Seroprevalence and risk factors of Hepatitis B and Hepatitis C infections among pregnant women in the Asante Akim North Municipality of the Ashanti region, Ghana; a cross sectional study

Epidemiology of hepatitis B virus infection among pregnant women in Africa: a systematic review and meta-analysis

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.

Seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia

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.

Hepatitis C virus seroprevalence, testing, and treatment capacity in public health facilities in Ghana, 2016-2021; A multi-centre cross-sectional study

The current burden of Hepatitis C virus infection and the availability of HCV-related services in Ghana are not well described. Previous estimates on HCV seroprevalence in the country are outdated. This study investigated the HCV seroprevalence and testing and treatment capacity in Ghana. A multi-centre cross-sectional study was conducted in which laboratory and blood bank registers from 17 public healthcare institutions in Ghana were reviewed. A survey on cost and availability of HCV-related testing and treatment was also performed. Crude and pooled estimates of HCV seroprevalence, frequency and median cost of available diagnostic tests and medicines were described. The crude HCV seroprevalence was 2.62% (95% CI 2.53-2.72) and the pooled estimate was 4.58% (95% CI 4.06-5.11) among 103,609 persons tested in laboratories. Age (OR 1.02 95% CI 1.01-1.02) and male sex (OR 1.26 95% CI 1.08-1.48) were predictors of a positive anti-HCV RDT test. Northern administrative regions in Ghana had the highest HCV seroprevalence ranging from 8.3-14.4%. Among 55, 458 potential blood donors, crude HCV seroprevalence was 3.57% (95% CI 3.42-3.72). Testing was through Rapid Diagnostic Test (RDT) kits in most facilities, and only 2 of 17 centres were performing HCV RNA testing. The median cost of an anti-HCV RDT test was $0.97 (0-1.61) and $3.23 (1.61-7.58) for persons with and without government health insurance respectively. The median cost of a 12-week course of the pan-genotypic direct-acting antiviral therapy sofosbuvir-daclatasvir was $887.70. In conclusion, there are significant regional differences in HCV burden across Ghana. Limited access to and cost of HCV RNA and DAA therapy hinders testing and treatment capability, and consequently HCV elimination efforts. A national HCV program supported with a sustainable financing plan is required to accelerate HCV elimination in Ghana.

Hepatitis B prevention and treatment needs in women in Senegal (ANRS 12356 AmBASS survey)

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.

Seroprevalence and Risk Factors of Sexually Transmitted Blood-Borne Infections among Pregnant Women Attending Antenatal Care in Jirapa, Upper West Region of Ghana

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.

High Seroprevalence of Hepatitis B and C Virus Infections among Pregnant Women Attending Antenatal Clinic in Borumeda General Hospital, Northeast Ethiopia

Background

Viral hepatitis are considered as the cause of solemn health problem for the human kind, particularly among pregnant women in the 21^th century. Therefore, this study is aimed at determining the seroprevalence of HBV and HCV infection among pregnant women attending at Borumeda General Hospital, Dessie, Northeast Ethiopia.

Methods

An institution-based cross-sectional study was conducted at Borumeda General Hospital from April to May, 2020. A consecutive total of 124 pregnant women who were attending at the antenatal clinic (ANC) of the hospital were included. A structured questionnaire was used to assess the associated factors and some sociodemographic characteristics. Five milliliters of venous blood was collected from each study participant, and a laboratory test using a rapid HBsAg and anti-HCV kit was done. The data were analyzed using SPSS software version 22.

Results

The mean age of the study subjects was 25.81 (±5.967) years. The overall seroprevalence of either HBV or HCV infections among the study participants was 14 (11.3%). HBsAg and anti-HCV were positive among 10 (8.1%) and 4 (3.2%) study participants, respectively. There was no coinfection result between HBV and HCV among pregnant women. Pregnant women who had abortion history [AOR 5.723; 95% CI 1.100-29.785, P value = 0.038] and hospitalization history with IV medication [AOR 6.939; 95% CI 1.017-47.322, P value = 0.048] exhibited statistically significant association with HBV infection.

Conclusions

Seroprevalence of HBV and HCV infections among pregnant women was high, and the rate of HBV particularly can be considered in the high endemic category of the WHO classification scheme. Continuous screening of pregnant mothers, provision of hepatitis B vaccine for females at the child-bearing age, and health education to create awareness about HBV and HCV should be implemented.

