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Israel E, Hizkel I, Geta T, Feleke T, Samuel B, Markos D. Triple sexually transmitted infections among pregnant woman in the context of Elimination of mother to child transmission in Southern Ethiopia: Reports from a survey of questionnaires and laboratory studies. Front Glob Womens Health 2023; 4:1190170. [PMID: 37404231 PMCID: PMC10316963 DOI: 10.3389/fgwh.2023.1190170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Sexually transmitted infections (STIs) cause a wide range of public health problems if left untreated. They can lead to adverse birth outcomes, including stillbirth, fetal loss, neonatal death, preterm birth, and low birth weight. Although great efforts have been made to reduce STIs nationally, their incidence remains high in Ethiopia, and their co-infection calls for urgent action. Therefore, this study aimed to identify the determinants of three STIs among pregnant women attending antenatal care (ANC) in the context of the elimination of mother-to-child transmission in public health facilities in Sawla Town, Gofa zone, Southern Ethiopia. Methods A cross-sectional study design was conducted among pregnant women attending antenatal care in public health facilities in Sawla Town, Southern Ethiopia, from May to July 2022. Data were collected from pregnant women's serum using an HIV rapid test, an HBsAg rapid test device, and a VDRL for HIV, HBV, and syphilis, respectively. Descriptive statistics, such as frequencies and percentages, were used to describe each relevant variable. Logistic regression analyses were used to identify the determinants of STIs. Results A total of 484 pregnant women attending antenatal care were screened. The mean age of the women was 24.0 ± 4.6 years, and nearly half of the participants had completed secondary school or higher. The overall seroprevalence of three STIs (HIV, HBV, and syphilis) among pregnant women was 6.8%. These three sexually transmitted infections were shown to be more common among pregnant women who were not able to read and write, had tattoos, had previously had an abortion, and had a history of multiple sexual partners. Conclusions The seroprevalence found in this study was intermediate in comparison with the WHO standard. Efforts should be made to strengthen the existing health education and RH service integration on STI screening, and treatment that further eliminates vertical infection.
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Affiliation(s)
- Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Iskindir Hizkel
- Department of Maternal and Child Health, Sawla Town Health Office, Gofa Zone, Sawla, Ethiopia
| | - Temesgen Geta
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tihun Feleke
- Department of Nursing, Hawassa College of Health Sciences, Hawassa, Ethiopia
| | - Beniyam Samuel
- Department of Midwifery, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Desta Markos
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Giri S, Sahoo S, Angadi S, Afzalpurkar S, Sundaram S, Bhrugumalla S. Seroprevalence of Hepatitis B Virus Among Pregnant Women in India: A Systematic Review and Meta-Analysis. J Clin Exp Hepatol 2022; 12:1408-1419. [PMID: 36340309 PMCID: PMC9630021 DOI: 10.1016/j.jceh.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal transmission contributing to the pool of HBV infection in the population. There is a wide variation in the reported data on the seroprevalence of HBV in pregnant patients from various parts of India. Hence, a systematic review and meta-analysis was conducted to determine the pooled seroprevalence of HBV and its associated demographic factors. Methods A comprehensive literature search of Medline, Scopus, and Google Scholar was conducted from January 2000 to April 2022 for studies evaluating the prevalence of HBV in pregnant patients from India. Results A total of 44 studies with data on 272,595 patients were included in the meta-analysis. The pooled prevalence of hepatitis B surface antigen (HBsAg) in pregnant women was 1.6% [95% confidence interval (CI), 1.4-1.8]. Among patients with HBsAg positivity, the pooled prevalence of hepatitis B e antigen was 26.0% (95%CI 17.4-34.7). There was no significant difference in the odds of HBV seroprevalence based on the age (<25 years vs. > 25 years) [odds ratio (OR) 1.07, 95%CI 0.74-1.55], parity (primipara vs. multipara) (OR 1.09, 95%CI 0.70-1.70) or area of residence (urban vs. rural) (OR 0.88, 95%CI 0.56-1.39). However, the odds of HBV seroprevalence in those with no or primary education was higher than in those with secondary level education or higher (OR 2.29, 95%CI 1.24-4.23). Prior history of risk factors was present in 13.5-22.7% of patients indicating a vertical mode of acquisition. Conclusion There is a low endemicity of HBV among pregnant women in India. Risk factors are seen in less than 25% of the cases, indicating vertical transmission as the predominant mode of acquisition, which can be reduced by improving vaccination coverage.
