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Riches N, Henrion MYR, MacPherson P, Hahn C, Kachala R, Mitchell T, Murray D, Mzumara W, Nkoka O, Price AJ, Riches J, Seery A, Thom N, Loarec A, Lemoine M, Ndow G, Shimakawa Y, Thompson P, Morgan C, Desai S, Easterbrook P, Stockdale AJ. Vertical transmission of hepatitis B virus in the WHO African region: a systematic review and meta-analysis. Lancet Glob Health 2025; 13:e447-e458. [PMID: 40021303 PMCID: PMC11868780 DOI: 10.1016/s2214-109x(24)00506-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 11/14/2024] [Accepted: 11/19/2024] [Indexed: 03/03/2025]
Abstract
BACKGROUND More new infections with hepatitis B virus (HBV) occur annually in the WHO African region than in the rest of the world combined. We did a systematic review and meta-analysis to estimate the prevalence of hepatitis B surface antigen (HBsAg) in pregnant women and vertical transmission events in the region. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, Africa Index Medicus, and Africa Journals Online for publications between Jan 1, 1992, and Jan 7, 2024, with no language restrictions. HBsAg prevalence and vertical transmission (HBsAg positivity in children aged 6-12 months) were estimated with the use of binomial mixed models with logit links, stratified by infant vaccination status. We estimated HBsAg prevalence for subregions of Africa and for the WHO African region by weighting by estimated livebirths for each subregion. We estimated transmission events using WHO and UNICEF vaccine coverage data and UN population estimates. FINDINGS We included 113 studies reporting on HBsAg prevalence from 190 983 pregnant women and 11 studies reporting on vertical transmission. HBsAg prevalence in women receiving antenatal care in the WHO African region (based on 2014-23 data) was 6·2% (95% CI 5·3-7·2). No relationship between risk of bias and HBsAg prevalence was observed. In 2022, an estimated 172 000 vertical transmission events (95% CI 82 000-383 000) occurred (0·4% of livebirths), a fall from a peak of 339 000 (149 000-634 000; 1·2% of all livebirths) in 2001. Increasing birth dose vaccination coverage to the WHO target of 90% could reduce vertical transmission by 43·7% (95% CI 11·6-78·0) to 97 000 events per year (95% CI 58 000-160 000). Adding maternal antiviral prophylaxis with 90% coverage could reduce transmission by 86·3% (95% CI 78·4-94·6) to 24 000 events per year (95% CI 14 000-39 000; 0·06% of livebirths) and achieve WHO elimination targets. INTERPRETATION Vertical transmission is an important contributor to HBV transmission in the WHO African region. Scaling up of hepatitis B birth dose vaccination and antiviral prophylaxis is urgently needed, which could achieve elimination of vertical transmission. FUNDING Wellcome Trust.
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Affiliation(s)
- Nicholas Riches
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Marc Y R Henrion
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Statistical Support Unit, Blantyre, Malawi
| | - Peter MacPherson
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Camilla Hahn
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Rabson Kachala
- Viral Hepatitis Programme, Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Thomas Mitchell
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Daniel Murray
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Wongani Mzumara
- Viral Hepatitis Programme, Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Owen Nkoka
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi; School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Alison J Price
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer Riches
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Aoife Seery
- East Sussex Healthcare National Health Service Trust, Bexhill, UK
| | - Noel Thom
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Anne Loarec
- Médecins Sans Frontières, Maputo, Mozambique
| | - Maud Lemoine
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK; Medical Research Council Unit The Gambia, London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Gibril Ndow
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK; Medical Research Council Unit The Gambia, London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Yusuke Shimakawa
- Insitut Pasteur, Université Paris Cité, Unité d'Épidémiologie des Maladies Émergentes, Paris, France
| | - Peyton Thompson
- Department of Pediatrics, Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Camille Morgan
