Hepatitis B virus infection and its determinants among HIV positive pregnant women: Multicenter unmatched case-control study

Prevalence of hepatitis B virus infection and associated factors among adults intrafamilial household contacts attending antenatal care clinics in the Central Ethiopian region: from pregnant women index cases

BACKGROUND

In Ethiopia, hepatitis B virus infections are prevalent and highly endemic. Additionally, there has been a significant increase in hospital admissions, morbidity, and mortality associated with hepatitis B virus infections. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among adult intrafamilial household contacts of pregnant women index cases attending antenatal care clinics in the central Ethiopian region.

METHODS

A community-based cross-sectional study was conducted between October 1, 2023, and March 1, 2024. Three hundred eighty-five adult intrafamilial household contacts were randomly selected via lottery methods. A 3 ml venous blood sample was taken from adult intrafamilial household contacts and checked for hepatitis B virus infection through hepatitis B surface antigen. An interviewer-administered questionnaire was used to collect the data. A logistic regression model predicted the relationship between predictor and outcome variables. A p-value of < 0.05 indicated statistical significance.

RESULTS

The overall response rate was 96.1%. Two-thirds of the adults of intrafamilial household contacts (n = 229; 61.9%) were aged between 18 and 28 years, with a mean age of 28 years. The prevalence rate of hepatitis B virus infection among adults of intrafamilial household contacts with pregnant women as the index case was 11.6% (95% CI, 8.6 to 15.1). Being male (AOR: 0.09; 95% CI: 0.03, 0.37) and a duration of stay with the index case of less than six months (AOR: 0.30; 95% CI: 0.11, 0.81) were associated with a reduced risk of hepatitis B virus infection. Meanwhile, large family sizes (≥ 7) (AOR: 4.32; 95% CI: 1.34, 13.98), genital discharge (AOR: 3.14; 95% CI: 1.60, 6.15), engagement in unsafe sex (AOR: 2.37; 95% CI: 1.13, 4.97), and a history of mortality due to hepatitis in the family (AOR: 3.03; 95% CI: 1.09, 8.42) were associated with an increased risk of hepatitis B virus infection.

CONCLUSION

This study found that hepatitis B surface antigen seropositivity among adult intrafamilial household contacts with pregnant women index cases in the central Ethiopia region was high at 11.6%. These findings suggest that interventions to prevent HBV infection should prioritize educational campaigns targeting adult intrafamilial household contacts of HBV-positive index cases, focusing on risk factors associated with HBV transmission, prevention, counselling, testing, and vaccination.

Mortality outcomes between pregnant women booked for antenatal care and unbooked pregnant women

BACKGROUND

Perinatal fetal mortality and maternal mortality remains relatively high in Saudi Arabia. Antenatal care aims to improve outcomes; however, evidence to demonstrate its impact on outcomes in Saudi Arabia is lacking.

OBJECTIVES

Investigate whether booking status for antenatal care impacted outcomes for pregnant women and identify outcomes that predicted booking status.

DESIGN

Retrospective observational cohort study.

SETTINGS

Tertiary care center.

PATIENTS AND METHODS

All Saudi women admitted to the labor or delivery units between January 2011 and December 2019 were included. Outcomes were compared between booked and unbooked women, and logistic regression was used to identify outcomes that predicted booking status, adjusted for age.

MAIN OUTCOME MEASURES

Booked/unbooked status and perinatal mortality of Saudi women.

SAMPLE SIZE

10 781 women; 9546 (88.5%) booked, (11.1%) 1192 unbooked.

RESULTS

Unbooked mothers had higher incidences of meconium-stained liquor (P=.040), ruptured uterus (P=.017), and blood loss >1000 mL during cesarean deliveries (P=.003), but a lower episiotomy rate (P<.001). Perinatal fetal mortality and maternal mortality were equivalent between the two groups. Episiotomy, higher birth weight, higher mother age, perinatal death, delivery mode, onset of labor, and use of analgesics were all independent predictors of the mother being booked when adjusted for all outcomes and age.

CONCLUSIONS

The rate of perinatal and maternal mortality in this cohort was relatively low and equivalent between booked and un-booked mothers, contrary to our expectations. More analysis of the socioeconomic data may explain this striking result.

LIMITATIONS

Retrospective chart-review with incomplete data retrieval that affected the completeness of data retrieved. The results of the multivariate analysis cannot be used to infer causality because the study is observational.

Prevalence of hepatitis B virus infection among pregnant women in the mountainous regions of southern China: A retrospective single-center study

BACKGROUND

Hepatitis B virus (HBV) infection remains a major public health issue worldwide. Moreover, its prevalence varies significantly in different geographic areas of China. The current study aimed to assess the prevalence of HBV infection among Hakka pregnant women in Meizhou, a remote mountainous region in southern China.

METHODS

This research was performed between January 2015 and December 2020. In total, 16,727 pregnant women receiving antenatal care at Meizhou People's Hospital were included in the analysis. All pregnant women were screened for serum HBV markers.

RESULTS

The prevalence rates of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody positivity among the participants were 11.74% (n = 1964) and 48.00% (n = 8029), respectively. The overall prevalence rates of susceptibility to infection, HBV immunity, previous/occult infection, inactive HBsAg carrier, and active infection were 36.16%, 33.61%, 16.94%, 8.11%, and 2.30%, respectively. According to age distribution, the prevalence rate of HBsAg positivity elevated concomitantly with increasing age (p < 0.001). From 2015 to 2020, the prevalence rate of HBsAg positivity decreased from 14.50% to 8.19% and that of hepatitis B pre-core antigen positivity from 4.42% to 2.31%. In addition, pregnant women with HBsAg-positive status were more likely to present with gestational diabetes, thrombocytopenia, and anemia than those with HBsAg-negative status.

CONCLUSION

The HBV infection rate remains high among pregnant women in the indigenous Hakka population in southern China. To prevent vertical transmission, cautious surveillance of maternal HBV infection status should be considered in Hakka pregnant women in Meizhou.