Co-infection of HIV or HCV among HBsAg positive delivering mothers and its associated factors in governmental hospitals in Addis Ababa, Ethiopia: A cross-sectional study

BACKGROUND

Blood borne viral infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency virus (HIV) cause substantial mortality and morbidity worldwide. Viral hepatitis during pregnancy is closely related to high risks of maternal and neonatal complications. In Ethiopia, only a little information is available on co-infection of HCV or HIV among Hepatitis B surface Antigen (HBsAg) positive pregnant mothers. Thus, the study aimed to determine HIV or HCV co-infection and associated risk factors among HBsAg positive delivering mothers.

METHOD

A health facility-based cross-sectional study was conducted in five governmental hospitals in Addis Ababa among 265 HBsAg positive delivering mothers in the year 2019 and 2020. A purposive sampling technique was used to select the study participants. Structured questionnaires and laboratory test results were used to collect the data. SPSS version 20 software was used to enter and analyze the data. Multivariable logistic regression was used to identify independent predictors of HIV or HCV co-infections.

RESULTS

Of the HBsAg positive delivering mothers, 9 (3.4%) and 3 (1.1%) were co-infected with HIV and HCV, respectively. None of them were with triplex infection. All of the socio-demographic characteristics were not significantly associated with both HIV and HCV co-infections. Mothers who had a history of sexually transmitted diseases (STDs) were 9.3 times more likely to have HBV-HIV co-infection (AOR = 9.3; 95% CI: 1.84-47.1). Mothers who had multiple sexual partners were 5.96 times more likely to have HIV co-infection (AOR = 5.96; 95% CI: 1.074-33.104). The odds of having HBV-HIV co-infection were 5.5 times higher among mothers who had a history of sharing shavers, razors, and earrings (AOR = 5.5;95% CI: 1.014-29.69). HCV co-infection was not significantly associated with any of the potential risk factors.

CONCLUSION

This dual infection rate of HBsAg positive delivering mother with HIV or HCV indicates that a substantial number of infants born in Ethiopia are at high risk of mother-to-child transmission (MTCT) of HBV, HIV, and HCV. Thus, all pregnant mothers need to be screened for HBV, HCV, and HIV during antenatal care, and also need implementation of prevention mechanisms of MTCT of these viral infections.

Prevalence and Predominant Genotype of Hepatitis C Virus Infection and Associated Risk Factors among Pregnant Women in Iran

OBJECTIVE

Knowledge regarding the prevalence and risk factors of hepatitis C virus (HCV) infection among pregnant women can give clue to health care providers regarding the appropriate management of HCV infection. Therefore, this study was conducted to determine the prevalence, genotypic pattern, and risk factors of HCV infection among pregnant women in the northern shores of the Persian Gulf, south of Iran.

METHODS

From January 2018 to June 2019, serum samples were obtained from 1425 pregnant women, ages ranging from 14 to 46 years (28.1 ± 5.99). Serum samples were tested for detection of anti-HCV antibodies using an enzyme-linked immunosorbent assay (ELISA) (HCV Ab ELISA kit, Dia.Pro, Milan, Italy). Following the extraction of nucleic acid, the molecular evaluation of HCV infection was performed by seminested reverse transcriptase-polymerase chain reaction assay (RT-PCR), targeting the 5' untranslated region (5'UTR) and core of HCV genome and sequencing.

RESULTS

Of the 1425 pregnant women, 19 women (1.33%, 95% CI: 0.85%-2.07%) were positive for anti-HCV antibodies. The majority of HCV-seropositive women were in the third trimester of pregnancy, educated, and had a history of blood transfusion, abortion, surgery, or dentistry. Moreover, Arab and Fars pregnant women and those aged >39 years had the highest rate of HCV seroprevalence. Nevertheless, none of these variables were significantly associated with HCV seropositivity. In contrast, HCV seropositivity was associated with place of residency, so that residents of Khormuj city had significantly higher HCV seroprevalence compared to the residents of other cities (OR: 7.05; 95% CI: 1.75-28.39; P = 0.006). According to the molecular evaluation, 9 of the 19 HCV-seropositive pregnant women (47.37%) had HCV viremia with genotype 3a.

