Call/whatsapp: +2348077215645, +2348176196229  Email: distinctvaluedproject@gmail.com

DISTINCTVALUED RESEARCH PROJECTS

www.dvlresearch.ng

research project writing and materials

A STUDY ON THE PREVALENCE OF HEPATITIS B VIRUS INFECTION AMONG PREGNANT WOMEN

ABSTRACT
This was a cross-sectional study carried out among the pregnant population in five healthcare facilities in Jos, between November 1, 2017 and April 30, 2018. Informed consent was obtained, and data on sociodemographic and risk factors for hepatitis B virus (HBV) infection were collected. Hepatitis B viral infection was assessed using the in vitro HBsAg diagnostic rapid kit (Acon Laboratories, USA). Descriptive statistics, Chi-square test, and logistic regression were performed to identify predictors of HBV infection in the study population. All statistical analyses were carried out on STATA version.

CHAPTER ONE
INTRODUCTION

Globally, estimates suggest that over 250 million people are living with chronic Hepatitis B Virus (HBV) infection, with 4.5 million new HBV infections, and 880,000 HBV-related deaths occurring yearly.[1] The highest prevalence of HBV disease of over 8% is reported in Central Asia, Southeast Asia, sub-Saharan Africa, and the Amazon basin; followed by an intermediate prevalence of 2%–8% reported in the Middle-East, South Asia, some Eastern European countries, and the Mediterranean basin; and the lowest prevalence of < 1% is reported in the United States, Western Europe, Australia, and parts of South America. In HBV endemic regions, the lifetime risk of HBV exposure is universal and 5%–10% of the adults have chronic HBV infection.[2,3]
The differences in the HBV burden across regions are reflected in the modes of transmission and the burden of pediatric HBV infection. In high prevalence regions, HBV is predominantly transmitted in the perinatal period or early childhood, accounting for over 50% of chronic HBV infection in the adult population.[4,5,6] The risk for the development of chronic hepatitis B infection varies inversely with the age at which acute hepatitis B infection occurs.[7,8] The risk for chronic HBV infection is about 90% if infected at birth or infancy, 30%–50% in children aged 1–6 years, and 5%–10% in children above the age of 6 years to adulthood.[9] Chronic HBV infection acquired in childhood carries a 25% risk of death resulting from complications of chronic liver disease, cirrhosis, or hepatocellular carcinoma.[10]
Although a higher prevalence of HBV infection is reported among surgeons (25.7%), voluntary blood donors (23.4%), and infants (25.7%), Hepatitis B surface antigenemia (HBsAg) studies of pregnant women in Nigeria have revealed HBV prevalence of between 2% and 15.2%.[11,12] In Zaria and Ilorin both in Northern-central Nigeria, studies showed HBV prevalence in pregnancy to be 8.2% and 5.7%, respectively.[13,14] Previous studies on risk factors for HBV infection in pregnancy have shown that high parity, history of blood transfusion, HBV infection in family members, tattooing, and previous surgeries are known risk factors for HBV infection in pregnancy.[15] However, other studies showed no association with a history of multiple sexual partners, previous surgeries, blood transfusion, and circumcision.[16]
There is a paucity of studies on the prevalence and risk factors of HBV in pregnancy, a window of opportunity in the global strategies to reduce HBV prevalence.[17] HBV infection in pregnancy is not only a determinant for vertical transmission, but also has the potential for horizontal transmission to close contacts and remains a significant source of HBV infection. A better understanding of the HBV epidemiology in pregnancy is crucial to developing or adopting strategies to reduce pediatric HBV infection and ultimately reduce its socioeconomic burden. In this study, we sought to determine the prevalence of HBV infection and associated risk factors among pregnant women in Jos, Nigeria.
Go to:
This cross-sectional study was conducted in five health facilities in Jos, North-Central Nigeria: Jos University Teaching Hospital (JUTH), Plateau State Specialist Hospital (PSSH), Bingham University Teaching Hospital (BHUTH), Faith Alive Foundation Hospital (FAF), and Our Lady of Apostles Hospital (OLA), together with caring for about 40% of pregnant women in this area.[18] Ethical approvals were obtained from the five Institutional Health Committees on ethics and research.
This study sampled antenatal clinic attendees between November 1, 2017 and April 30, 2018, at their first or second visit after obtaining informed written consent.
Data on socio-demographics, obstetric, and sexual risk factors for HBV infection were collected. HBV was tested using the in vitro diagnostic assay for HBsAg manufactured by Wondfo Biotech Co. Ltd, USA. The test kit (dipsticks) was a rapid immune-chromatographic assay designed for the qualitative determination of the HBsAg in plasma. Twenty-five microliters of blood were placed into the specimen pot of the cassette and a drop of the buffer solution was added. A single red or pink band in the control region indicated a negative result, while two bands each at the control and the test region indicated a positive result. The test was deemed invalid if a single band appeared at the test region and thus was repeated. The study participants who were found to be positive for HBsAg were referred to the Gastro-Intestinal unit for further clinical evaluation and care. In addition, blood samples were tested for HIV-1 and HIV-2 antibodies according to the National HIV testing algorithm.
All statistical analyses were performed on STATA 15 (Corp LP, USA). We performed descriptive statistics and relevant tests of hypotheses to identify risk factors for HBV infection in the study population. We further built a multivariable logistic regression model for risk factors that were associated with HBV (P < 0.05) to identify independent predictors of HBV infection among pregnant women. The results were presented as adjusted odds ratio (aOR), with a 95% confidence interval (CI). A value of P < 0.05 was considered statistically significant.
Acknowledgment
We thank the participants, midwives, counselors, and laboratory staff in the five study sites for their commitments to the study. We equally thank the data assistant, who ensured that all the data was captured for the analysis.

