1
|
Gedefie A, Debash H, Asmamaw S, Getaneh FB, Alemayehu E, Molla A, Kassaw AB, Kebede B. Epidemiology of an overlapping and parallel infection of Sexually Transmitted Infections among pregnant women in North-east Ethiopia: Its implication for prevention of mother to child transmission. PLoS One 2024; 19:e0300149. [PMID: 38768132 PMCID: PMC11104588 DOI: 10.1371/journal.pone.0300149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/22/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND The burden of parallel and overlapping infections of Sexually Transmitted Infections (STIs), particularly HIV, syphilis, hepatitis B (HBV), and hepatitis C virus (HCV) are disproportionately higher among pregnant women globally, leading to unwanted consequences. These infections pose significant public health challenges as they can be transmitted vertically to the offspring. This study aimed to determine the sero-epidemiological patterns and predictors of STIs (HIV, syphilis, HBV, and HCV) among pregnant women attending antenatal care clinics at ten health facilities in North-eastern Ethiopia. METHODS An institution-based multi-center cross-sectional study was conducted from May to November 2022 among 422 pregnant women selected using simple random sampling technique. Semi-structured questionnaire was used to collect socio-demographic characteristics and predictor variables of STIs through face-to-face interviews. Venous blood was collected and it was tested for anti-HIV, HBsAg, anti-HCV, and anti-Treponemal antibodies using immunochromatographic test kits. Multinomial logistic regression analysis was used to identify associated factors of STIs. Variables with an adjusted odds ratio (AOR) and a p-value <0.05 were considered statistically significant. RESULTS The overall prevalence of STIs was 23.9% (95% CI = 20.08-28.25). The prevalence of parallel infections of HIV, hepatitis B, hepatitis C, and syphilis were 6.4%, 9%, 1.7%, and 6.9%, respectively. The overlapping infections for HIV-HBV was 4% but HIV-HCV overlapping infection wasn't found. Increased age, tattooing, multiple sexual partners, exposure to unsafe sex, and RH status were independent factors of HBV. Likewise, increased age, rural residence, illiteracy, and tattooing were independently associated with HCV. Moreover, rural residence and a history of tattooing were independent predictors for the acquisition of HIV, whereas multiple sexual partners and RH status were found to be significant predictors of syphilis infection among pregnant women. CONCLUSION The magnitude of overlapping and parallel STD infections is still continued to be a problem among pregnant women. Moreover, there were overlapping infections of HBV-HIV. Therefore, continuous screening of pregnant women for HIV, syphilis, hepatitis B, and C infections should be performed, and special attention should be given to pregnant women who have co-infections.
Collapse
Affiliation(s)
- Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Shambel Asmamaw
- Department of Medical Laboratory Sciences, Tropical College of Medicine, Dessie, Ethiopia
| | - Fekadesilassie Belege Getaneh
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Asressie Molla
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Altaseb Beyene Kassaw
- Department of Biochemistry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Berhanu Kebede
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| |
Collapse
|
2
|
Asgedom YS, Kassie GA, Woldegeorgis BZ, Meskele Koyira M, Kebede TM. Seroprevalence of hepatitis B virus infection and factors associated among pregnant women in Ethiopia: A systematic review and meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241235881. [PMID: 38444072 PMCID: PMC10916469 DOI: 10.1177/17455057241235881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/24/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hepatitis B virus infection is a major public health problem among pregnant women worldwide. Hepatitis B virus is highly infectious and is the most common cause of morbidity and mortality among pregnant women, and evidence is scarce on the pooled seroprevalence of hepatitis B virus in Ethiopia. OBJECTIVES This study aimed to investigate the pooled seroprevalence of hepatitis B virus infection and factors associated with pregnant women in Ethiopia. DESIGN A systematic review and meta-analysis was employed in accordance with the Preferred Reporting Items for Systematic Reviews. DATA SOURCES Searches were carried out in biomedical databases such as PubMed/Medline, Science Direct, Web of Science, Google Scholar, Hinari, and the Cochrane Library published in English until June 2023. METHODS Observational study designs were selected. Endnote citation manager was used to collect and organize the search outcomes and remove duplicate articles. The data were extracted using a Microsoft Excel spreadsheet and exported to STATA 16.0 software for the analysis. RESULTS A total of 48 research articles were included in the final analysis. The pooled estimated sero prevalence of hepatitis B virus infection among pregnant women in Ethiopia was 5.78% (95% confidence interval = 5.14, 6.43). History of abortion (odds ratio = 6.56, 95% confidence interval = 4.88, 8.90), history of blood transfusion (odds ratio = 5.74, 95% confidence interval = 4.04, 8.16), history of hospitalization (odds ratio = 5.40, 95% confidence interval = 3.68, 7.94), history of multiple sexual partner (odds ratio = 5.80, 95% confidence interval = 3.71, 9.05), history of surgical procedure (odds ratio = 7.39, 95% confidence interval = 4.16, 13.14), history of tattooing (odds ratio = 4.59, 95% confidence interval = 2.83, 7.43), and history of tooth extraction (odds ratio = 4.46, 95% confidence interval = 2.42, 8.22) were significantly associated with hepatitis B virus infection among pregnant women in Ethiopia. CONCLUSION The overall pooled prevalence of hepatitis B virus infection among pregnant women in Ethiopia is relatively high. Having a history of abortion, blood transfusion, hospitalization, multiple sexual partners, surgical procedures, tattooing, and tooth extraction were found to be risk factors for hepatitis B virus. Therefore, extensive screening programs for hepatitis B virus in all pregnant women in Ethiopia are needed to prevent further infection and decrease the vertical transmission caused by the disease. REGISTRATION NUMBER PROSPERO CRD: 42023438522.