CONCLUSION

This study reports the HCV prevalence of 1.33% for anti-HCV antibodies and 0.63% for HCV RNA among pregnant women in the south of Iran. Considering the asymptomatic nature of chronic HCV infection and the fact that vertical transmission is possible in women with detectable viremia, therefore, screening of women before pregnancy is recommended to reduce the risk of HCV infection and its complications during pregnancy.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Pregnant Women Attending Antenatal Care in Public Health Facilities in Jigjiga Town, Eastern Ethiopia

Background

Hepatitis B virus (HBV) remains a major global public health problem affecting millions of people across the world. The risk of developing a chronic hepatitis B virus infection is affected by the age at the time of acquiring infection. For instance, around 95% of these infections are acquired during the perinatal period. Although evidences indicate the wider effects of hepatitis B virus and its negative consequences, there are limited studies and a scarcity of data in Eastern Ethiopia. Therefore, this study was aimed at determining seroprevalence of HBV and associated factors among pregnant women attending antenatal care in the public health facilities of Jigjiga town, Eastern Ethiopia, from March 4 to April 4, 2019.

Methods

A facility-based cross-sectional study was employed among pregnant women in the public health facilities of Jigjiga town, Eastern Ethiopia. A total of 589 pregnant women were enrolled in the study using a systematic sampling technique. Data were collected using a pretested interviewer administered questionnaire. Five milliliters of venous blood samples was collected and tested for HBV using ELISA diagnostic test. The collected data were entered in to Epidata version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics was carried out using frequency tables and summary measures. Multivariable analysis was done to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05.

Results

Overall, 8.5% (95% CI: 6.5–10.7) of the study participants were seropositive for HBsAg. Having any surgical history [AOR = 3.41, 95% CI (1.26–9.24)], family history of HBV [AOR = 4.96, 95% CI (2.11–10.60)], history of sharing sharps [AOR = 2.78, 95% CI (1.13–6.83)] and having multiple sexual partners [AOR = 6.12, 95% CI (2.12–17.64)] were significant predictors of HBV infection.

Conclusion

The seroprevalence of HBV was relatively high in this study area. Having a history of surgery, family history of hepatitis, history of sharing sharps and multiple sexual partners were significantly associated with HBV infection. Therefore, health information dissemination and awareness creation on mode of transmission of HBV are very crucial.

The prevalence of positive rapid diagnostic test of hepatitis C virus infection in Ghana

Introduction

hepatitis C virus (HCV) infection is one of the most common viral hepatitis in Africa. Rapid diagnostic test (RDT) is a useful tool to identify antibody anti-HCV in point of care. In this study, we decided to determine prevalence of cases with positive rapid diagnostic test of HCV infection.

Methods

this cross-sectional study was conducted in a polyclinic, Accra, Ghana. Using convenience sampling, 728 participants were screened with blood-based RDT and interviewed about personal risk behaviors for transmission of HCV. Data was entered in SPSS version 18 and analyzed.

Results

there was 1.6% positive RDT in our participants. The mean age of them was 29.58 ± 12.31 years old that were younger than the participants with negative RDT (p: 0.027). The rate of positive test was 66.67% in women and 33.33% in men. There was a negative association between age and RDT positive (aOR: 0.91, 95%CI 0.85-0.96). The odds of positive RDT in married participants was 6.32 fold others after adjusting model (p: 0.014). There were no important risk behavior for HCV, except one person with history of contacting blood or needles.

Conclusion

the risk of positive RDT has a reverse relationship with aging and also it has an increase in married individuals. Therefore preventive education and screening for HCV should be a priority in young and middle-aged adults because of more sexual activity.

[Prevention and factors associated with anti-HCV carriage in pregnant women living in Cotonou]

Introduction

hepatitis C is an infection which can be passed from mother to child. The purpose of this study was to investigate the prevalence of colonization by anti-HCV antibodies in pregnant women living in Cotonou and to identify factors associated with it.

Methods

we conducted a cross-sectional study of 253 pregnant women admitted for prenatal care in four major maternity hospitals in Cotonou (Benin) from 01/06/2018 to 01/09/2018. Anti-HCV antibodies were detected using rapid diagnostic tests. A venous blood sample was collected from pregnant women tested positive for anti-HCV before confirmatory serological tests and screening tests for gestational diabetes.

Results

the prevalence of anti-HCV antibodies was 1.2% (3/253 pregnant women). Factors associated with HCV carriage couldn't be identified given the low number of positive cases. However, pregnant women who were carriers of hepatitis C antibodies had higher mean age (32 ± 3) compared to the remainder of the population (29.58 ± 5.5). Potential risk factors for HCV infection were scarifications, piercing, tattooing, sharing of manicure equipment, a history of surgery and blood transfusions. The prevalence of gestational diabetes in our study population was 7.9% (20/253). No association was found between gestational diabetes and hepatitis C.