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Affiliation(s)
- Suprabhat Giri
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Shradhanjali Sahoo
- Department of Maternal and Fetal Medicine, Fernandez Hospital, Hyderabad, India
| | - Sumaswi Angadi
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Shivaraj Afzalpurkar
- Institute of Gastrosciences and Liver, Apollo Multispecialty Hospital, Kolkata, India
| | - Sridhar Sundaram
- Department of Digestive Disease & Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
| | - Sukanya Bhrugumalla
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
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Olakunde BO, Adeyinka DA, Ndukwe CD, Oladele TT, Yahaya HB, Ijaodola OA. Antenatal hepatitis B screening in Nigeria: A comparative analysis with syphilis and HIV. Int J STD AIDS 2021; 32:1290-1297. [PMID: 34387113 DOI: 10.1177/09564624211035922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nigeria has adopted routine screening of pregnant women for hepatitis B virus (HBV) as part of the interventions to eliminate its vertical transmission. However, there is a dearth of evidence on the coverage of routine antenatal HBV screening as recommended in the national guidelines. This study examined the antenatal HBV screening rate and the positivity rate compared with syphilis and HIV. We conducted a descriptive analysis of the 2019 national HIV/AIDS health sector data. The study included approximately 2.8 million pregnant women who received antenatal care (ANC) in over 6000 health facilities providing prevention of mother-to-child transmission of HIV services in Nigeria. Of the ANC clients, 0.2 million (7.2%) were screened for HBV. At the zonal level, the South West had the highest HBV screening rate (19%), while the lowest rate was in the North East (2.5%). The percentage of pregnant women screened for HBV was lower than those screened for syphilis (16.3%) and HIV (90.3%). Among those screened for HBV, the positivity rate was 5%. The HBV positivity rate ranged from 8.5% in the North Central zone to 1.3% in the South East zone. The positivity rates for syphilis and HIV were 0.4% and 0.5%, respectively. Our results indicate a low antenatal HBV screening rate and a wide disparity compared with HIV and syphilis. This finding highlights the need to understand and address the barriers affecting routine antenatal HBV screening and to strengthen the integration of HBV services into the HIV program in Nigeria.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria.,Center for Translation and Implementation Research, University of Nigeria, Nsukka, Nigeria
| | - Daniel A Adeyinka
- Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja, Nigeria.,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Chinwendu D Ndukwe
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria.,African Institute of Health Policy and Health Systems, Abakaliki, Nigeria
| | - Tolulope T Oladele
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria
| | - Hidayat B Yahaya
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria
| | - Olugbengba A Ijaodola
- Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja, Nigeria
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Mirambo MM, Mshana SE, Groß U. Rubella virus, Toxoplasma gondii and Treponema pallidum congenital infections among full term delivered women in an urban area of Tanzania: a call for improved antenatal care. Afr Health Sci 2019; 19:1858-1865. [PMID: 31656468 PMCID: PMC6794536 DOI: 10.4314/ahs.v19i2.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND A significant proportion of newborns in the developing countries are born with congenital anomalies. OBJECTIVE This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. METHODS Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. RESULTS A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. CONCLUSION Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.