Collapse
|
3
|
Ebogo-Belobo JT, Kenmoe S, Mbongue Mikangue CA, Tchatchouang S, Robertine LF, Takuissu GR, Ndzie Ondigui JL, Bowo-Ngandji A, Kenfack-Momo R, Kengne-Ndé C, Mbaga DS, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Kenfack-Zanguim J, Esemu SN, Tagnouokam-Ngoupo PA, Ndip L, Njouom R. Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020. World J Crit Care Med 2023; 12:264-285. [PMID: 38188451 PMCID: PMC10768416 DOI: 10.5492/wjccm.v12.i5.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health. AIM To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation. METHODS The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test. RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3). CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
Collapse
Affiliation(s)
- Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | | | | | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
| |
Collapse
|
4
|
Getaneh Y, Getnet F, Amogne MD, Liao L, Yi F, Shao Y. Burden of hepatitis B virus and syphilis co-infections and its impact on HIV treatment outcome in Ethiopia: nationwide community-based study. Ann Med 2023; 55:2239828. [PMID: 37498806 PMCID: PMC10375928 DOI: 10.1080/07853890.2023.2239828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and syphilis have been the most common co-infections that hinder treatment outcomes and increase early mortality among people living with human immunodeficiency virus (PLHIV). In this study, we aimed to determine the burden of HBV and syphilis co-infections and its impact on treatment outcomes among PLHIV in Ethiopia. METHODS We used data from the Ethiopian Population-based HIV Impact Assessment (EPHIA), which was a household-based national survey in 2017/2018. Human immunodeficiency virus (HIV) testing was done among 19,136 participants using the national testing algorithm and 662 participants (3.50%) were HIV positives who were further tested for viral hepatitis and syphilis co-infections using HBV surface antigen and Chembio DPP syphilis assay, respectively. Viral load, CD4 count and high-sensitivity C-reactive protein (hsCRP) were done to measure HIV treatment outcomes. Descriptive statistics were used to determine the burden of co-infections and a logistic regression model to evaluate the determinants of co-infections using STATA V17.0. RESULTS Overall prevalence of HBV and syphilis co-infection was 5.5% and 2.2%, respectively. HBV and syphilis (double co-infection) was 5.9%. The highest prevalence of HBV co-infection was observed among 10-19 years age group (12.9%) and male participants (7.44%) while the highest syphilis co-infection was among people aged ≥50 years (3.5%) followed by age groups 40-49 (3.3%) and 10-19 years (3.2%). Syphilis co-infection was higher among males (5.2%) compared to females (1.1%). After adjusted regression analysis, HBV co-infected PLHIV had higher odds of virologic failure (AOR (95% confidence interval (CI)) = 6.3 (4.2-14.3)), immunosuppression (CD4 count < 500 cells/mm3) (AOR (95%CI) = 2.1(1.3-4.9)) and inflammation (hsCRP >10 mg/dL) (AOR (95%CI) = 9.2(4.3-14.6)). Immunosuppression was also significantly higher among syphilis co-infected PLHIV (AOR (95%CI) = 3.4 (1.3-5.2)). CONCLUSIONS Burden of HBV and syphilis co-infections is high particularly among male and adolescent PLHIV and these co-infections hinder virologic and immunologic outcome in Ethiopia. Hence, the program shall enhance HBV and syphilis testing and treatment.
Collapse
Affiliation(s)
- Yimam Getaneh
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fentabil Getnet
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Minilik Demissie Amogne
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Lund University, School of Public Health, Lund, Sweden
| | - Lingjie Liao
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Yi
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiming Shao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
5
|
Tesfu MA, Belay NB, Habtemariam TT. 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. PLoS One 2022; 17:e0273300. [PMID: 36026484 PMCID: PMC9417033 DOI: 10.1371/journal.pone.0273300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Mebrihit Arefaine Tesfu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa Universty, Addis Ababa, Ethiopia
- * E-mail:
| | - Nega Berhe Belay
- Aklilu Lemma Institute of Pathobiology, Addis Ababa Universty, Addis Ababa, Ethiopia
| | | |
Collapse
|
6
|
Argaw B, Kedir S, Mustefa A, Yesse M, Hussen L, Abdella B, Muze M, Jemal M. Sero-Prevalence, Infectivity, and Associated Risk Factors of Hepatitis B Virus Among Pregnant Women Attending Antenatal Care in Sankura Primary Hospital, Silte Zone, Southern Ethiopia, 2021. Open Microbiol J 2022. [DOI: 10.2174/18742858-v16-e2206030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Hepatitis B (HBV) infection causes a major public health problem around the globe. Therefore, this study aimed to assess the Seroprevalence, infectivity, and associated factors of hepatitis B virus infection among pregnant women attending antenatal care in Sankura Primary Hospital, Southern Ethiopia.
Methods:
A cross-sectional study design was conducted in Sankura Primary Hospital, Southern Ethiopia, from April to June 2020. A total of 338 pregnant women were recruited using systematic random sampling. Sociodemographic and associated risk factors were collected through a structured questionnaire. Blood samples and plasma analysis were performed for the presence of hepatitis B surface antigen (HBsAg) and hepatitis B envelope antigen (HBeAg) using the rapid test strip method. Statistical analysis was done using SPSS version 20, and P-value < 0.05 was considered statistically significant.
Results:
The overall Seroprevalence of HBsAg was 11 (3.3%) [95% CI 1.5% - 5.0%], of whom 2 (18.2%) were positive for HBeAg. In multivariate analysis, a history of blood transfusion [AOR=4.8 95% CI (1.25-6.69)] and contact with a family history of the liver [AOR=5.7 95% CI (1.28-7.9)] was found to be significant predictors of HBV infections.
Conclusion:
The Seroprevalence of HBV infection among pregnant women in the study area was intermediate. Family history of liver disease and blood transfusion were risk factors associated with HBV infection. Hence, improving the screening of blood, increasing awareness about the transmission of HBV infection, and screening pregnant women for HBV infection should be implemented. The government will build efficient service delivery models equipped with an appropriate and well-trained workforce.