Conclusion

the prevalence of anti-HCV antibodies in pregnant women living in Cotonou was low. A national-level study is needed to identify factors associated with this infection.

Prevalence and Knowledge of Hepatitis B Virus Infection among Pregnant Women in the Ningo-Prampram District, Ghana

BACKGROUND

Hepatitis B virus (HBV) infection has been suggested to play a role in various adverse birth outcomes. The study determined the prevalence as well as knowledge of hepatitis B virus infection among pregnant women in the Ningo-Prampram District of the Greater Accra Region of Ghana.

MATERIALS AND METHODS

A cross-sectional study using simple random sampling technique was used to recruit 213 pregnant women receiving antenatal care in three different health facilities (Prampram Polyclinic (PPC), Dangme Community Hospital (DCH), and Old Ningo Health Center (ONHC)) in the Ningo-Prampram District of Ghana from November 2018 to January 2019. A semi-structured questionnaire was used to collect data which included participants' HBsAg test results, sociodemographic and gynaecological characteristics, and their level of knowledge on HBV infection. Knowledge of the participants on HBV infection was classified as either excellent, good, or poor based on their cumulative percentage scores from the questionnaire according to Al Rubaish system of classification.

RESULTS

Overall low-intermediate prevalence of HBV infection was 3.3%; however, PPC recorded the highest prevalence of 4.0% while DCH and ONHC recorded 2.82% and 2.50%, respectively. Statistically significant association was observed between HBV infection and the health facility. Majority (77.40%) of the study participants had poor knowledge on HBV infection while only 14 (6.57%) had excellent knowledge on HBV. Regarding excellent knowledge, 8 (11.0%) among the participants were demonstrated by the majority of those who received antenatal care from DCH. Generally, knowledge on HBV and the infection was poor among the study participants. Knowledge on HBV infection was found to be associated with residential status (p = 0.006), educational level (p < 0.001), occupation (p < 0.001), and gestational period (p < 0.001). Participant's knowledge was also significantly associated with the health facility (p = 0.027).

CONCLUSION

HBV infection among pregnant women is prevalent in the Ningo-Prampram District even though the prevalence is not very high. The majority of pregnant women in the Ningo-Prampram District inadequate knowledge on HBV infection and it mode of transmission. Intensive public health education on the HBV infection is required in the district to help prevent and manage future transmissions as well as inform the population about the negative side effects of the virus and the need to prevent it by way of vaccination.

Seroprevalence of Hepatitis B virus infection and associated factors among pregnant women at Korle-Bu Teaching Hospital, Ghana

INTRODUCTION

Hepatitis B virus infection is a global public health problem. Though, the disease is endemic in sub-Saharan Africa, little is known about its epidemiology among pregnant women in Ghana. This study sought to determine the seroprevalence of Hepatitis B virus infection and associated factors among pregnant women attending antenatal care at Korle-Bu Teaching Hospital; Ghana's largest hospital.

METHODS

We conducted a facility-based cross-sectional survey among 232 antenatal attendants. Participants were recruited using systematic random sampling technique and screened with HBsAg Rapid Test. Data was analyzed with the aid of Statistical Package for Social Sciences (SPSS), version 23.0. Results were presented using descriptive statistics, Fisher's Exact test and Logistic Regression analysis.

RESULTS

Two hundred and twenty-one (221) of the total sample (n = 232) agreed to participate in this study; representing a response rate of 95%. The mean age of the participants was 31 years and standard deviation of 5.3. The mean gestational period at recruitment was 28 weeks and standard deviation of 6.8. Majority of the participants were married (83.3%), parous (69.6%), educated (91.4%) and employed (90.5%). The prevalence of HBsAg was 7.7%. We found no significant association between socio-demographic characteristics of the participants and HBV infection.

CONCLUSION

Seroprevalence of 7.7% indicates moderate endemicity. Socio-demographic characteristics did not influence HBV infection among pregnant women attending antenatal care at Korle-Bu Teaching Hospital. The findings provide empirical evidence that will contribute to knowledge of HBV epidemiology in Ghana.

Seroprevalence of hepatitis B virus among antenatal clinic attendees in Gamawa Local Government Area, Bauchi State, Nigeria

BACKGROUND

Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State.