REFERENCES

  1. Global Hepatitis Report. Guidelines. World Health Organization. 2019. [Last accessed on 2020 Apr 28].
  2. Evans AA, Cohen C, Block TM. In viral Infections of Humans: Epidemiolology and Control. Springer US: New York; 2014. pp. 747–64.
  3. Rapti I, Hadziyannis S. Risk for hepatocellular carcinoma in the course of chronic hepatitis B virus infection and the protective effect of therapy with nucleos (t) ide analogues. World J Hepatol. 2015;7:1064–73
  4. Lozano R, Naghari M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for over 20 age groups in 1999 and 2010: A systematic analysis for the Global Burden of Disease study 2010. Lancet. 2012;380:2095–128.
  5. Jonas MM. Hepatitis B and Pregnancy: An underestimated issue. Liver Int off J Int Assoc Study Liver. 2009;29:133–9.
  6. Emeche GO, Emodi IJ, Ikefuna AN, Ilechukwu GC, Igwe WC, Ejiofor OS, et al. Hepatitis B virus infection in Nigeria. A review. Niger Med J. 2009;50:18–22.
  7. Eke AC, Eke UA, Okafor CI, Ezebialu IU, Ogbuagu C. Prevalence, correlates and patterns of hepatitis B surface antigen in a low resource setting. Virology J. 2011;8:12.
  8. Coppola N, Loquercio G, Tonziello G. HBV transmission from an occult carrier with five mutations in the major hydrophilic region of HBsAg to an immunosuppressed plasma recipient. J Clin Virol. 2013;58:315–7.
  9. Coppola N, Tonziello G, Colombatto P. Lamuvidine – Resistant HBV strain rtM204V/I in acute hepatitis B. J Infect. 2013;67:322–8.
  10. Borgia G, Carleo MA, Gaeta GB, Gentile I. Hepatitis B in pregnancy. World J Gastroenterol. 2012;18:4677–83
  11. Eke CB, Onyire NB, Amadi OF. Prevention of mother to child transmission of hepatitis B virus infection in Nigeria: A call to action. Niger J Paediatr. 2016;43:201–8.
  12. Alegbele JO, Nyengidiki TK, Ikimalo JI. Maternal and neonatal seroprevalence of hepatitis B surface antigen in a hospital based population in South-South, Nigeria. Int J Med Med Sci. 2013;5:2416. [
  13. Musa B, Bussel S, Borodo MM, Samaila AA, Femi OL. Prevalence of hepatitis B virus infection in Nigeria, 2000 – 2013: A systemic review and meta-analysis. Niger J Clin Pract. 2015;18:163–72. ]
  14. Luka SA, Ibrahim MB, Iliya SN. Seroprevalence of hepatitis B surface antigen among pregnant women attending Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Niger J Parasitol. 2008;29:38–41.
  15. Agbede OO, Iseniyi JO, Kolawole MO, Ojuawo A. Risk factors and seroprevalence of hepatitis surface antigenemia in mothers and their pre-school age children in Ilorin, Nigeria. Therapy. 2007;4:67–72.
  16. Nyamusi MM, M’Imunya JM, Muvunyi CM, Habtu M. Factors associated with hepatitis B surface antigen seropositivity among pregnant women in Kigali, Rwanda: A cross sectional study. J Comm Pub Health Nursing. 2017;3:192. 1
  17. YIi P, Chen R, Huang Y, Zhau RR, Fan XG. Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges. J Clin Virol. 2016;77:32–9.
