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Prevalence of hepatitis B virus infection and associated risk factors among pregnant women attending antenatal clinic in Mulago Hospital, Uganda: a cross-sectional study.

ABSTRACT: AIM:To determine the prevalence and factors associated with hepatitis B virus infection among pregnant women attending antenatal clinic in Mulago Hospital. DESIGN:Cross-sectional observational study. SETTING:Mulago National Referral Hospital, Uganda, antenatal clinic. PARTICIPANTS:We randomly selected 340 pregnant women attending their first antenatal visit at Mulago Hospital antenatal clinic. PRIMARY OUTCOME:Hepatitis B surface antigen positivity. RESULTS:We recruited 340 participants, with a mean age of 27±5.7 years, and a median gravidity of 3. The prevalence of hepatitis B virus infection among pregnant women attending the antenatal clinic in Mulago Hospital, in our study, was 2.9% (95% CI 1.58% to 5.40%, n=10). Factors positively associated with hepatitis B virus infection were: marital status (adjusted OR (aOR)=11.37, p=0.002), having a hepatitis B positive family member (aOR=49.52, p<0.001) and having had a blood or body fluid splash to mucous membranes from a hepatitis B positive patient (aOR=61.69, p=0.015). Other factors such as age, socioeconomic status, number of sexual partners, HIV serostatus, piercing of ears and history of blood transfusion were not significantly associated with hepatitis B virus infection in this study. CONCLUSION:The prevalence of hepatitis B virus infection among pregnant women attending antenatal clinic in Mulago Hospital was of intermediate endemicity. We found that marital status, having a hepatitis B positive family member at home and having had a blood or body fluid splash to mucous membranes from a hepatitis B positive patient were independently associated with hepatitis B infection. Factors such as age, HIV status, history of blood transfusion, piercing of ears and social status were not associated with hepatitis B status in this study.

SUBMITTER: Kayondo SP

PROVIDER: S-EPMC7279652 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Prevalence of hepatitis B virus infection and associated risk factors among pregnant women attending antenatal clinic in Mulago Hospital, Uganda: a cross-sectional study.

Kayondo Simon Peter SP Byamugisha Josaphat K JK Ntuyo Peter P

BMJ open 20200603 6

<h4>Aim</h4>To determine the prevalence and factors associated with hepatitis B virus infection among pregnant women attending antenatal clinic in Mulago Hospital.<h4>Design</h4>Cross-sectional observational study.<h4>Setting</h4>Mulago National Referral Hospital, Uganda, antenatal clinic.<h4>Participants</h4>We randomly selected 340 pregnant women attending their first antenatal visit at Mulago Hospital antenatal clinic.<h4>Primary outcome</h4>Hepatitis B surface antigen positivity.<h4>Results< ...[more]

PMID: 32499255

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Project description:Introduction:Viral hepatitis is a serious blood-borne and sexually transmitted systemic communicable disease affecting the liver. Commonly, it is caused by hepatitis B and C viruses. HIV infection has been one of the largest public health challenges that can also be transmitted vertically. Objective:To determine seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic at Atat Hospital, Southern Ethiopia. Methods:Hospital-based cross-sectional study was conducted among 222 pregnant women from May to July, 2017. A structured questionnaire was used to collect socio-demographic characteristics and predicators of hepatitis B, C and HIV infections through face-to-face interview. Venous blood sample of 5?mL was collected from study participants, and serum was tested for HBsAg, anti-HCV and anti-HIV using rapid test kits and further confirmed by enzyme-linked immunosorbent assay. Logistic regression analysis was used to identify predictors of hepatitis and HIV infections. A p-value less than 0.05 was considered statistically significant. Results:The overall seroprevalence of hepatitis B, C and HIV infections were 4.5%, 1.8% and 2.7%, respectively. In multivariate analysis, the prevalence of hepatitis B virus infections was significantly higher among patients having history of poly-sexual practices (adjusted odds ratio?=?11.31; 95% confidence interval?=?1.24-28.69, p?=?0.003), history of abortion (adjusted odds ratio?=?8.64; 95% confidence interval?=?5.5-30.36, p?=?0.034), home delivery by traditional birth attendants (adjusted odds ratio?=?9.06; 95% confidence interval?=?2.01-13.36, p?=?0.005) and blood transfusion (adjusted odds ratio?=?18.1; 95% confidence interval?=?2.63-114.24, p?=?0.001). HIV co-infection was present in 40% and 100% of hepatitis B virus and hepatitis C virus positive pregnant women, respectively. All hepatitis C virus positive women had a history of ear piercing, abortion and home delivery. Conclusion:Hepatitis B, C and HIV were all uncommon infections in this population, with hepatitis B virus the most common. All hepatitis C virus positive pregnant women were co-infected with HIV. Significant association was found between hepatitis B virus infection and predictors. Therefore, continuous screening of pregnant women for hepatitis B and C infections should be performed.