- Department of Pediatrics, Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Shalini Desai
- Global HIV, Hepatitis and STI Programme, WHO, Geneva, Switzerland
| | | | - Alexander J Stockdale
- Malawi Liverpool Wellcome Research Programme, Blantyre, Malawi; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
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Wondmeneh TG, Mekonnen AT. Epidemiology of hepatitis B virus infection among pregnant women in Africa: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:921. [PMID: 39237884 PMCID: PMC11375975 DOI: 10.1186/s12879-024-09839-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/29/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Although hepatitis B infection is highly endemic in Africa, information on its epidemiology among pregnant women in the region is limited. Therefore, this systematic review provided up-to-date information on the epidemiology of hepatitis B virus (HBsAg) infection among pregnant women in Africa. METHODS A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews. The Web of Science, Scopus, PubMed, Google Scholar, and African journals online were searched to identify relevant studies published between January 1, 2015, and May 21, 2024, on hepatitis B virus infection in pregnant women living in Africa. The Joanna Briggs Institute tool was used to assess the methodological qualities of the included studies. The random effects model was used to estimate the pooled prevalence of HBV infection. I2 assessed the amount of heterogeneity. Publication bias was assessed using Egger's test and a funnel plot. RESULTS We included 91 studies from 28 African countries. The pooled prevalence of hepatitis B infection among pregnant women in Africa was 5.89% (95% CI: 5.26-6.51%), with significant heterogeneity between studies (I2 = 97.71%, p < 0.001). Family history of hepatitis B virus infection (AOR = 2.72, 95%CI: 1.53-3.9), multiple sexual partners (AOR = 2.17, 95%CI: 1.3-3.04), and sharing sharp materials were risk factors for hepatitis B infection. CONCLUSION An intermediate endemic level of hepatitis B virus infection (2-7%) was observed among pregnant women in Africa. To prevent disease transmission, interventions should focus on pregnant women with a family history of hepatitis B infection, multiple sexual partners, and sharing sharp materials.
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Affiliation(s)
| | - Ayal Tsegaye Mekonnen
- Department of Biomedical, College of Medical and Health Science, Samara University, Semera, Ethiopia
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Ayinde M, Olufemi-Aworinde K, Joel-Medewase V, Aliu-Ayinde M, Aworinde O, Adeyemi A. Determinants of mother-to-child transmission of hepatitis B virus among pregnant women in southwestern Nigeria. Pan Afr Med J 2024; 48:161. [PMID: 39629313 PMCID: PMC11613995 DOI: 10.11604/pamj.2024.48.161.41605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 06/28/2024] [Indexed: 12/07/2024] Open
Abstract
Introduction hepatitis B virus (HBV) infection is a serious public health problem in sub-Saharan Africa and a common cause of liver disease globally. This study aimed to determine the seroprevalence and the rate of mother-to-child transmission of HBV after the age of viability. Methods the study was a cross-sectional study that involved 543 eligible consenting pregnant women and newborns of Hepatitis B surface antigen (HBsAg) positive mothers. A one-step rapid HBsAg strip was used to screen eligible patients for HBV infection. Venous blood sample (5mls) was taken from every HBsAg-positive woman for Hepatitis B e Antigen (HBeAg), Hepatitis B e antibody (HBeAb), Hepatitis B core Antibody (HBcAb) and Hepatitis B surface Antibody (HBsAb). In addition, 2mls of cord blood was taken to assay for HBsAg and HBV DNA. Data was analysed using SPSS version 22. Results of 543 pregnant women screened, 18 (3.3%) of them were HBsAg-positive with all of them testing negative for HBeAg. HBV DNA was detected in the cord blood of 4 (22.2%) new-borns delivered while 2 (11.1%) tested positive for HBsAg; the above finding indicated that only 4 of the neonates had detectable HBV DNA (>100copies/ml) in their cord blood. Conclusion findings from this study demonstrate a low prevalence of HBV infection among pregnant women after the age of viability in Ogbomoso. HBV DNA analysis rather than HBsAg was shown to be more sensitive and specific in determining the risk of intrauterine infections.