Collapse
|
7
|
Tadesse M, Tafesse G, Hajare ST, Chauhan NM. Assessment of Prevalence of Hepatitis B Virus and its Associated Factors among Pregnant Women from Wolaita Sodo, Ethiopia. JOURNAL OF CLINICAL VIROLOGY PLUS 2022. [DOI: 10.1016/j.jcvp.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
8
|
Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis. Infect Dis Obstet Gynecol 2020; 2020:9418475. [PMID: 32577077 PMCID: PMC7305536 DOI: 10.1155/2020/9418475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/23/2020] [Indexed: 12/20/2022] Open
Abstract
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.
Collapse
|
9
|
Weldesenbet H, Asrat D, Weldeamanuel Y. The prevalence and associated factors of Treponema pallidum among HIV-positive and HIV-negative individuals who attended voluntary counseling and testing center of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design. SAGE Open Med 2020; 8:2050312120904604. [PMID: 32110402 PMCID: PMC7026812 DOI: 10.1177/2050312120904604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers. Objectives: This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20. Results: The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum. Conclusion: In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV. Recommendation: There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.
Collapse
Affiliation(s)
- Habtamu Weldesenbet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Weldeamanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
10
|
Bafa TA, Egata AD. Seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic of Atat Hospital, Southern Ethiopia. SAGE Open Med 2020; 8:2050312119900870. [PMID: 32002184 PMCID: PMC6963336 DOI: 10.1177/2050312119900870] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Temesgen Abera Bafa
- Department of Medical laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Andamlak Dendir Egata
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| |
Collapse
|
11
|
Kebede KM, Abateneh DD, Belay AS, Manaye GA. The epidemiology of syphilis in Ethiopia: a protocol for systematic review and meta-analysis covering the last three decades. Syst Rev 2019; 8:210. [PMID: 31439009 PMCID: PMC6706880 DOI: 10.1186/s13643-019-1136-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 08/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Several individual epidemiological studies in Ethiopia suggest that syphilis is a public health problem. However, to the best of our knowledge, there is no synthesized and meta-analysis data on the epidemiology of syphilis in Ethiopia. This systematic review and meta-analysis aimed to summarize and synthesize existing data on the prevalence of syphilis in Ethiopia. METHOD Studies reporting the prevalence of syphilis will be identified from major databases and gray literature. The major databases (MEDLINE/PubMed, EMBASE, Web of Science, CINAHL, The Cochrane Library, Lilacs, and African journal online) and gray literature (Google Scholar search engine, official WHO and CDC websites, the online library of academic and governmental institutions in Ethiopia) will be searched. Studies published/reported from 1 January 1990 to 1 January 2019 will be included to have a contemporary estimation. A random-effect meta-analysis of prevalence will be used after stabilizing the variance of included studies using a single arc transformation. The quality of the included studies will be assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments. Heterogeneity and publication bias will be assessed. If significant heterogeneity is detected, subgroup analysis will be done using study region, study population, diagnostic assay/syphilis screening tool, median sample size, year of data collection, study sites, sampling method, and methodological quality as grouping variables. DISCUSSION This systematic review and meta-analysis intend to contribute an improved knowledge on the epidemiology of syphilis in Ethiopia. Knowledge about the epidemiology of syphilis may help policymakers and other stakeholders to allocate resources and target interventions for the prevention and elimination of syphilis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018116231.
Collapse
Affiliation(s)
- Kindie Mitiku Kebede
- Department of Public Health, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Dejene Derseh Abateneh
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Alemayehu Sayih Belay
- Department of Nursing, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Gizachew Ayele Manaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| |
Collapse
|
12
|
Ngoma AM, Mutombo PB, Omokoko MD, Mvika ES, Nollet KE, Ohto H. Prevalence and Molecular Epidemiology of Human T-Lymphotropic Virus Type 1 among Women Attending Antenatal Clinics in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2019; 101:908-915. [PMID: 31407658 DOI: 10.4269/ajtmh.19-0182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) imposes a substantial disease burden in sub-Saharan Africa (SSA), which is arguably the world's largest endemic area for HTLV-1. Evidence that mother-to-child transmission persists as a major mode of transmission in SSA prompted us to estimate the pooled prevalence of HTLV-1 among pregnant women throughout the region. We systematically reviewed databases including EMBASE, MEDLINE, Web of Science, and the Cochrane Database of Systemic Reviews from their inception to November 2018. We selected studies with data on HTLV-1 prevalence among pregnant women in SSA. A random effect meta-analysis was conducted on all eligible data and heterogeneity was assessed through subgroup analyses. A total of 18 studies, covering 14,079 pregnant women, were selected. The evidence base was high to moderate in quality. The pooled prevalence, per 100 women, of the 18 studies that screened HTLV-1 was 1.67 (95% CI: 1.00-2.50), a figure that masks regional variations. In Western, Central, Southern, and Eastern Africa, the numbers were 2.34 (1.68-3.09), 2.00 (0.75-3.79), 0.30 (0.10-0.57), and 0.00 (0.00-0.21), respectively. The prevalence of HTLV-1 infection among pregnant women in SSA, especially in Western and Central Africa, strengthens the case for action to implement routine screening of pregnant women for HTLV-1. Rigorous studies using confirmatory testing and molecular analysis would characterize more accurately the prevalence of this infection, consolidate the evidence base, and further guide beneficial interventions.
Collapse
Affiliation(s)
- Alain M Ngoma
- Douglas Hospital Research Centre, McGill University, Montreal, Canada
| | - Paulin B Mutombo
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Magot D Omokoko
- Hôpital de la Cité-de-la Santé, Affiliated to the University of Montreal, Laval, Canada
| | - Eddy S Mvika
- Centre National de Transfusion Sanguine, Kinshasa, Democratic Republic of the Congo
| | - Kenneth E Nollet
- Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan.,Department of Blood Transfusion and Transplantation Immunology and Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center, Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
13
|
Hussen S, Tadesse BT. Prevalence of Syphilis among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4562385. [PMID: 31392211 PMCID: PMC6662498 DOI: 10.1155/2019/4562385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/20/2019] [Accepted: 06/27/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. DESIGN Systematic review and meta-analysis. DATA SOURCES Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. DATA EXTRACTION Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. RESULTS The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. CONCLUSION This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.
