Hepatitis B virus (HBV) infection and HBV-associated diseases are prevalent in many parts of the Middle East and North Africa. Postnatal horizontal childhood transmission appears to be the predominant method by which high hepatitis B carrier rates are maintained. To control hepatitis B in this region, mass immunization should be initiated prior to one year of age. This effort would be most cost-beneficial when integrated into the Expanded Programme of Immunization (EPI) and should be preceded by demonstration projects designed to gather practical data on the impact, methods and feasibility of such programmes which can subsequently be used to expand the immunization programmed to other parts of the region. © 1990.
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