On Tuesday, January 7, 2025, the Faculty of Public Health (FPH) at the Universitas Indonesia (UI) once again held a Doctoral Promotion Session for the Epidemiology program, with a focus on Community Epidemiology. The session, which took place in the Doctoral Promotion Room of Building G at FPH UI, featured Faisal as the doctoral candidate, presenting his dissertation titled “Probabilistic Model of Hepatitis B Occurrence and Evaluation of the Implementation of the Early Detection Program for Hepatitis B in Pregnant Women and Its Impact on Hepatitis B Incidence in Children in Makassar City and Gowa Regency.”
The dissertation focused on the National Early Detection Program for Hepatitis B (DDHB), designed to prevent the transmission of hepatitis B from mother to child (mother-to-child transmission/MTCT). HBsAg (Hepatitis B surface antigen) is a protein found on the surface of the hepatitis B virus (HBV). The presence of HBsAg in the blood indicates that a person is infected with the hepatitis B virus. The risk of hepatitis B transmission from a mother with reactive HBsAg to her baby is extremely high, with approximately 90% of cases developing into chronic hepatitis B. “Although infant immunization is an important preventive step, this measure has not fully eliminated the risk of hepatitis B transmission to the child,” explained Faisal.
Through his research, Faisal analyzed various risk factors that affect the occurrence of hepatitis B in children, developed a probabilistic model to predict the risk of the disease, and evaluated the implementation of the DDHB program as a preventive and control measure for hepatitis B transmission from mother to child. This study used a concurrent mixed-methods approach, combining both quantitative and qualitative methods. The quantitative research employed a retrospective cohort design involving 166 mother-child pairs, where the mothers were confirmed to be infected with hepatitis B (HBsAg-positive) based on antenatal care (ANC) screening, and the HBsAg status of the children was determined through rapid testing. The qualitative approach involved in-depth interviews with 23 informants.
Multivariate analysis using the Generalized Linear Model (GLM) with a binomial link log was performed to calculate the adjusted risk ratio (aRR) of various risk factors related to hepatitis B in children. The results showed that mothers with high levels of HBV-DNA (>10^6 copies/mL) had a higher risk of transmitting hepatitis B to their children. Furthermore, children who did not receive hepatitis B immunoglobulin (HBIg), did not receive the HB0 vaccine, or did not complete the HB2 vaccination were also at a higher risk of hepatitis B infection.
These findings emphasize the importance of implementing the Early Detection Program for Hepatitis B (DDHB) in pregnant women to identify HBV-DNA levels, which serves as the basis for providing appropriate antiviral therapy. Additionally, administering hepatitis B immunoglobulin (HBIg) and hepatitis B vaccines (HB0, HB1, HB2) to children has been shown to be highly effective in reducing the risk of hepatitis B transmission. Therefore, these steps make DDHB an essential strategy for preventing hepatitis B infection in children. According to Faisal, to ensure the effectiveness of the program, comprehensive optimization of DDHB is needed, starting with HBsAg screening for pregnant women, HBV-DNA testing for reactive mothers, and increasing the coverage of HBIg administration and hepatitis B vaccination for children.
The Indonesian government has integrated the DDHB program into maternal health services through the Antenatal Care (ANC) policy, which includes mandatory HBsAg screening at primary healthcare facilities. “In efforts to achieve the target of eliminating hepatitis B transmission from mother to child, monitoring and evaluation at all levels, including at community health centers (puskesmas), are essential. Furthermore, research on antiviral therapy for pregnant women should be conducted on a larger scale in provinces that have implemented this program,” said Faisal. A thorough study of the benefits, effectiveness, and efficiency of this therapy would significantly impact reducing hepatitis B infection rates in mothers and lowering the transmission risk to children.
Based on the results of his dissertation, Faisal was awarded a Doctoral degree in Epidemiology with a Cumulative Grade Point Average (CGPA) of 3.86 and was graduated with Honors. Faisal became the 5th PhD graduate in Public Health in 2025, the 121st PhD graduate in Epidemiology, and the 444th PhD graduate from FPH UI.
Faisal’s research was supervised by Promoter Prof. drg. Nurhayati A. Prihartono, M.P.H., M.Sc., Sc.D., and two Co-Promoters, Prof. Dr. dr. Rinoo A. Gani, Sp.PD-KGEH, and Prof. Dr. drg. Ella Nurlaella Hadi, M.Kes. The doctoral promotion session was chaired by the Head of the Examining Committee, Prof. Dr. dr. Ratna Djuwita Hatma, M.P.H., alongside other committee members: Prof. dr. Mondastri Korib Sudaryo, M.S., D.Sc.; Prof. Dr. dr. Hanifah Oswari, Sp.A(K); and Dr. Agus Handito, S.K.M., M.Epid. (DFD)