METHODS

We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49 years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel.

RESULTS

The mean age of respondents was 24.5 ± 6.0 years; 112 (53%) of whom were younger than 25 years. All were married, 183 (87%) had no formal education and up to 190 (90%) were employed. Overall, 14 (6.7%) tested positive for HBsAg; women aged ≥35 years had the highest prevalence (10%). None with tertiary education tested positive and women married before 18 years had 13 (6.2%) prevalence.

CONCLUSIONS

The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC.

Hepatitis B and C in the adult population of Bissau, Guinea-Bissau: a cross-sectional survey

OBJECTIVE

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent in West Africa. To address the WHO 2030 goals of a 90% reduction in incidence and a 65% reduction in mortality for both infections, we assessed the prevalence of HBV and HCV from surveys in the general population.

METHODS

Participants in this cross-sectional survey were included from randomly selected houses in a demographic surveillance site in Bissau, Guinea-Bissau. Participants were interviewed and had a blood sample drawn for viral analyses (HBsAg, anti-HBs, anti-HBc, anti-HCV and HCV RNA). Risk factors of HBV and HCV infection were determined by binomial regression adjusted for sex and age.

RESULTS

A total of 2715 participants were included in this study. The overall HBsAg prevalence was 18.7% (95% CI: 17.3-20.2%). HBsAg was associated with male sex (adjusted risk ratio (aRR): 1.64), and prevalence decreased with age >34 years. HBV exposure was found in 91.9% of participants. Although 72.6% of individuals without sexual debut had been exposed to HBV, ever engaging in a sexual relationship was associated with higher risk of HBV exposure (aRR 1.18). The anti-HCV prevalence was 0.5% (95% CI: 0.3-0.9%), and 78.6% of those had detectable HCV RNA. Risk factors for anti-HCV sero-positivity were age above 55 (aRR 10.60), a history of blood transfusion (aRR 5.07) and being in a polygamous marriage (aRR 3.52).

CONCLUSION

In Guinea-Bissau initiatives to implement treatment and widespread testing are needed to reach the WHO 2030 goals.

Sero-prevalence of hepatitis B and C viral infections in Ghanaian HIV positive cohort: a consideration for their health care

BACKGROUND

Antiretroviral therapy (ART) has significantly decreased HIV/AIDS-related morbidity and mortality. However, globally, many people living with HIV die from non-AIDS related illnesses including liver diseases which occur partly due to co-infection with HBV and or HCV. The aim of this study was to determine the seroprevalence of HBV and HCV among HIV infected individuals receiving care from three different hospitals in the Central Region of Ghana.

METHODS

This research was a case-case study. The population consisted of ART naive persons (newly confirmed HIV cases) and those who had been on ART for more than 3 months (old cases). Each individual's sociodemographic characteristics and clinical data including their HBV and HCV status were collected. Those who knew their HBV and HCV status and those who did not know their status were tested for circulating HBsAg and anti-HCV using rapid diagnostic test cassettes. Descriptive analysis was done, and the data presented as median with interquartile range, frequency and percentage. Fisher's exact test and Pearson Chi-square (χ²) test were used to determine associations between categorical variables.

RESULTS

Overall, 394 HIV individuals aged, 3 to 76 years old with a median age of 41 (IQR:34-49) participated in this study. Circulating HBsAg and anti-HCV were detected in 6.1% (24/394) and 0.5% (2/393) participants respectively with an overall seroprevalence of 6.6% (26/394). None of the participants was positive for both HBV and HCV infections. 92.1% (363/394) had no information on their HBV status while all the 394 participants did not know their HCV status during data collection. No significant association of HBV infection rate was found in all the socio-demographic data of the participants. But HBV infection rates were significantly higher in those at WHO clinical stages 2 and 3 (P = 0.004).

CONCLUSION

HBV and HCV were detected among the HIV-infected participants. Majority of the participants had no information on their HBV status and none of the participants had information on his or her HCV status. This study recommends the need for policy makers to provide free HBV and HCV screening for all HIV infected individuals for their effective management.

Prevalence of Hepatitis C Virus and HIV Infection Among Pregnant Women Attending Antenatal Care Clinic in Western Ethiopia

Background:Hepatitis C virus (HCV) and HIV infection remain a major public health challenge in Sub-Saharan Africa. The HCV and HIV infection among pregnant women have a serious outcome on maternal and newborn health. There is limited information in this regards in West part of Ethiopia. This study aims to identify the sero- prevalence and predictor factors of HCV and HIV infection among pregnant women attending antenatal care (ANC) in Western Ethiopia.