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Affiliation(s)
- Musa Ayinde
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Kehinde Olufemi-Aworinde
- Department of Haematology and Blood Transfusion, Faculty of Basic Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Victor Joel-Medewase
- Department of Paediatrics and Child Health, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Medinat Aliu-Ayinde
- Department of Epidemiology and Community Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Olufemi Aworinde
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Adewale Adeyemi
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Belete D, Fekadie E, Kassaw M, Fenta M, Jegnie A, Mulu T, Adane G, Abebe W, Amare A. Seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia. BMC Pregnancy Childbirth 2024; 24:512. [PMID: 39075410 PMCID: PMC11285531 DOI: 10.1186/s12884-024-06714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infections are global issues that disproportionately affect developing countries. Pregnancy-related HBV and HCV infections are associated with a high risk of vertical transmission and complications for the mother as well as the newborn. Therefore, this study aims to determine the seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia. METHODS A hospital-based retrospective study was conducted from July to September 2022 on HBV and HCV registered books from September 1, 2017, to August 30, 2019, for a year. The presence of HBsAg and anti-HCV in serum was detected using the One Step Cassette Style HBsAg and anti-HCV antibody test kit. Data were analyzed using SPSS version 26 software. RESULTS In this study, a total of 2252 participants for HBsAg and 538 participants for ant-HCV rapid tests of records in the laboratory logbook were included. The mean age of the study participants was 25.6years (± 5.8SD). The overall prevalence of HBsAg and anti-HCV was 6.0% (134/2252) and 2.4% (13/538), respectively. There were 0.4% (2/538) coinfection results between HBV and HCV among pregnant women. CONCLUSION AND RECOMMENDATION In this study, intermediate seroprevalence of HBV and HCV infection was detected among pregnant women attending antenatal care. The Hepatitis B virus was predominantly higher among pregnant women aged between 25 and 34 years. To manage and stop the potential vertical transmission of these viral agents during the early stages of pregnancy, routine prenatal testing for HBV and HCV infections should be taken into consideration.
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Affiliation(s)
- Debaka Belete
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Engidayehu Fekadie
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Kassaw
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Fenta
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azanu Jegnie
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigist Mulu
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Adane
- Department of Immunology and Molecular Biology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwossen Abebe
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azanaw Amare
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Larebo YM, Anshebo AA, Abdo RA, Behera SK, Gopalan N. Prevalence of hepatitis B virus infection among pregnant women in Africa: A systematic review and meta-analysis. PLoS One 2024; 19:e0305838. [PMID: 39012904 PMCID: PMC11251621 DOI: 10.1371/journal.pone.0305838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/05/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION Africa exhibits a considerably high prevalence of the hepatitis B virus among pregnant women. Furthermore, there is a discernible lack of a well-established surveillance system to adequately monitor and comprehend the epidemiology of the hepatitis B virus, particularly among pregnant women. The eradication efforts of the virus in Africa have been impeded by the significant disease burden in the region, and there is a lack of evidence regarding the pooled prevalence of the hepatitis B virus in Africa. Consequently, this systematic review and meta-analysis aims to determine the prevalence of hepatitis B virus infection among pregnant women in Africa. METHODS We conducted a systematic literature search using reputable databases such as PubMed, Advanced Google Scholar, Scopus, and the Cochrane Library. The search spanned from July 2013 to July 2023 and included all relevant articles published within this period. To identify potentially eligible articles, we conducted a comprehensive manual review of the reference lists of the identified studies. Our review encompassed articles from the African Journal Online. The analysis focused on observational studies published in peer-reviewed journals that reported the prevalence of hepatitis B surface antigen-positive testing among pregnant women. We utilized the Newcastle-Ottawa critical appraisal checklist to assess the methodological quality of each paper. Finally, a meta-analysis was conducted using a random-effects model. RESULTS Out of the 774 studies identified, 31 studies involving 33,967 pregnant women were selected for the meta-analysis. According to the random-effects model, the combined prevalence of hepatitis B virus among pregnant women was 6.77% [95% CI: 5.72, 7.83]. The I2 statistic was calculated to be 95.57% (p = 0.00), indicating significant heterogeneity among the studies. The high I2 value of 95.57% suggests a substantial degree of heterogeneity. A subgroup meta-analysis revealed that factors such as time-dependent bias, sample size dependence, or individual variation among study participants contributed to this heterogeneity (p-difference < 0.05). CONCLUSION According to the findings of this study, the pooled prevalence of hepatitis B infection among pregnant women in Africa was found to be intermediate-high. It is recommended that policymakers implement hepatitis B virus immunization programs targeting pregnant women and their new-born babies at higher risk of exposure.
