Perception of and Attitude towards Hepatitis B Infection among Saudi Pregnant Females Attending Antenatal Care Unit in Al-Ahsa City, Kingdom of Saudi Arabia

Social challenges experienced by Hepatitis B patients: A mixed method study

Background

Hepatitis B has a wide range of effects on patients' lives due to its chronic nature. Living with Hepatitis B has been associated with various social challenges such as stigma, disclosure, and discrimination.

Aim

To assess the social challenges experienced by Hepatitis B-positive patients seeking treatment at a super specialty liver hospital of the country.

Methods and Results

A mixed-method research design was used to explore various social challenges experienced by Hepatitis B-positive patients. Descriptive research design was used in the first phase and thematic analysis was done in the second phase of the study. Data were collected using a modified Hepatitis B stigma assessment tool and semi-structured interview guide. Total 180 Hepatitis B-positive patients were recruited for the first phase. Face to face interviews were recorded for the 9 patients facing high stigma in the second phase of the study. Mean age of the patients was 45 ± 13.1 years and 80% of the patients were male. Mean overall stigma score was found to be 74.34 ± 10.13. Of all, 5.1% patients experienced high stigma, 2.1% moderate stigma, and 92% patients experienced low stigma. Thematic analysis method uncovered various attributing factors to social challenges broadly classified into reaction on getting diagnosed with Hepatitis B, psychological issues, stigmatization in families, stigmatization at workplace, and stigmatization in healthcare settings.

Conclusion

Patients with Hepatitis B experience social challenges in aspect of lack of awareness, psychological issues, and stigmatization by healthcare providers, family members, and by the colleagues at their workplace. A better understanding and awareness regarding Hepatitis B is needed to eliminate stigma and discrimination among these patients. Hence, a holistic approach is must to treat patients with Hepatitis B.

A mixed-methods evaluation of hepatitis B knowledge, attitudes, and practices among migrant women in Thailand

BACKGROUND

Globally 90 % of transmission of Hepatitis B virus (HBV) is from mother-to child and occurs predominantly in resource limited countries where the prevalence of HBV is high. Transmission could be interrupted by timely vaccinations but coverage remains problematic in these areas. Low knowledge or awareness of HBV may play a part in low vaccination coverage. This study examines the provision of antenatal care counselling with a focus on HBV in two different regions of northern Thailand, Sarapee Hospital (SH), Chiang Mai, and Shoklo Malaria Research Unit (SMRU), Tak Province.

METHODS

A mixed-methods sequential explanatory study design was used to evaluate antenatal services for migrants. Cross-sectional knowledge, attitude and practice (KAP) surveys were conducted immediately after counselling at first ANC contact, at 3-6 months after first ANC contact and at delivery. Surveys provided quantitative data, and qualitative methods included observations, focus group discussions (FGD) and in-depth interviews (IDI); analysed thematically to explore concepts of knowledge and understanding, attitude and practice of pregnant women and providers.

RESULTS

Between September-2019 and May-2020, 757 women participated to KAP surveys, and 31 observations of counselling, 16 FGD and 9 IDI were conducted. KAP surveys showed in spite of low knowledge about HBV transmission, infection, or vaccination (correct response: SH 5.7 %, 9/157; SMRU 34.0 %, 204/600), most women (≥ 93 %, either site) understood they were screened for HBV and were willing to vaccinate infants for HBV. In explaining KAP survey results, qualitative analysis suggests counselling should: use the appropriate language; be tailored to the local health literacy level, provide only pertinent information, be repeated over the antenatal period; and attempt to ensure patient privacy (where possible). Programme effectiveness benefits from positive attitudes to screening and vaccinations and a high level of trust in the providers nevertheless participants provided good suggestions for improvements of the service.

CONCLUSIONS

Limited knowledge of HBV among migrant women can be improved by counselling that emphasizes actionable knowledge such as vaccination schedule. Key improvements to the counselling process include training counsellors to conduct interactive counselling sessions in the woman's language, using appropriate visual aids and timely repetition over the course of the antenatal period.

