Identification of Hepatitis B Positive Mothers through Birth Certificate Data in Kansas

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe the additional detection method of Hepatitis B (HBV)-positive women who recently gave birth in Kansas.

Background:
Kansas law requires physicians to test all pregnant women for HBV and to report positive results to the Kansas Department of Health and Environment (KDHE) for each pregnancy. Each year, KDHE identifies approximately 50 pregnant HBV-positive women, which is less than 50% of the CDC estimate.

Setting:
KDHE, county health departments and Kansas hospitals.

Population:
All infants born in Kansas and their mothers.

Project Description:
To address potential underreporting, KDHE developed a new method of identifying HBV-positive pregnant women by utilizing electronic birth registry data for newly born children. State law requires birth registration with KDHE within five days; more than 95% are registered electronically. Records indicating the mother is HBV-positive are forwarded weekly to the Office of Surveillance and Epidemiology (OSE) electronically. These are entered into the Web-based surveillance system which OSE and county health department access. County health departments verify information and conduct case management.

Results/Lessons Learned:
From January 2006 to June 2007, mothers of ninety-seven infants were identified as HBV-positive using birth registry data; 17 were previously reported as HBV-positive during pregnancy via traditional surveillance. Twenty-one mothers were previously reported HBV-positive, but pregnancy was unknown. Twenty-three mothers identified were falsely reported as HBV-positive on the birth certificate. County health departments are determining HBV status on the remaining.
The additional surveillance was successful in identifying additional cases for follow-up. Despite multiple identification methods, pregnant women with HBV and their infants are not easily identified for case management. OSE needs to develop new methods and relationships with physicians, hospitals, laboratories, and county health departments to increase the identification of infants born to HBV-positive mothers. We will adopt this surveillance for identification of infants born to HIV-positive mothers.