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Affiliation(s)
- Yilma Markos Larebo
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
- Department of Epidemiology, School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Abebe Alemu Anshebo
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
- Department of Midwifery, School of Nursing, Wachemo University, Hossana, Ethiopia
| | - Ritbano Ahmed Abdo
- Department of Midwifery, School of Nursing, Wachemo University, Hossana, Ethiopia
| | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Science, Central University of Tamil Nadu, Thiruvarur, India
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Lanyo TN, Adjei CA, Ani-Amponsah M. Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana. SAGE Open Nurs 2024; 10:23779608241255183. [PMID: 38828400 PMCID: PMC11141223 DOI: 10.1177/23779608241255183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/24/2024] [Accepted: 04/28/2024] [Indexed: 06/05/2024] Open
Abstract
Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.
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Affiliation(s)
- Theresa Norpeli Lanyo
- Department of Women and Children, University of Ghana Medical Centre, Accra, Greater Accra, Ghana
| | - Charles Ampong Adjei
- Department of Public Health Nursing, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
| | - Mary Ani-Amponsah
- Department of Maternal and Child Health, University of Ghana, School of Nursing and Midwifery, Legon, Greater Accra, Ghana
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Assefa A, Kiros T, Delelegn B. Seroprevalence and Associated Factors of HBV and HCV among Pregnant Women Attending Antenatal Care at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A Cross-Sectional Study. Int J Microbiol 2023; 2023:2282673. [PMID: 37576850 PMCID: PMC10413223 DOI: 10.1155/2023/2282673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/01/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Background Infections with the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are worldwide problems that particularly place a heavy burden on developing nations. HBV and HCV infections during pregnancy have a high rate of vertical transmission and harmful consequences for both the mother and the child. Therefore, this study was carried out to assess the seroprevalence and associated factors of HBV and HCV infections among pregnant women attending antenatal care at Debre Tabor Comprehensive Specialized Hospital in Ethiopia. Methods A cross-sectional study was conducted from March 15th to September 16th, 2022, at the Debre Tabor Comprehensive Specialized Hospital antenatal care clinic. Five milliliters of venous blood were collected from 422 pregnant women selected using a simple random sampling method. Data on sociodemographic characteristics and risk factors were collected using a prestructured questionnaire. A chi-square test, bivariate, and multivariate analyses were used to evaluate the association between dependent and independent variables. p values less than 0.05 were considered statistically significant. Results The seroprevalence of HBV and HCV infections was found to be 13% and 0.5%, respectively. Undertaking blood transfusion (AOR = 14.2, CI = 5.81-34.526, p = 0.001), tattooing (AOR = 3.99, CI = 1.1-14.36, p = 0.034), and dental therapy (AOR = 4.9, CI = 1.41-17.025, p = 0.012) were significantly associated with HBV infection. Conclusion HBV infection in pregnant women was shown to have a high endemicity (13%) in this investigation, whereas the seroprevalence of HCV infection was low (0.5%). HBV infection was significantly associated with a history of blood transfusions, tattooing, and dental therapy. Screening pregnant women for HBV and HCV infections and providing effective therapy would ensure better outcomes for the newborn. In addition, health education must be used to increase knowledge of screening and modes of transmission.