  18. National Bureau of Statistics Federal Republic of Nigeria: 2006 Population Census Official Gazette FGP 71/52007/2,500(OL24); Legal Notice on Publication of the Details of the breakdown of the National and State Provisional Totals 2006 Census. National Bureau of Statistics Federal Republic of Nigeria: 2006 Population Census Official Gazette FGP. [[Last accessed on 2015 Aug 23]]. Available from: http//wwwnigerianstatgovng/connectionn/pop2006 .
  19. Imade GE, Sagay AS, Ugwu BT, Thacher RW. Seroprevalence of Hepatitis B and Human Immunodeficiency virus infections in pregnant women in Nigeria. J Med Tropics. 2004;6:15–1.
  20. Opaleye OO, Salami S, Funmilayo F, Olowe OA. Seroprevalence of hepatitis B surface antigen and antibody among pregnant women attending a Tertiary Health Institution in Southwestern Nigeria. J Dent Med Sci. 2014;13:67–71.
  21. Yakasai IA, Ayuba R, Abubakar IS, Ibrahim SA. Seroprevalence of Hepatitis B virus infection and its risk factors among pregnant women attending antenatal clinic at Aminu Kano Teaching Hospital, Kano, Nigeria. J Basic Clin Reprod Sci. 2012;1:49–55.
  22. Rabiu KA, Akinola OI, Adewunmi AA, Omololu OM, Ojo TO. Risk factors for hepatitis B virus infection among pregnant women in Lagos, Nigeria. Acta Obstet Gynecol Scand. 2010;89:1024–8.
  23. Zenebe Y Mulu W, Yimer M, Abera B. Seroprevalence and risk factors of hepatitis B virus and human immunodeficiency virus infection among pregnant women in Bahir Dar city, Northwest Ethiopia: A cross-sectional study. BMC Infect Dis. 2014;14:8
  24. Chinenye GA, Adeola F, Chukwuma EO, Rasheed AB. Prevalence, socio-demographic features and risk factors of Hepatitis B virus infection among pregnant women in Southwestern Nigeria. Pan Afri Med J. 2015;20:6.
  25. Noubiap JJ, Nansseu JR, Ndoula ST, Bigna JJ, Jingi AM. Prevalence, infectivity, and correlates of hepatitis B virus infection among pregnant women in a rural district of the Far-North Region of Cameroon. BMC Public Health. 2015;15:4.
  26. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30:2212–9.
  27. Awoleke JO. Hepatitis B surface antigenaemia among pregnant women in a tertiary health institution in Ekiti state, Nigeria. Trop J Obstet Gynaecol. 2012;29:34–9
  28. Ndams IS, Joshua IA, Lika SA, Sadiq HO. Epidemiology of Hepatitis B infection among pregnant women in Minna, Nigeria. Sci World J. 2008;3:5–8.
  29. Choisy M, Keomalaphet S, Xaydalasouk K, Quet F, Lattaphasavang V, Buisson Y. Prevalence of Hepatitis B virus infection among pregnant women attending antenatal clinics in Vientiane, Laos, 2008-2014. Hepatitis Res Treat. 2017;1:1–5. [PMC free article] [PubMed] [Google Scholar]
  30. USPSTF A and B Recommendations. 2018. [Last accessed on 2019 Mar 14]. Available from: http://wwwuspreventiveservicestaskforceorg/uspstf/recommendation/hepatitis-b-virus-infection-in-pregnant-women-screening .

Leave a Reply

Your email address will not be published. Required fields are marked *

× Make inquiry/Contact us?