Collapse
Affiliation(s)
- Siraj Hussen
- School of Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| |
Collapse
|
14
|
Rosadas C, Taylor GP. Mother-to-Child HTLV-1 Transmission: Unmet Research Needs. Front Microbiol 2019; 10:999. [PMID: 31134031 PMCID: PMC6517543 DOI: 10.3389/fmicb.2019.00999] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/18/2019] [Indexed: 02/04/2023] Open
Abstract
Mother-to-child transmission (MTCT) of Human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection. At least 5–10 million individuals worldwide are currently living with HTLV-1. Studies of regional variation are required to better understand the contribution of MTCT to the global burden of infection. Although most infected individuals remain asymptomatic ∼10% develop high morbidity, high mortality disease. Infection early in life is associated with a higher risk of disease development. Adult T-cell leukemia (ATL), which is caused by HTLV-1 and has a median survival of 8 months is linked to MTCT, indeed evidence of ATL following infection as an adult is sparse. Infective dermatitis also only occurs following neonatal infection. Whilst HTLV-1-associated myelopathy (HAM) follows sexual and iatrogenic infection approximately 30% of patients presenting with HAM/TSP acquired the infection through their mothers. HAM/TSP is a disabling neurodegenerative disease that greatly impact patient’s quality of life. To date there is no cure for HTLV-1 infection other than bone marrow transplantation for ATL nor any measure to prevent HTLV-1 associated diseases in an infected individual. In this context, prevention of MTCT is expected to contribute disproportionately to reducing both the incidence of HTLV-1 and the burden of HTLV-1 associated diseases. In order to successfully avoid HTLV-1 MTCT, it is important to understand all the variables involved in this route of infection. Questions remain regarding frequency and risk factors for in utero peri-partum transmission whilst little is known about the efficacy of pre-labor cesarean section to reduce these infections. Understanding the contribution of peripartum infection to the burden of disease will be important to gauge the risk-benefit of interventions in this area. Few studies have examined the impact of HTLV-1 infection on fertility or pregnancy outcomes nor the susceptibility of the mother to infection during pregnancy and lactation. Whilst breast-feeding is strongly associated with transmission and avoidance of breast-feeding a proven intervention little is known about the mechanism of transmission from the breast milk to the infant and there have been no clinical trials of antiretroviral therapy (ARV) to prevent this route of transmission.
Collapse
Affiliation(s)
- Carolina Rosadas
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
15
|
Geremew D, Tajebe F, Ambachew S, Endalamaw A, Eshetie S. Seroprevalence of HIV among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Res Notes 2018; 11:908. [PMID: 30567589 PMCID: PMC6299960 DOI: 10.1186/s13104-018-4022-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 12/15/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to determine the pooled prevalence of HIV among pregnant women in Ethiopia. RESULT PubMed, EMBASE, Science Direct and Google scholar databases were searched to retrieve 15 relevant articles based on the inclusion criteria. A total of 13,746 participants were included in the original studies and considered in this analysis. Among subjects, 717 were infected with HIV only, and 12 were HIV-HBV co-infected pregnant women. In this meta-analysis, the pooled prevalence of HIV among pregnant women in Ethiopia was 5.74% (95% CI 3.96-7.53%). Regional analysis showed that 9.50% (95% CI 7.76-11.23%) in Amhara, 4.80% (95% CI 3.12-6.49%) in Addis Ababa, 2.14% (95% CI - 0.54 to 4.82%) in SNNP and 4.48% (95% CI 2.56-6.41%) in Oromia region. Besides, six studies reported HIV-HBV co-infection and the pooled prevalence was 0.68% (95% CI 0.27-1.08%) among pregnant women in Ethiopia.
Collapse
Affiliation(s)
- Demeke Geremew
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Fitsumbrhan Tajebe
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Eshetie
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
16
|
Malekifar P, Babanejad M, Izadi N, Alavian SM. The Frequency of HBsAg in Pregnant Women from Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis. HEPATITIS MONTHLY 2018; In Press. [DOI: 10.5812/hepatmon.58830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
17
|
Prevalence, Infectivity, and Associated Risk Factors of Hepatitis B Virus among Pregnant Women in Yirgalem Hospital, Ethiopia: Implication of Screening to Control Mother-to-Child Transmission. J Pregnancy 2018; 2018:8435910. [PMID: 30174956 PMCID: PMC6098924 DOI: 10.1155/2018/8435910] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 06/30/2018] [Accepted: 07/15/2018] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive mother has up to 90% likelihood of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) to newborns in the absence of any prophylaxis or antiviral therapy utilization. However, routine antenatal screening and intervention strategies are not yet practiced in Ethiopia. Therefore, this study was conducted to determine the prevalence, infectivity, and associated risk factors of HBV among pregnant women. Methods A cross-sectional study was conducted from October 2015 to August 2016 in Yirgalem Hospital. A total of 475 pregnant women were recruited, and data on sociodemography and potential risk factors were collected using a structured questionnaire. In addition, blood samples were tested for HBsAg, and HBsAg positive samples were retested for HBeAg using commercially available strip test. The status of HIV was collected from the records. Results The seroprevalence of HBsAg was 34 (7.2%), of whom 13 (38.8%) were positive for HBeAg. The prevalence of HIV infection was 10.1% (48/475). Ten out of 34 HBV positive cases (29.4%) were coinfected with HIV. The overall HBV/HIV coinfection rate was 2.1% (10/475). Women with history of multiple sexual partners and being HIV positive were significantly associated with HBsAg positivity. Among the study participants, 35.4% were aware of MTCT of HBV and only 12 (2.5%) have taken HBV vaccine. Conclusions High prevalence of HBsAg and HBeAg as well as low awareness and practices of HBV prevention methods suggests that perinatal transmission of HBV might be the prevailing mode of HBV transmission in the study area. Thus, screening of all pregnant women, particularly those who had history of multiple sexual partners and HIV coinfection, and provision of health education about HBV prevention methods are inevitable.