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Affiliation(s)
- Ayenew Assefa
- Unit of Immunology, Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Teklehaimanot Kiros
- Unit of Medical Microbiology, Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Birtukan Delelegn
- Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
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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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Djaogol T, Périères L, Marcellin F, Diouf A, Carrieri MP, Diallo A, Boyer S. Hepatitis B prevention and treatment needs in women in Senegal (ANRS 12356 AmBASS survey). BMC Public Health 2023; 23:825. [PMID: 37143029 PMCID: PMC10161542 DOI: 10.1186/s12889-023-15710-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Although mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is prevalent in West Africa, epidemiological data on HBV infection in women remain scarce. We studied i) hepatitis B surface antigen (HBsAg) prevalence and its correlates, ii) HBV screening history and serological status awareness, iii) MTCT risk and treatment needs in Senegalese women. METHODS A cross-sectional population-based serosurvey for HBsAg positivity was conducted in 2018-2019 in the rural area of Niakhar (Fatick region, Senegal). Participants were offered home-based HBV screening and answered face-to-face questionnaires. HBsAg-positive participants underwent clinical and biological assessments. Data were weighted and calibrated to be representative of the area's population. Logistic regression models helped identify factors associated with HBsAg-positivity in adult women (> 15 years old). RESULTS HBsAg prevalence in adult women was 9.2% [95% confidence interval: 7.0-11.4]. Factors associated with HBsAg-positivity were being 15-49 years old (ref: ≥ 50), living in a household with > 2 other HBsAg-positive members, and knowing someone with liver disease. Only 1.6% of women had already been tested for HBV; no one who tested HBsAg positive was already aware of their serological status. In women 15-49 years old, 5% risked MTCT and none were eligible for long-term antiviral treatment. CONCLUSIONS Adult women have a high HBsAg prevalence but a low MTCT risk. Low rates of HBV screening and serological status awareness argue for the adoption of systematic screening during pregnancy using free and rapid diagnostic tests. Additionally, screening household members of HBsAg-positive women may greatly improve the cascade of care in rural Senegal. TRIAL REGISTRATION ClinicalTrials.gov identifier (NCT number): NCT03215732.
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Affiliation(s)
- Tchadine Djaogol
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, F-33000, Bordeaux, France
| | - Lauren Périères
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
- VITROME, Campus IRD-UCAD, Dakar, Senegal
| | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | | | - Maria Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | | | - Sylvie Boyer
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France.
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Kampe A, Kannaiyan Abbai M, Tilahun D, Daka D, Aliyo A, Dedecha W, Edin A. Seroprevalence of Hepatitis B Virus Infection and Associated Factors
Among Pregnant Women Attending Antenatal Care At Public Hospitals in Borena
Zone, Southern Ethiopia. Health Serv Res Manag Epidemiol 2023; 10:23333928231161946. [PMID: 36970374 PMCID: PMC10034274 DOI: 10.1177/23333928231161946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 03/24/2023] Open
Abstract
Background Hepatitis B virus (HBV) is one of the major threats to global health,
affecting millions of people each year and causing morbidity and mortality.
The risk of acquiring chronic HVV infection varies with age, with 90% of
infections acquired during the perinatal period. Despite many studies, there
is little evidence of this virus in the Borena Zone. Objectives This study was done to assess seroprevalence HBVinfection and associated
factors among pregnant women attending antenatal care at selected Borena
Zone public hospitals from June 1 to September 30, 2022. Methods A cross-institutional study was conducted on 368 randomly selected pregnant
women who received antenatal care at Yabelo General Hospital and Moyale
Primary Hospital. Data on sociodemographic and HBV-related factors were
collected using a structured questionnaire. A 5 mL blood sample is then
taken and tested using a diagnostic method, the enzyme-linked immunosorbent
assay. Finally, data were entered using Epidata version 3.1 and exported to
SPSS version 25 and Stata version 14 for analysis. Independent predictors
were identified using logistic regression analysis and
P < .05 was considered statistically significant. Results The prevalence of HBV infection was 21 (5.7%) (95% confidence interval [CI],
3.74-8.61). History of hospitalization (adjusted odds ratio [AOR] = 3.44,
95% CI, 1.07-11.09), traditional tonsillectomy (AOR = 4.16, 95% CI,
1.29-13.40), history of sexually transmitted infection (AOR = 5.99, 95% CI,
1.81-19.85), human immunodeficiency virus (HIV) (AOR = 8.28, 95% CI,
1.66-41.41), and alcohol drinking (AOR = 5.08, 95% CI, 1.49-17.31) were
independent predictors of HBV infection. Conclusions The results of this study indicate a moderate prevalence of HBV in selected
public hospitals in the Borena Zone. History of hospitalization, traditional
tonsillectomy, sexually transmitted infections, HIV, and alcohol use was
significantly associated with HBV infection. Therefore, there is a need to
conduct health education and more community-based research on disease
transmission routes.