Project description:BACKGROUND:Tanzania has a high prevalence (7.17%) of chronic hepatitis B infection. Mother to Child transmission is very common, resulting in high rate of chronic infections. Currently, there is no screening program for HBV in pregnant women. This study investigated the prevalence and risk factors for chronic HBV infection in pregnant women in a tertiary hospital in Mwanza, Tanzania. METHODS:Seven hundred and forty-three women attending antenatal care and/or delivering at the Bugando Medical Centre were enrolled. All answered a questionnaire on sociodemographic and other risk factors and were tested for HBsAg using a rapid test. In HBsAg positive mothers, maternal blood and umbilical cord blood samples collected after delivery were analyzed for serological (HBsAg, HBeAg and anti-HBe) and virologic (HBV-DNA viral load and genotype) markers. All their babies were vaccinated within 24?h of delivery. The children were followed up at 3 years of age. Data was analyzed using the Mann-Whitney U-test, independent sample T-test and logistic regression. RESULTS:Of the 743 participants, 22 (3%) were positive for HBsAg, and 2 (9%) had detectable HBe-antigen. Low condom use was the only statistically significant risk factor for chronic HBV infection (OR?=?3.514, 95%CI?=?1.4-8.0). Of 14 maternal blood samples genotyped, 10 (71%) were genotype A and 4 (29%) were genotype D. HBV-DNA was detected in 21/22 samples, with a median of 241?IU/ml (range: 27.4-25.9?×?107 IU/ml). Five (33%) of 15 available cord blood samples were positive for HBsAg and 10 (67%) were negative. At follow-up, one child showed chronic HBV infection characteristics, one had anti-HBs level of 7 mIU/ml and 5/7(71%) had protective anti-HBs levels (>?10 mIU/ml). CONCLUSION:This cohort of pregnant women showed a lower-intermediate prevalence of HBV of 3%. In the 3 years follow-up only 1 out of 7 children showed evidence of chronic HBV infection. The child's mother with high viral load (25.9?×?107?IU/ml), was positive for HBeAg with a high degree of sequence similarity suggesting vertical transmission. These results highlight a need for improved diagnosis and treatment of HBV infection in pregnant women in Tanzania, in order to prevent vertical transmission.

Project description:BACKGROUND: Malaria during pregnancy remains a serious public health problem. The aim of this study was to determine the prevalence and possible risk factors for malaria in pregnant women attending antenatal clinic at two primary health facilities in Bobo-Dioulasso. METHODS: We conducted a cross sectional study from September to December 2010 in two primary health facilities located in the periurban area of Bobo-Dioulasso. Pregnant women attending antenatal clinic (ANC) were included in the study after signing informed consent. For each participant, the social-demographic profile, malaria and obstetric histories were investigated through a questionnaire. Peripheral blood was collected and thick and thin blood smears were prepared to check Plasmodium falciparum parasitaemia. Hemoglobin concentration was measured. The associations between age, parity, gestational age, schooling, number of ANC visits, use of IPTp-SP, use of insecticide-treated nets (ITN) and anemia with the occurrence of P. falciparum malaria infection during pregnancy were analyzed through logistic regression. RESULTS: During the period of study, 105 (18.1%) out of 579 pregnant women were infected by P. falciparum. The hemoglobin concentration mean was 10.5?±?1.7/dL and was significantly lower in pregnant women with malaria infection (9.8 g/dL ±1.6) than in those who had no malaria infection (10.6 g/dL ±1.7) (P?<?0.001). Multivariate analysis indicated that, education (AOR 1.9, 95% CI?=?[1.2-3.2]), parity [primigravidae (AOR 5.0, 95% CI?=?[2.5-9.8]) and secundigravidae (AOR 2.1, 95% CI?=?[1.2-3.8])], and anaemia (AOR 2.1, 95% CI?=?[1.3-3.5]) were significantly associated with P. falciparum malaria infection. The use of IPTp-SP was not associated with P. falciparum malaria infection. CONCLUSIONS: P. falciparum malaria infection is common in pregnant women attending antenatal clinic and anaemia is an important complication. The results show that the use of IPTp-SP does not reduce the risk of malaria incidence during pregnancy.

Project description:BackgroundThe third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women's understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies.MethodsThis was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan's largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as 'good' (≥80%), 'satisfactory' (60-79%) and 'poor' (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson's correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good' versus 'satisfactory' and 'poor' combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant.ResultsFour hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had 'good' knowledge, 245 (58.1%) had 'satisfactory' knowledge and 157 (37.2%) had 'poor' knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having 'good' level of knowledge.ConclusionsMost pregnant women had 'satisfactory' knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

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Prevalence of hepatitis B virus infection and associated risk factors among pregnant women attending antenatal clinic in Mulago Hospital, Uganda: a cross-sectional study.

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Prevalence of hepatitis B virus infection and associated risk factors among pregnant women attending antenatal clinic in Mulago Hospital, Uganda: a cross-sectional study.

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