Methods: An institutional based cross-sectional study was conducted from July to September, 2014 among 421 pregnant women's attending ANC services in purposively selected health facilities of western Ethiopia. The HCV and HIV infections were diagnosed by detection antibodies from aseptically collected serum sample. HCV was identified using an enzyme linked immune sorbent assay (ELISA) while HIV infection was tested with rapid HIV tests following the national HIV test algorithm. The pretested and structured questionnaire was used to collect socio-demographic data, and potential predictor factors of HCV and HIV infection. The collected data were analyzed using SPSS version 20.0 statistical software.

Result: The overall sero-prevalence of HCV and HIV among the study population was 8.1% and 1.0%, respectively. The prevalence of HCV/HIV co-infection was 0.23% (1/421). Among HIV infected women, the prevalence of HCV infection was 25% (1/4). The risk of HCV infection was significantly low for urban residents (AOR = 0.38, 95%CI: 0.16-0.90) and illiterate (AOR = 0.24, 95%CI: 0.06-0.85). However, the history of blood transfusion was significantly increases the risk of HIV infection (AOR = 19.52, 95%CI: 1.80-150.6).

Conclusion: Our study confirms public health importance of HCV and HIV infections among pregnant women in the study area. The study suggests need of attention for rural residents and educated segment of the population for HCV prevention, and national blood blank to check HIV test method used for blood transfusion.

Risk factors of hepatitis B virus surface antigen carriage and serological profile of HBsAg carriers in Lomé Togo, 2016

BACKGROUND

In Togo, the prevalence of Hepatitis B Virus Surface Antigen (HBsAg) among young people aged 15-24 years was estimated at 16.4% in 2010; however, risk factors for HBsAg carriage are poorly documented. We sought to identify risk factors for HBsAg carriage and the serological profile of HBsAg carriers in Lomé (capital city of Togo).

METHOD

We conducted a case control study from October 2016 to March 2017 in Lomé. Cases and controls were randomly selected from a database of Institut National d'Hygiène (INH) of Lomé during a free screening campaign for hepatitis B. We calculated means, frequencies, proportions, odds ratios (OR), and 95% confidence interval (CI) and performed logistic regression.

RESULTS

We included 83 confirmed cases and 249 controls. The median age was 31 years among cases and 30 years among the controls. The sex ratios (M/F) were 11/6 among cases and 4/3 for the controls. The independent risk factors for HBsAg carriage were the awareness of hepatitis B serological status (OR = 3.56, 95% CI [1.80-7.04]) and Kabyè-tem ethnic group (OR = 3.56, 95% CI [1.98-6.39]). Among HBsAg carriers, 13.3% were at the viral replication stage (all of whom were between 30 and 45 years of age) and 1.2% were at the acute stage of the disease. The prevalence of co-infection with hepatitis B and C was 4.80%. All co-infections were in women aged 24-28 years.

CONCLUSION

The Kabyè-tem ethnic group is at risk of HBsAg carriage in Lomé. Of note, most HBsAg carriers in this ethnic group are aware of their HBsAg serological status. Furthermore, the prevalence of Hepatitis among adults of reproductive age is high and is cause for concern. We therefore recommend screening and vaccination campaigns at subsidized prices among people aged 30 years and older.

Hepatitis B Infection among Parturient Women in Peri-Urban Ghana

Global evidence suggests that hepatitis B viral (HBV) infection is endemic in Africa and perinatal transmission remains one of the most important modes of HBV transmission in this area. This cross-sectional survey examined the seroprevalence and knowledge of hepatitis B among pregnant women attending antenatal clinic (ANC) in a mission hospital in Ghana. Systematic sampling technique was used to recruit 196 pregnant women. The level of statistical significance was set at 0.05 alpha level. The hepatitis B prevalence estimate (hepatitis B surface antigen) was 10.2% (N = 20) and all of the participants were aware of HBV infection. Majority cited media (radio) as their main source of information. Approximately 86% of the participants (N = 168) associated HBV infection with a curse and 88.8% (N = 174) indicated witches and wizards as possible causes of the infection. Those with higher level of school education had high hepatitis B knowledge score (P < 0.01). Implementation of a health education program on the route of hepatitis B transmission is required in the study setting. Also, inclusion of hepatitis B education as part of ANC activities will enable HBV-positive pregnant women to appreciate the need for hepatitis B vaccination of their newborns at birth.