Collapse
|
18
|
Kebede KM, Abateneh DD, Belay AS. Hepatitis B virus infection among pregnant women in Ethiopia: a systematic review and Meta-analysis of prevalence studies. BMC Infect Dis 2018; 18:322. [PMID: 29996785 PMCID: PMC6042274 DOI: 10.1186/s12879-018-3234-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/03/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There are several epidemiological studies available on hepatitis B virus among pregnant women in Ethiopia. These individual studies revealed wide variation over time and across geographical areas. The aim of this systematic review and Meta-analysis is to estimate the overall prevalence of hepatitis B virus infection among pregnant women in Ethiopia. METHODS A comprehensive search of electronic databases including PubMed, Popline, Lalicus, Ovid, MedNar, African Journal Online (AJOL) and advanced Google Scholar was conducted regardless of publication year from August 30, 2017 to September 25, 2017. The search was updated on January 02, 2018 to minimize time-lag bias. The methodological qualities of included studies were assessed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments. RESULTS Out of 103 studies, 17 studies with a total of 5629 pregnant women were included in the Meta-analysis. The pooled prevalence of hepatitis B virus infection among pregnant women using random-effect model was 4.7%(95% CI 4.0-5.4%). The I2 statistics was I2 = 37.9%(p = 0.0575). Even though significant heterogeneity among studies was not detected, the I2 = 37.9% suggests medium heterogeneity. A subgroup Meta-analysis showed that study site, region, mean/median sample size, hepatitis B virus screening methods and methodological quality were not source of heterogeneity (p-difference > 0.05). CONCLUSION This review shows an intermediate level of hepatitis B virus infection among pregnant women in Ethiopia. In addition to the current practice of child vaccination, routine and universal antenatal hepatitis B virus screening program need to be implemented.
Collapse
Affiliation(s)
- Kindie Mitiku Kebede
- Department of Public Health, College of Health Sciences, Mizan -Tepi University, PO.box 260, Mizan-Teferi, Ethiopia
| | - Dejene Derseh Abateneh
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan -Tepi University, Mizan-Teferi, Ethiopia
| | - Alemayehu Sayih Belay
- Department of Nursing, College of Health Sciences, Mizan -Tepi University, Mizan-Teferi, Ethiopia
| |
Collapse
|
19
|
Prevalence of Curable Sexually Transmitted Infections in Pregnant Women in Low- and Middle-Income Countries From 2010 to 2015: A Systematic Review. Sex Transm Dis 2017; 43:450-8. [PMID: 27322048 DOI: 10.1097/olq.0000000000000460] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current literature comparing the prevalence rates of curable sexually transmitted infections (STIs) in pregnant women in various global regions is limited. As a result, antenatal screening practices for curable STIs in pregnant women, specifically Treponema pallidum (syphilis), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) vary around the world, differing by country and particular STI. METHODS We conducted a systematic review of publications on STI prevalence among pregnant women in 30 different low- and middle-income countries. We searched PubMed for studies reporting prevalence of syphilis, CT, NG, and TV in pregnant women. English language studies published between January 1, 2010, and March 1, 2015, were included. The adjusted mean STI prevalence by region was calculated via multivariable linear regression adjusting for health care setting, women's mean age, study sample size, and sensitivity of diagnostic test. RESULTS We identified 75 studies that met inclusion criteria, providing 116 point prevalence estimates for curable STIs among 3,489,621 pregnant women. Adjusted mean prevalence for NG ranged from 1.2% (95% confidence interval [CI], 1.0-1.3) in Latin America to 4.6% (95% CI, 4.0-5.2) in Southern Africa; syphilis prevalence ranged from 1.1% (95% CI, 0.5-1.6) in Asia to 6.5% (95% CI, 4.7-6.3) in Southern Africa; CT ranged from 0.8% (95% CI, 0.4-1.1) in Asia to 11.2% (95% CI, 6.0-16.4) in Latin America; and TV ranged from 3.9% (95% CI, 2.2-5.6) in Latin America to 24.6% (95% CI, 17.9-31.4) in Southern Africa. CONCLUSIONS Although we observed a wide variation in STI burden in pregnancy after adjusting for age, test, and health care setting, further valid comparison may depend on adjustment for access to care and screening practices.
Collapse
|
20
|
Geremew RA, Agizie BM, Bashaw AA, Seid ME, Yeshanew AG. Prevalence of Selected Sexually Transmitted Infection (STI) and Associated Factors among Symptomatic Patients Attending Gondar Town Hospitals and Health Centers. Ethiop J Health Sci 2017; 27:589-600. [PMID: 29487468 PMCID: PMC5811938 DOI: 10.4314/ejhs.v27i6.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Sexually transmitted infection (STI) is a major global cause of acute illness, infertility, long-term disability and death, with serious medical and psychological consequences to millions of men, women and infants. Moreover, in Ethiopia, epidemiological studies on STI among STI clinic clients are limited. Therefore, the aim of this study was to determine the prevalence and associated risk factors of sexually transmitted infection (STI). METHODS A cross sectional study was conducted between April and August 2014 among STI clinic clients in Gondar Town hospitals and health centers. One hundred twenty study participants who fulfill the criteria were included. Different laboratory methods and techniques were applied to identify the possible microorganisms. Data were entered and analyzed using SPSS version 20. Logistic regression was used to determine risk factors for STI and P values < 0.05 was considered statistically significant. RESULTS The overall laboratory test confirmed that STIs prevalence was 74.1% with 32.5% being Candida spp., 30% T. palladium, 20.8% N. gonorrhoeae and 14.2% T. vaginalis. Two or more organisms were isolated in 20% of the study subjects. Risk factors for STI had knowledge about STI and alcohol consumption. CONCLUSION The prevalence of N. gonorrhoeae, T. pallidum, T. vaginalis, and Candida spp. in the study area was high. It needs health education programs, promotes condom utilization and more comprehensive community based STI studies.
