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Publications

Journal Article Epublish

PubMed: 42542601 DOI: 10.1016/j.dialog.2026.100330

Rapid cross-sectional impact assessment of an earthquake on the continuity of antenatal care for pregnant women living with hepatitis B in Vanuatu.

Dialogues Health 9:100330

Authors: Leila Bell, Aleesha Kalulu, Nicole Allard, Kali Ameara, Emily Deed, Zeshi Fisher, Caroline S E Homer, Jessica Howell, Kaylene Kalmos, Navin Karan, Leias Obed, Sereana Natuman, Mark Stoové, Annie Taissets, Florita Toa, Margaret Hellard, Caroline van Gemert

Affiliations

  • Burnet Institute, Melbourne, Australia.
  • Monash University, Melbourne, Australia.
  • Department of Infectious Diseases, University of Melbourne, Melbourne, Australia.
  • WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute, Melbourne, Australia.
  • London School of Hygiene and Tropical Medicine, London, UK.
  • Department of Gastroenterology, St. Vincent's Hospital, Melbourne, Australia.
  • Department of Medicine, University of Melbourne, Melbourne, Australia.
  • Ministry of Health, Port Vila, Vanuatu.
  • Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
  • Vanuatu Family Health Association, Port Vila, Vanuatu.
  • Burnet Institute, Melbourne, Australia. Monash University, Melbourne, Australia. Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia. Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia.
  • Burnet Institute, Melbourne, Australia. Fiji National University, Suva, Fiji. School of Medicine, Deakin University, Melbourne, Australia.

Abstract

PURPOSE

Natural disasters such as earthquakes, cyclones, and volcanic eruptions directly and indirectly impact health and wellbeing. This work aimed to understand how access to, and use of, peripartum health services were impacted following a large 7.3 magnitude earthquake in Vanuatu in the context of an ongoing field trial looking at the effectiveness of universal peripartum antiviral prophylaxis for pregnant women living with hepatitis B to prevent mother-to-child transmission.

METHODS

Participants were pregnant women enrolled in the intervention-arm of a field trial at sites in the earthquake-affected area. During routine monitoring calls, we asked additional questions about the impact of the earthquake on continued access to health services and continued use of daily hepatitis B antiviral prophylaxis with tenofovir disoproxil fumarate.

RESULTS

Seventeen participants of 26 women enrolled in the trial could be contacted and answered all questions from early-February to early-March 2025. Self-reported continued use of tenofovir disoproxil fumarate was high, with only two of 17 participants reporting interruptions to use in the weeks following the earthquake. Seven participants (41%) reported missing at least one routine antenatal or postnatal appointment in the three months following the earthquake.

CONCLUSIONS

In natural disaster-prone settings, it is critical that field research take an adaptive approach that can adjust and respond to health emergencies. While natural disasters are inevitable, health systems must implement risk mitigation strategies to limit interruptions to routine health services to reduce negative short-, medium-, and long-term health impacts of natural disasters.

MeSH

Disasters, Pregnant Women, Tenofovir, Prenatal Care, Fumarates, Earthquakes, Peripartum Period, Hepatitis B, Antiviral Agents, Hepatitis, Health Services, Natural Disasters