Epidemiology of hepatitis B in pregnant Iranian women: a systematic review and meta-analysis

Perinatal transmission is one of the most common routes of hepatitis B virus (HBV) transmission. This study aims to identify the epidemiological features of HBV among pregnant Iranian women. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Two authors independently searched several online databases without time limit until May 2017. The databases include Magiran, Iranmedex, SID, Medlib, IranDoc, Scopus, PubMed, Science Direct, Cochrane, Web of Science and Google Scholar. The data were analyzed based on a random-effects model using Comprehensive Meta-Analysis software version 2. Thirty-seven studies were included in the meta-analysis. The prevalence of HBV among pregnant Iranian women was 1.18% (95% CI: 0.09%-1.53%). The prevalence of HBV among pregnant women living in urban and rural areas was 1.60% (95% CI: 0.06%-4.30%) and 1.70% (95% CI: 0.09%-3.2%), respectively. The prevalence of HBV among housewives and working pregnant women was 4.3% (95% CI: 1.4%-12.5%) and 1.2% (95% CI: 0.02%-5.8%), respectively. The risk of developing an HBV infection was significantly associated with illiteracy (p = 0.013), abortion (p = 0.001), blood transfusion (p < 0.001) and addicted spouse (p = 0.045). However, no significant relationship was observed between HBV infection and urbanization (p = 0.65), occupation (p = 0.37), history of surgery (p = 0.32) or tattooing (p = 0.69). Vaccination coverage (receiving at least a single dose) in pregnant women was 9.8% (95% CI: 5.3%-17.5%). The prevalence of HBV among pregnant women is lower than in the general population of Iran. HBV vaccination coverage was low among pregnant Iranian women. Therefore, health policy-makers are recommended to enforce immunization programs for HBV vaccination among high-risk pregnant women.

The status of hepatitis B control in the African region

The World Health Organization (WHO) African Region has approximately 100 million people with chronic hepatitis B virus (HBV) infection. This review describes the status of hepatitis B control in the Region. We present hepatitis B vaccine (HepB) coverage data and from available data in the published literature, the impact of HepB vaccination on hepatitis B surface antigen (HBsAg) prevalence, a marker of chronic infection, among children, HBsAg prevalence in pregnant women, and risk of perinatal transmission. Lastly, we describe challenges with HepB birth dose (HepB-BD) introduction reported in the Region, and propose strategies to increase coverage. In 2015, regional three dose HepB coverage was 76%, and 16(34%) of 47 countries reported ≥ 90% coverage. Overall, 11 countries introduced HepB-BD; only nine provide universal HepB-BD, and of these, five reported ≥ 80% coverage. From non-nationally representative serosurveys among children, HBsAg prevalence was lower among children born after HepB introduction compared to those born before HepB introduction. However, some studies still found HBsAg prevalence to be above 2%. From limited surveys among pregnant women, the median HBsAg prevalence varied by country, ranging from 1.9% (Madagascar) to 16.1% (Niger); hepatitis B e antigen (HBeAg) prevalence among HBsAg-positive women ranged from 3.3% (Zimbabwe) to 28.5% (Nigeria). Studies in three countries indicated that the risk of perinatal HBV transmission was associated with HBeAg expression or high HBV DNA viral load. Major challenges for timely HepB-BD administration were poor knowledge of or lack of national HepB-BD vaccination guidelines, high prevalence of home births, and unreliable vaccine supply. Overall, substantial progress has been made in the region. However, countries need to improve HepB3 coverage and some countries might need to consider introducing the HepB-BD to help achieve the regional hepatitis B control goal of < 2% HBsAg prevalence among children < 5 years old by 2020. To facilitate HepB-BD introduction and improve timely coverage, strategies are needed to reach both facility-based and home births. Strong political commitment, clear policy recommendations and staff training on HepB-BD administration are also required. Furthermore, high quality nationally representative serosurveys among children are needed to inform decision makers about progress towards the regional control goal.

Epidemiology of hepatitis C virus in Ghana: a systematic review and meta-analysis

Background

To fully understand the burden of hepatitis C (HCV) infection in Ghana towards informing appropriate preventive measures, accurate prevalence estimates are needed. In this study, we estimate the prevalence of chronic HCV infection by systematically reviewing primary studies published between 1995 and 2015.