Collapse
Affiliation(s)
- Rozina Ambachew Geremew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Beyene Moges Agizie
- School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Abate Assefa Bashaw
- School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Mengistu Endris Seid
- School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Addisu Gize Yeshanew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| |
Collapse
|
21
|
Chernet A, Yesuf A, Alagaw A. Seroprevalence of Hepatitis B virus surface antigen and factors associated among pregnant women in Dawuro zone, SNNPR, Southwest Ethiopia: a cross sectional study. BMC Res Notes 2017; 10:418. [PMID: 28830531 PMCID: PMC5567916 DOI: 10.1186/s13104-017-2702-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/29/2017] [Indexed: 01/16/2023] Open
Abstract
Background Hepatitis B is the world’s most common serious liver infection. Infection by hepatitis B virus during pregnancy has high rate of vertical transmission and adverse effect on both the mother and child. Data on seroprevalence and associated factors among pregnant women in Dawuro or surrounding was scarce. Therefore, the aim of this study was to assess prevalence of hepatitis B virus and factors associated among pregnant women in Dawuro Zone. Methods Institution based cross-sectional study was conducted from 1st April to May 31, 2015 in Dawuro zone. Venous blood was collected, plasma was separated and hepatitis B virus surface antigen was screened using rapid test. Logistic regression was employed with 95% CI and p value of <0.05 was used as statistically significant. Results Data were collected on 289 women. The overall prevalence from this study was (p = 3.5%, 95% CI 1.4–5.6%) multivariate analysis using logistic regression showed multiple sexual partner (AOR = 6.923; 95% CI 1.685–28.441), and abortion history (AOR = 4.975; 95% CI 1.21–20.456), were significantly associated with hepatitis B virus surface antigen (HBsAg) infection. Conclusion This seroprevalence was categorized as intermediate endemicity according to WHO classification criteria. Health education on sexual transmission of hepatitis B virus and inclusion of screening hepatitis b virus as routine antenatal care service is recommended.
Collapse
Affiliation(s)
- Asrat Chernet
- Epidemiology and Biostatistics, Public Health Emergency Management Officer, Dawuro Zone Health Department, SNNPR, PO Box: 20, Dawuro, Ethiopia.
| | - Aman Yesuf
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, PO Box: 21, Arba Minch, Ethiopia
| | - Amsalu Alagaw
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, PO Box: 21, Arba Minch, Ethiopia
| |
Collapse
|
22
|
Breakwell L, Tevi-Benissan C, Childs L, Mihigo R, Tohme R. The status of hepatitis B control in the African region. Pan Afr Med J 2017; 27:17. [PMID: 29296152 PMCID: PMC5745934 DOI: 10.11604/pamj.supp.2017.27.3.11981] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/10/2017] [Indexed: 01/05/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Lucy Breakwell
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carol Tevi-Benissan
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Lana Childs
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Mihigo
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Rania Tohme
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
23
|
Manyahi J, Msigwa Y, Mhimbira F, Majigo M. High sero-prevalence of hepatitis B virus and human immunodeficiency virus infections among pregnant women attending antenatal clinic at Temeke municipal health facilities, Dar es Salaam, Tanzania: a cross sectional study. BMC Pregnancy Childbirth 2017; 17:109. [PMID: 28388879 PMCID: PMC5383970 DOI: 10.1186/s12884-017-1299-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 03/29/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and Human immunodeficiency virus (HIV) infection in pregnancy is associated with direct effect of pregnancy and potential viral transmission from mother to newborn. In Tanzania very little in known on prevalence of HBV infection and their associated factors among pregnant women in lower health facilities. The main objective of the study was to determine the prevalence of HBsAg, HIV and HBV-HIV co-infection among pregnant women attending antenatal clinics in Dar es Salaam. METHODS This cross sectional study was conducted in three Temeke municipal health-care facilities between May 2014 and June 2014. A total of 249 pregnant women attending antenatal clinic (ANC) were consecutively enrolled in the study. A data collection tool was used to extract socio-demographic characteristics from ANC card. Commercial ARCHITECT® ci4100™ was used to assess HBsAg status and liver function (Alanine amino-transferase (ALAT). HIV status was determined by anti-HIV antibody test. RESULTS Of 249 pregnant women enrolled the median age was 25 years (IQR 22-30) and most of them were married (72.4%). The overall prevalence of HBsAg and HIV were 8.03% (95% CI: 5.0-12.1%) and 17.2% (95% CI: 12.8-22.5%), respectively. HBV/HIV co-infection rate was 2.8% (95% CI; 1.3-5.4%). HBsAg positive rate was significantly high in women who were HIV positive (p < 0.05). Being employed /student were less associated with HBV infection (aOR 0.35, 95% CI 0.13-0.95). Only 3 (15%) of pregnant women with HBsAg positive had abnormal ALAT. CONCLUSIONS High prevalence of HBV and HIV infections among pregnant women were reported in this setting thus calls for the national expansion of the integration of prevention of mother-to-child transmission (PMTCT) services for HBV infection.