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Affiliation(s)
- Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology, Gottingen University Medical Centre, Germany
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Balaeva T, Grjibovski AM, Samodova O, Sannikov A, Klouman E. Seroprevalence of Markers of Hepatitis B Virus Infection, Associated Factors, and Vaccination Status in Young Adults in Arkhangelsk, Northwest Russia: A Population-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091905. [PMID: 30200487 PMCID: PMC6163199 DOI: 10.3390/ijerph15091905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
Russia had a high incidence of hepatitis B virus (HBV) infection before the vaccination campaigns of 1997, 2001, 2007, which targeted newborns, adolescents, and adults, respectively. The aim of our study was to assess the prevalence of serological markers of HBV infection, associated factors, and vaccination status among young adults in Arkhangelsk, Northwest Russia. In this cross-sectional, population-based study, we used a quota sampling method to recruit 1243 adults aged 18–39 years. Participants completed a self-administrated questionnaire and were tested for hepatitis B markers. Associations between positivity for markers and selected sociodemographic and behavioral factors were studied by logistic regression. 10.9% of our participants were positive for at least one marker of hepatitis B, 1.2% were positive for HBsAg, and 42.1% were negative for all markers. In multivariable logistic regression analyses, age 30–34 years; lack of self-reported vaccination; and having ≥2 sexual partners in the last 6 months were associated with positivity for markers of hepatitis B. Hepatitis B vaccination was confirmed in 46.9% of participants. Although half of our study sample was vaccinated, four in 10 were still susceptible to infection and more than one participant in 100 showed evidence of an active infection.
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Affiliation(s)
- Tatiana Balaeva
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
- Institute of Public Health, Northern State Medical University, 163000 Arkhangelsk, Russia.
- Center of Hygiene and Epidemiology in the Arkhangelsk Region, 163001 Arkhangelsk, Russia.
| | - Andrej M Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, 163000 Arkhangelsk, Russia.
- Department of Public Health, Health Care, General Hygiene and Bioethics, North-Eastern Federal University, 677000 Yakutsk, Russia.
- Department of Health Policy and Management, Al-Farabi Kazakh National University, 050038 Almaty, Kazakhstan.
- West Kazakhstan Marat Ospanov State Medical University, 030010 Aktobe, Kazakhstan.
| | - Olga Samodova
- Department of Infectious Diseases, Northern State Medical University, 163000 Arkhangelsk, Russia.
| | - Anatoly Sannikov
- Institute of Public Health, Northern State Medical University, 163000 Arkhangelsk, Russia.
| | - Elise Klouman
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
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Kumar P, Sangal B, Ramanathan S, Ammassari S, Venkatesh SR. Unsafe injecting practices, sexual risk behaviours and determinants of HIV among men who inject drugs: Results from Integrated Biological and Behavioural Surveillance in India. Int J STD AIDS 2018; 29:1066-1075. [PMID: 29747557 DOI: 10.1177/0956462418769808] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In India, while an overall reduction in HIV is achieved among most key populations, the continued higher prevalence among people who inject drugs (PWIDs) is an area of concern. This paper analyses unsafe injecting and sexual risk behaviours in male PWIDs according to HIV status and also examines the determinants of HIV infection in this high-risk group. Data from India's Integrated Biological and Behavioural Surveillance, conducted across 29 Indian states and Union Territories among 19,902 male PWIDs, were used. Informed consent was obtained and men aged 15 years or more, who used psychotropic substances or drugs in the past three months for non-medical reasons were recruited for the survey. Results from the multivariable analysis suggest that drug use debut at age 25 years or above (adjusted odds ratio [AOR]: 1.41, confidence interval [CI]: 1.05-1.88), engagement in drug use for a longer duration (AOR: 1.81, CI: 1.32-2.48), injecting three times or more per day (AOR: 1.53, CI: 1.1-2.12), sharing of needle/syringes (AOR: 1.34, CI: 1.02-1.76), self-reported sexually transmitted infections (AOR: 1.55, CI: 1.12-2.14) and higher self-risk perception for exposure to HIV (AOR: 2.08, CI: 1.58-2.75) increase the likelihood of HIV infection. Sustained higher prevalence, unsafe injecting and risky sexual practices are major challenges which may prevent India from reaching the 'end of AIDS' by 2030. This underscores the need for adoption of a tailored, evidence-driven HIV prevention approach that adequately addresses local needs to limit the spread of HIV within this population, and thereby prevents the onward transmission of HIV to the general population.