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Affiliation(s)
- Abdo Kampe
- Department of Medical Laboratory Science, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| | - Moorthy Kannaiyan Abbai
- Department of Medical Laboratory Science, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| | - Dagnamyelew Tilahun
- Department of Medical Laboratory Science, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| | - Deresse Daka
- Department of Medical Laboratory Science,
College of
Medicine and Health Sciences, Hawassa
University, Hawassa, Ethiopia
| | - Alqeer Aliyo
- Department of Medical Laboratory Science, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
- Alqeer Aliyo, Department of Medical
Laboratory Science, Institute of Health, Bule Hora University, Bule Hora 144,
Ethiopia.
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
| | - Alo Edin
- School of Public Health, Institute of Health,
Bule Hora
University, Bule Hora, Ethiopia
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Kuugbee ED, Maaldu G, Adamu A, Salia N, Walana W, Kampo S, Vicar EK, Ziem JB. Seroprevalence and Risk Factors of Sexually Transmitted Blood-Borne Infections among Pregnant Women Attending Antenatal Care in Jirapa, Upper West Region of Ghana. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:3157202. [PMID: 37168817 PMCID: PMC10164872 DOI: 10.1155/2023/3157202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
Background Sexually transmitted blood-borne infections (STBBIs) contribute to negative outcomes of pregnancy. Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections in pregnancy contribute significantly to maternal and child morbidities and mortalities. This study assessed the prevalence, knowledge, and risk factors of STBBIs (HBV, HCV, HIV, and syphilis) among pregnant women attending antenatal clinics in Jirapa. Methods A cross-sectional study design involving 246 pregnant women was employed for the study. A structured questionnaire was used to solicit information about the knowledge, prevalence, and risk factors of STBBIs. Results The overall prevalence of STBBIs was 11.4%; HBV prevalence was 9.8% and 0.8% each for HCV, HIV, and syphilis. About 66% of mothers were aware of mother-to-child transmission of infections during pregnancy. Knowledge of transmission of HIV (93.9%), hepatitis (67.1%), and syphilis (53.7%) in pregnancy was relatively high. Knowledge of risk factors for HIV, hepatitis, and syphilis was 97.6%, 74.4%, and 76.0%, respectively. More than 98% of respondents knew about the prevention of HIV, hepatitis, and syphilis. Significant risk factors associated with and predictive of STBBIs were female genital mutilation (FGM) and gravidity. Conclusion The occurrence of STBBIs among pregnant women was strongly associated with FGM and gravidity. Public health education should be directed at stopping the practice of FGM and improving reproductive health in the study area.
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Affiliation(s)
- Eugene D. Kuugbee
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
| | - Gloria Maaldu
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
- Obstetrics and Gynecology Unit, St Joseph's Hospital, P.O. Box 3, Jirapa, UWR, Ghana
| | - Aseta Adamu
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Nafisa Salia
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Williams Walana
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Sylvanus Kampo
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
| | - Ezekiel K. Vicar
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Juventus B. Ziem
- School of Medical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, UER, Ghana
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12
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Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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13
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Nabizadeh E, Ghotaslou A, Salahi B, Ghotaslou R. The Screening of Rubella Virus, Cytomegalovirus, Hepatitis B Virus, and Toxoplasma gondii Antibodies in Prepregnancy and Reproductive-Age Women in Tabriz, Iran. Infect Dis Obstet Gynecol 2022; 2022:4490728. [PMID: 35046632 PMCID: PMC8763548 DOI: 10.1155/2022/4490728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/27/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The organisms of Toxoplasma gondii, Rubella virus, Cytomegalovirus, and Herpes simplex virus as an acronym of TORCH are major pathogens in prepregnancy and reproductive-age women. These microorganisms are considered a serious problem and cause 2-3% of all birth defects in the fetus. Our study was aimed at screening the seroprevalence of TORCH antibodies among prepregnancy and reproductive-age