Methods

A systematic review and meta-analysis was conducted as per the PRISMA guidelines. Comprehensive searches for hepatitis C prevalence studies for the years 1995–2015 were conducted in PubMed, ScienceDirect, Google Scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus databases. We also searched the websites of the ministry of health and Ghana Health service for non-indexed studies or reports on the subject. Further systematic reference screening of published reviews and retrieved studies were also conducted to identify additional publications not captured through the online searches.

Results

Twenty-Four (24) studies from nine regions of Ghana with a combined sample size of 100,782 were analyzed. No study involving participants from Upper West region was retrieved. The national prevalence of chronic HCV was estimated as 3.0 % (95 % CI = 2.6 % to 3.5 %; I² = 97.61 %, p < 0. 001). Prevalence rates of chronic HCV infection among blood donors was 2.6 % (95 % CI = 2.1 % to 3.1 %; I² = 98.33 %, p < 0.001) with higher prevalence rate estimated for replacement blood donors (RBDs) than voluntary blood donors (RBDs). Among pregnant women and parturients, anti-HCV seroprevalence was estimated as 4.6 % (95 % CI = 1.8 % to 7.5 %; I² = 75.74 %, p = 0.016). The national prevalence of HIV/HCV co-infection was also estimated as 2.8 % (95 % CI = 0.4-6 %; I² = 65.86 %, p = 0.0053). Regional prevalence of chronic HCV infection were determined for Ashanti (1.5 %, 95 % CI = 1.2 % to 1.9 %; I² = 96.24 %, p < 0.001) and Greater Accra (6.4 %, 95 % CI = 4.2 % to 8.6 %; I² = I² = 88.5 %, P < 0. 001) regions but no estimates were available for the other eight regions. The ascending order of HCV prevalence rates according to years in which studies were conducted was 2006–2010 < 2011–2015 < 1995–2002 < 2001–2005. Higher prevalence of chronic HCV infection was estimated for rural (5.7; 95 % CI 5.0–6.3 %; I² = 0, p = 0.804) than urban (2.6 %, 95 % CI = 2.1 % to 3.0 %; I² = 97.3 %, p = 0.0001) settings.

Conclusion

Our study demonstrates a high prevalence of chronic hepatitis C infection in Ghana. This highlights the urgent need for stronger commitments from government and all stakeholders within the country to outline efficient preventive and curative measures towards reducing the overall burden of the disease.

Hepatitis B in Ghana: a systematic review & meta-analysis of prevalence studies (1995-2015)

BACKGROUND

Although, chronic hepatitis B (HBV) is considered to be of significant public health importance in Ghana, not many reviews detailing the burden (prevalence) of the disease have been conducted. This study was aimed at summarizing the available information and to make an accurate estimate of HBV infection prevalence in Ghana over the last two decades (1995-2015).

METHODS

A systematic search was conducted in PubMed, ScienceDirect, Google Scholar and Africa Journals Online (AJOL) databases to retrieve primary studies published between 1st January 1995 and 4th October 2015, assessing the prevalence of HBV among populations in Ghana. This was supplemented by a manual search of retrieved references.

RESULTS

Thirty (30) studies across all the ten (10) regions of Ghana and involving an overall population size of 105,435 were analyzed. The national prevalence of HBV as determined by HBsAg seropositivity was 12.3%. HBV prevalence among voluntary blood donors (VBDs), replacement blood donors (RBDs) and pregnant women were 10.8, 12.7 and 13.1% respectively. HBV infection prevalence was highest among studies published within the period 1995-2002 (17.3%), followed by those published within 2003-2009 (14.7%) and the lowest prevalence rate being recorded across studies published in the period 2010-2015 (10.2%). Regional prevalence were determined for Ashanti, Greater Accra, Eastern, Northern, central and Brong-Ahafo regions as 13.1, 10.6, 13.6, 13.1, 11.5 and 13.7% respectively. No aggregate data were derived for Volta, Western, Upper East and Upper West regions. Higher prevalence of HBV infection was attained for rural (13.3%) compared to urban settings (12.2%). Across the country, highest HBV infection prevalence rates were recorded in persons within the age group 16-39 years.

CONCLUSION

Hepatitis B infection is clearly an important public health problem in Ghana. The burden of the disease as dictated by a high prevalence rate calls for urgent public health interventions and strategic policy directions to controlling the disease to avert any potential future explosion.