tropical ulcer scars, and between e antigenaemia and the presence of bedbugs in each child's bed. There was no association between infection and traditional scarring, circumcision, or injections. Skin disease and arthropods are the two most likely modes of transmission of hepatitis B virus between children in West Africa.

Acute Disease↗
PubMed1990

The first 2 years of the Gambian National Cancer Registry.

We describe the creation, and the first 2 years experience, of the Gambian National Cancer Registry. The major problems involved in the creation of such a registry in a developing country are discussed. The data accumulated show a low overall rate of cancer incidence compared to more developed parts of the world and indicate that the prevalent cancers, hepatoma, carcinoma of the cervix and lymphoma, are likely to be due to infectious agents. It is hoped that immunisation of children under one year against hepatitis B will drastically reduce the incidence of hepatocellular carcinoma.

Adolescent↗