women in Tabriz, Iran. Design and Setting. This study was carried out in 2726 prepregnancy and reproductive-age women, who were referred to the laboratory for prenatal TORCH screening. To detect the presence of IgG, IgM antibodies and Hepatitis B surface antigen against these microorganisms were carried out using a chemiluminescence immunoassay analyzer (CLIA). RESULTS In the current study, the rates of anti-Toxoplasma gondii IgG, anti-Rubella virus IgG, and anti-Cytomegalovirus IgG were found in 722 cases (26.5%), 2579 cases (94.6%0), and 2718 cases (99.7%), respectively. Moreover, the rates of anti-Toxoplasma gondii IgM, anti-Rubella virus IgM, and anti-Cytomegalovirus IgM were discovered in 10 cases (0.4%), 13 cases (0.5%), and 16 cases (0.6%), respectively. The Hepatitis B surface antigen was found in 32 cases (1.2%). The dissemination of positive TORCH in various ages was different (P < 0.05). CONCLUSIONS In our study, the seroprevalence of acute TORCH infections was relatively low. Due to the probability of vertical transmission to the fetus during pregnancy and the unpleasant complication of these pathogens, it is essential to be screened for detection of specific IgG and IgM antibodies in reproductive ages.
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Affiliation(s)
- Edris Nabizadeh
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Behnaz Salahi
- Razi Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghotaslou
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Atalay AA, Abebe RK, Dadhi AE, Bededa WK. Seroprevalence of hepatitis B virus among pregnant women attending Antenatal care in Dilla University Referral Hospital Gedio Zone, Ethiopia; health facility based cross-sectional study. PLoS One 2021; 16:e0249216. [PMID: 33765065 PMCID: PMC7993874 DOI: 10.1371/journal.pone.0249216] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/12/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION A pregnancy that has been complicated with Hepatitis B virus (HBV) infection results in typical management problems for both the mother and the newborn. One of the universal efforts in tackling the impact of chronic HBV is the prevention of mother-to-child transmission during Antenatal care via prompt screening as the majority of chronic infections globally harbored during this period. Rewarding result have been achieved in reducing this problem at this period of life through maternal screening programs and universal vaccination of infants. This study was aimed at assessing the seroprevalence and associated risk factor of HBV among pregnant women attending Antenatal Care (ANC) in Dilla University Referral Hospital (DURH), Southern Ethiopia. METHOD A facility- based cross- sectional study was conducted from December 01 to May 30, 2017 among pregnant women attending ANC. A total of 236 pregnant women were included in this study. All Pregnant women who were attending antenatal clinic and were volunteer during the study period were included, whereas those women who were unable to communicate due to any problem, and not volunteer to give informed consent were excluded. Volunteer participants were asked to complete a questionnaire and had offered to test for HBsAg infection. The data was analyzed using SPSS version 20 software. Logistic regression was used to determine the association between dependent and independent variables. RESULTS From 215 pregnant women attending ANC, the prevalence of HBsAg by the rapid test was found to be 11 (5.1%). Among the study participants, 91.1% (215) were tested for HIV antibody during the ANC visit, with the positivity rate of 4.5%. The result showed 1.86% of the study participants who were tested for HIV were also positive for HBsAg. Among those factors affecting the transmission of HBV infection, multiple partners and HIV confection have significant association at P-value less than 0.05. CONCLUSION The Seropositivity of Hepatitis B Virus among Pregnant Women was found to be significant and hence, routine screening of pregnant mother at Antenatal care for this virus, and subsequent management according to the guideline for both the mother and child is recommended.
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Affiliation(s)
- Adugnaw Atnafu Atalay
- Department of Internal Medicine, College of Health Sciences, St Paul Millennium College, Addis Ababa, Ethiopia
| | - Reta Kassa Abebe
- School of Public Health, College of Health Sciences, Dilla University, Dilla, Ethiopia
| | - Aberash Eifa Dadhi
- Department of Midwifery, College of Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Worku Ketema Bededa
- Department of Pediatrics and Child Health, College of Health Sciences, Hawassa University, Hawassa, Ethiopia
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