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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:ObjectivesHypertensive disorders of pregnancy contribute significantly to maternal and neonatal morbidity and mortality globally. Health-seeking behaviour is influenced by adequate knowledge of the condition. However, current data on pregnant women's knowledge of the condition and health-seeking behaviour are relatively scant in Ghana and has not been previously studied in the Central Region where hypertensive disorders of pregnancy was the leading cause of maternal mortality from 2016 to 2018. The study sought to generate data to fill this knowledge gap.MethodsA cross-sectional study was conducted among 404 pregnant women attending antenatal clinic at the Cape Coast Teaching Hospital from 1 April to 30 September 2020. Data on sociodemographic characteristics, including age, level of education and parity, and knowledge of hypertensive disorders of pregnancy, including its risk factors, clinical presentations and complications, were collected using structured questionnaires. The outcome variable, knowledge of hypertensive disorders of pregnancy, was a composite variable categorized as adequate and inadequate knowledge. Descriptive statistics were generated and association between independent and outcome variables were explored using chi-square and Fisher's exact tests and logistic regression methods.ResultsSixty-two participants (15.4%) showed adequate knowledge of hypertensive disorders of pregnancy. About 62% (251/404) of respondents had heard about hypertensive disorders of pregnancy. Of those who had heard of hypertensive disorders of pregnancy, 29.4% (72/245) correctly indicated the condition was underlined by hypertension in pregnancy ⩾ 20 weeks gestation. Women with tertiary education were six times more likely to have adequate hypertensive disorders of pregnancy knowledge than those with basic education. Women with parity 1-4 were 52% less likely to have adequate knowledge compared to nulliparous women.ConclusionThe remarkably low proportion of pregnant women with adequate knowledge of hypertensive disorders of pregnancy in the study is worrisome because of its potential adverse implication for the health of mothers and their babies. Re-packaging the antenatal health education programme and its delivery is needed for greater impact as far as hypertensive disorders of pregnancy morbidity/mortality is concerned.

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.

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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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