Collapse
Affiliation(s)
- Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Yohannes Msigwa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| |
Collapse
|
24
|
Umare A, Seyoum B, Gobena T, Haile Mariyam T. Hepatitis B Virus Infections and Associated Factors among Pregnant Women Attending Antenatal Care Clinic at Deder Hospital, Eastern Ethiopia. PLoS One 2016; 11:e0166936. [PMID: 27898721 PMCID: PMC5127527 DOI: 10.1371/journal.pone.0166936] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 11/07/2016] [Indexed: 12/18/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is a serious public health problem worldwide. Reports have shown that 68,600 people die of HBV infection and more than 300,000 deaths due to liver cancer secondary to hepatitis B every year globally. Women who are infected with HBV can vertically transmit the infection to their infants. This study aims to determine the prevalence of HBV infection and associated factors among pregnant women. Methods and Findings A hospital-based cross-sectional study was conducted among pregnant women who attended antenatal care clinic (ANC) for routine pregnancy check-up between 18 March 2015 and 15 May 2015. Data were collected by face to face interview using a pre-tested questionnaire. Serum was withdrawn for each study subject and used to test for Hepatitis B Surface Antigen (HBsAg) by an enzyme linked immunosorbent assay (ELISA) test kit. Binary logistic regression analysis was used to examine the association between explanatory variables and outcome variable. The prevalence of HBV infection was found to be 6.9%. Interestingly, the history of abortion (AOR 10.9; 95% CI: 2.2–53.9), nose piercing (AOR 9.1; 95% CI: 1.34–61.79), surgical procedure (AOR 12.8; 95% CI: 1.68–97.06) and history of multiple sexual partners (AOR 16.8; 95% CI: 3.18–89.06) were significant predictors of HBV infection. Conclusions This study determined that the prevalence of HBV infection among pregnant women was 6.9%, implying that it is high-intermediate endemic area, which is important public health issue needs to be addressed. History of abortion, nose piercing, surgical procedures and multiple sexual partners were significantly associated with this viral infection. Accordingly we advocate that health education programs on the mode of HBV transmission, high-risk behaviors and methods of preventions should be instituted at antenatal care clinics to raise the awareness of mothers and limit the spread of infection. It is also advisable to implement nosocomial infection prevention strategies to prevent the transmissions of HBV through health care related activities such as surgical procedures. Furthermore, all pregnant women should be screened for HBV, treated if necessary to reduce their viral loads and their children vaccinated at birth with the single-dose hepatitis B vaccine to break the cycle of mother-to-child transmission.
Collapse
Affiliation(s)
- Abdi Umare
- Department of Medical Laboratory, Deder Hospital, Deder, Ethiopia
- * E-mail:
| | - Berhanu Seyoum
- Department of Microbiology Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | | |
Collapse
|
25
|
Moghaddasifar I, B. Lankarani K, Moosazadeh M, Afshari M, Malary M. Prevalence of Hepatitis B Virus infection among Pregnant Women in Iran: A Systematic Review and Meta-analysis. IRANIAN JOURNAL OF CANCER PREVENTION 2016. [DOI: 10.17795/ijcp-3703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
26
|
Metaferia Y, Dessie W, Ali I, Amsalu A. Seroprevalence and associated risk factors of hepatitis B virus among pregnant women in southern Ethiopia: a hospital-based cross-sectional study. Epidemiol Health 2016; 38:e2016027. [PMID: 27336446 PMCID: PMC4974445 DOI: 10.4178/epih.e2016027] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/19/2016] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES: Hepatitis B virus (HBV) is a major blood-borne and sexually transmitted infectious agent that is a significant global public health issue. The aim of this study was to determine the seroprevalence and risk factors of HBV among pregnant women attending the antenatal clinic of the Hawassa University referral hospital in Ethiopia. METHODS: A cross-sectional study was conducted from April to May, 2015. A total of 269 consecutive pregnant women attending antenatal consultations were enrolled. Sociodemographic information and data regarding possible risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) screening was performed using an enzyme-linked immunosorbent assay, and the data were analyzed. RESULTS: The overall seroprevalence of HBsAg among the 269 participants enrolled in the study was 7.8% (n=21). The prevalence of human immunodeficiency virus (HIV) infection was 5.2% (n=14), of whom two participants (14.2%) were also positive for HBsAg. Study participants with no formal education (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.27 to 10.68; p<0.05) were more likely to be infected with HBV than those who had completed at least secondary school. Although HBsAg was detected more often in pregnant women who had multiple exposure factors (8.8%, n=13) than in pregnant women who had not experienced possible risk factors (4%, n=1), this difference was not statistically significant (OR, 2.33; 95%CI, 0.29 to 18.63). CONCLUSIONS: A high prevalence of HBV infection was detected in the study population. Neither the type of risk factors nor exposure to multiple risk factors was significantly associated with HBV infection. Hence, screening pregnant women regardless of risk factors and improving awareness of the transmission routes of HBV within this group may reduce the risk of HBV infections.
Collapse
Affiliation(s)
- Yeshi Metaferia
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Walelign Dessie
- Department of Medical Laboratory Sciences, School of Allied Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ibrahim Ali
- Department of Medical Laboratory Sciences, School of Allied Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anteneh Amsalu
- Department of Medical Microbiology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
27
|
Desalegn Z, Wassie L, Beyene HB, Mihret A, Ebstie YA. Hepatitis B and human immunodeficiency virus co-infection among pregnant women in resource-limited high endemic setting, Addis Ababa, Ethiopia: implications for prevention and control measures. Eur J Med Res 2016; 21:16. [PMID: 27075475 PMCID: PMC4831185 DOI: 10.1186/s40001-016-0211-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 04/06/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hepatitis, a highly contagious viral infection, is one of the leading killer diseases globally caused by hepatitis virus. Among the existing viral causes for hepatic failure, hepatitis B virus (HBV) plays a significant role with devastating implications, especially when combined with other viral infections such as human immunodeficiency virus (HIV). Co-infection with hepatitis B virus and HIV leads to increased morbidity and mortality as compared to independent HIV and HBV infections. In this study, we aimed to assess the seroprevalence of HBV and HIV coinfection and associated risk factors among pregnant women in a selected hospital facility around Addis Ababa, Ethiopia. METHODS A total of 215 pregnant women were recruited between July and October 2014 from Tirunesh Beijing General Hospital. A pretested and structured questionnaire was used to collect socio-demographic characteristics and possible risk factors. In addition, 5 ml venous blood was collected and centrifuged to estimate the seroprevalence of HBV and HIV. Descriptive statistics and logistic regression analysis were done and a P value less than 0.05 was considered statistically significant. RESULTS The overall prevalence of hepatitis B virus infection was 13 (6%). This positivity was different across different age categories: 1 (11.1%), 3 (4.5%), 6 (6%), 1 (3.2%), and 2 (25%) among those between 15-19, 20-24, 25-29, 30-34, and 35-39 years, respectively. However, a statistically significant association was not established between age and HBV. Among the total, 9 (4.2%) of the positive cases were detected among primary school completed. Multivariate analyses indicated that history of abortion (p = 0.003), history of surgery (p = 0.0.022), and tattooing (p = 0.033) were significantly associated with HBV infection. A total of 9 (4.2%) women were found to be HIV seropositive, of whom 2 (22.2%) were co-infected with HBV. CONCLUSIONS We observed a relatively higher seroprevalence of HBV infection among pregnant women in the study area, in which majority of the cases had underlying risk factors for acquiring the infection. Since none of the mothers were vaccinated for HBV, the possibility of perinatal transmission is inevitable. Hence, routine screening and immunization against HBV during pregnancy and health education are highly warranted to alleviate the situation.
