Hepatitis B vaccine birth dose coverage correlates worldwide with rates of institutional deliveries and skilled attendance at birth

Background: Chronic hepatitis B virus (HBV) infection occurs in 90% of infants infected perinatally but is prevented when a hepatitis B vaccine is given within 24 h of birth (HepB-BD), followed by 2-3 additional doses. Methods: Using Spearman's rho correlation coefficients (rho), we analyzed global and regional data to assess correlations between HepB-BD coverage, institutional delivery rates (IDR), skilled birth attendance (SBA) rates, and other potential co-variates. Results: Significant correlations were observed worldwide between HepB-BD and SBA rates (rho = 0.44, p < 0.001), IDR (rho = 0.42, p < 0.001), adult literacy rate (rho = 0.37, p = 0.003), total health expenditure per capita (rho = 0.24, p = 0.03) and live births (rho = -0.27, p = 0.014). HepB-BD, IDR, and SBA rates were significantly correlated in the World Health Organization African, South-East Asia and Western Pacific Regions. Conclusions: Increasing IDR and SBA rates, training and supervising staff, increasing community awareness, and using HepB-BD outside the cold chain where needed would increase HepB-BD coverage and prevent chronic infections. Published by Elsevier Ltd.