Knowledge, Attitude, and Associated Factors Towards Vertical Transmission of Hepatitis B Virus Among Pregnant Women Attending Antenatal Care in Tertiary Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study

PURPOSE

Hepatitis B virus (HBV) infection is a major public health problem globally. Mother-to-child transmission (MTCT) of HBV is high in endemic countries; however, little is known about pregnant women`s knowledge and attitudes regarding MTCT and prevention methods in Ethiopia. Therefore, this study aimed to assess the knowledge, attitude and associated factors of pregnant women towards MTCT of HBV and its prevention in three tertiary hospitals in the Amhara region, northwestern Ethiopia.

MATERIALS AND METHODS

A cross-sectional study was conducted from May 1, 2018 to September 30, 2019. A total of 1121 pregnant women participated in the study. A structured questionnaire was used to collect the sociodemographic, knowledge, and attitudes of pregnant women towards MTCT of HBV and its prevention. Data were analyzed using SPPS version 20. χ 2-test, multivariate logistic regression, Spearman correlation, and analysis of variance (ANOVA) were used for data analysis.

RESULTS

The majority of 89.6%; 95% CI (87.9-91.3%) pregnant women had poor knowledge of MTCT of HBV and its prevention. However, more than half of the study participants had favorable attitudes. Only 141 (12.6%) of the pregnant women knew that HBV transmitted from mother-to-child and 169 (15.1%) knew that HBV had a vaccine. There was a significant difference in attitude between the three hospitals (P<0.001). In multivariable analysis, education, gravida and vaccination history were independent factors significantly associated with good knowledge and favorable attitudes while income and residence significantly associated only to knowledge and attitude, respectively. There was a significant positive correlation between the knowledge and attitude of pregnant women (P<0.001).

CONCLUSION

The knowledge of pregnant women was found to be poor and their attitude was also limited to MTCT of HBV infection and its prevention. Educational status and vaccination history were predictors of knowledge and attitude, but income and residence only to knowledge and attitude, respectively. This study revealed a lack of knowledge in pregnant women for the prevention and control of MTCT of HBV. This calls for the Amhara Health Bureau and Ministry of Health to promote health education programs for pregnant women attending antenatal care on MTCT of HBV and its prevention methods to improve knowledge and attitudes.

Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

Background

Hepatitis B virus (HBV) is an infectious and a global public health problem. The prevalence of HBV infection among pregnant women is between 2.3% and 7.9%. HBV infection during pregnancy is associated with prenatal transmission to the fetus. HBV has an effective vaccine which reduces up to 96% of the transmission. Although different studies were conducted in Ethiopia, none of them showed the national prevalence of HBV infection among pregnant women. Therefore, this study was conducted to determine the pooled prevalence of HBV and its associated factors in Ethiopia.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles. All observational published studies were retrieved using relevant search terms in Google Scholar, African Online Journal, CINAHL, and PubMed databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I ² statistics were used to test heterogeneity whereas Begg's and Egger's tests were used to assess publication bias. Odds ratio (OR) with a 95% confidence interval (CI) was presented using the forest plot.

Results

A total of twenty-three studies were included in this systematic review and meta-analysis. The pooled prevalence of HBV in Ethiopia was 4.75% (95% CI: 4.06, 5.44). The subgroup analysis showed a higher prevalence of HBV infection among pregnant women in Gambella (7.9%) and the lowest in Southern Nations, Nationalities, and Peoples' Region (SNNPR) (2.3%). Associated factors with HBV infection include history of multiple sexual partner (OR = 6.02 (95%CI = 3.86, 9.36)), blood transfusion history (OR = 5.71 (95%CI = 3.25, 10.04)), abortion history (OR = 3.58 (95%CI = 2.10, 6.09)), and history of body tattoo (OR = 2.83 (95%CI = 1.55, 5.17)).

Conclusions

HBV infection among pregnant women is a common public health problem in Ethiopia. Multiple sexual partners, abortion history, blood transfusion history, and body tattoo were significantly associated with HBV infection. Policies and strategies should focus on factors identified in this study to improve the prevention of HBV among pregnant women.