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Affiliation(s)
- Pradeep Kumar
- 1 National AIDS Control Organisation, New Delhi, India
| | - Bhavna Sangal
- 1 National AIDS Control Organisation, New Delhi, India
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Boa-Sorte N, Purificação A, Amorim T, Assunção L, Reis A, Galvão-Castro B. Dried blood spot testing for the antenatal screening of HTLV, HIV, syphilis, toxoplasmosis and hepatitis B and C: prevalence, accuracy and operational aspects. Braz J Infect Dis 2014; 18:618-24. [PMID: 25022566 PMCID: PMC9425210 DOI: 10.1016/j.bjid.2014.05.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Screening for vertically transmitted infection is mandatory and must be conducted at the first prenatal consultation. The most vulnerable women's groups are those at the lowest socio-economic level. Dried blood spot testing on filter paper could represent a secure way to screen pregnant women in the prenatal period. METHODS A cross-sectional study was conducted between November 2009 and March 2010, in the Metropolitan Region of Salvador, Bahia, Brazil, to compare the accuracy of the dried blood spot in filter paper and venipuncture serological as screening methods for HIV, HTLV, VHB, VHC, Treponema pallidum, and Toxoplasma gondii during prenatal period. Results of the venous blood sample collected in tubes were considered the gold standard. RESULTS Serum samples and dried blood spot were obtained from 692 pregnant women aged between 14 and 42 years, with a median age of 26. Thirteen women were seropositive for T. gondii (1.88%; 95% CI: 0.60-2.71%), five for T. pallidum (0.72%; 95% CI: 0.15-1.61%), two for HBV (0.29%; 95% CI: 0.050.95%) and one for HTLV-1 (0.14%; 95% CI: 0.01-0.71%). No one was positive for HCV and HIV. The dried blood spot accuracy for syphilis and HTLV were 100% (95% CI: 99.25-100) and 100% (95% CI: 99.45-100%), respectively. The average time between blood collection and recording of the sample in the reference laboratory was 4.93 (3.82) days and between dried blood spot processing and active search for pregnant women was 3.44 (4.27) days. CONCLUSIONS The use of dried blood spot may represent a secure way to expedite access to results of vertically transmitted diseases in the prenatal period, particularly in regions with scarce healthcare resources.
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Affiliation(s)
- Ney Boa-Sorte
- Associação de Pais e Amigos dos Excepcionais de Salvador - APAE Salvador, Salvador, BA, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | - Antônio Purificação
- Associação de Pais e Amigos dos Excepcionais de Salvador - APAE Salvador, Salvador, BA, Brazil; Secretaria Estadual de Saúde do Estado da Bahia - SESAB, Salvador, BA, Brazil
| | - Tatiana Amorim
- Universidade do Estado da Bahia (UNEB), Salvador, BA, Brazil.
| | - Lorena Assunção
- Associação de Pais e Amigos dos Excepcionais de Salvador - APAE Salvador, Salvador, BA, Brazil
| | - Alan Reis
- Secretaria Estadual de Saúde do Estado da Bahia - SESAB, Salvador, BA, Brazil; Secretaria Municipal de Saúde, Lauro de Freitas, BA, Brazil
| | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil; Laboratório Avançado de Saúde Pública, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, BA, Brazil
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Hussain T. HIV infection among different population groups in India: A comprehensive review of seroprevalence and co-infection studies. HIV & AIDS REVIEW 2014. [DOI: 10.1016/j.hivar.2014.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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