Collapse
Affiliation(s)
- Zelalem Desalegn
- />Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, P. O. Box: 9086, Addis Ababa, Ethiopia
| | - Liya Wassie
- />Armauer Hansen Research Institute (AHRI), Jimma Road, ALERT Campus, Addis Ababa, Ethiopia
| | - Habtamu Bedimo Beyene
- />Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, P. O. Box: 9086, Addis Ababa, Ethiopia
| | - Adane Mihret
- />Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, P. O. Box: 9086, Addis Ababa, Ethiopia
- />Armauer Hansen Research Institute (AHRI), Jimma Road, ALERT Campus, Addis Ababa, Ethiopia
| | - Yehenew A. Ebstie
- />Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, P. O. Box: 9086, Addis Ababa, Ethiopia
| |
Collapse
|
28
|
Fox JM, Mutalima N, Molyneux E, Carpenter LM, Taylor GP, Bland M, Newton R, Martin F. Seroprevalence of HTLV-1 and HTLV-2 amongst mothers and children in Malawi within the context of a systematic review and meta-analysis of HTLV seroprevalence in Africa. Trop Med Int Health 2016; 21:312-24. [PMID: 26700941 PMCID: PMC4819700 DOI: 10.1111/tmi.12659] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Human T-lymphotropic virus (HTLV)-1 causes T-cell leukaemia and myelopathy. Together with HTLV-2, it is endemic in some African nations. Seroprevalence data from Malawi are scarce, with no reports on associated disease incidence. HTLV seroprevalence and type were tested in 418 healthy mothers from Malawi. In addition, we tested the sera of 534 children to investigate mother-to-child transmission. To provide context, we conducted a systematic review and meta-analysis of HTLV seroprevalence in African women and children. METHODS Stored samples from a previous childhood cancer and BBV study were analysed. ELISA was used for HTLV screening followed by immunoblot for confirmation and typing. Standard methods were used for the systematic review. RESULTS HTLV seroprevalence was 2.6% (11/418) in mothers and 2.2% (12/534) in children. Three mothers carried HTLV-1 alone, seven had HTLV-2 and one was dually infected. Three children carried HTLV-1 alone, seven had HTLV-2 and two were dually infected. Only two corresponding mothers of the 12 HTLV-positive children were HTLV positive. The systematic review included 66 studies of women and 13 of children conducted in 25 African countries. Seroprevalence of HTLV-1 varied from 0 to 17% and of HTLV-2 from 0 to 4%. CONCLUSIONS In contrast to findings from other studies in Africa, the seroprevalence of HTLV-2 was higher than that of HTLV-1 in Malawi and one of the highest for the African region. The lack of mother-child concordance suggests alternative sources of infection among children. Our data and analyses contribute to HTLV prevalence mapping in Africa.
Collapse
Affiliation(s)
- James M Fox
- Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, UK
| | - Nora Mutalima
- Health Sciences, University of York, York, UK.,Department of Orthopaedic Surgery, Monash Health, Melbourne, Australia
| | - Elizabeth Molyneux
- Paediatric Department, College of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Graham P Taylor
- National Centre for Human Retrovirology/HTLV clinic, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | | | - Robert Newton
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Fabiola Martin
- Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, UK
| |
Collapse
|
29
|
Melku M, Kebede A, Addis Z. Magnitude of HIV and syphilis seroprevalence among pregnant women in Gondar, Northwest Ethiopia: a cross-sectional study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2015; 7:175-82. [PMID: 26082663 PMCID: PMC4459633 DOI: 10.2147/hiv.s81481] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Human immunodeficiency virus (HIV) and syphilis are major public health problems in sub-Saharan Africa, causing numerous adverse pregnancy outcomes. The aim of study was to assess the magnitude of HIV and syphilis seroprevalence among pregnant women at University of Gondar Teaching Hospital. Method The study was conducted between March and May, 2012. Sociodemographic data were collected through face-to-face interview. HIV1/2 was tested following current national HIV1/2 testing algorithm. Syphilis infection was also tested using the rapid plasm reagin test for screening and Treponema pallidum hemagglutination as a confirmatory test. Both bivariate and multivariate analysis were used to identify factors associated with HIV and syphilis seroprevalence from selected sociodemographic variables. Results Of 300 women, 31 (10.33%), eleven (3.7%), and three (1%) were seroreactive for HIV, syphilis, and HIV–syphilis coinfection, respectively. High seroprevalence of HIV was found in women ages 25–30 years (13.4%), and women whose husbands attended primary school (19.7%). Syphilis was high in women occupationally housewives (15.2%) and whose husbands were illiterate (11.5%). HIV was associated with husband illiteracy (AOR [adjusted odds ratio] of 4.13, 95% CI [confidence interval] [1.01, 16.95]) and primary educational level of husbands (AOR [95% CI] =3.83 [1.50, 9.90]), whereas syphilis was associated with illiteracy of husband (AOR [95% CI] =7.25 [1.74, 30.30]). Conclusion Seroprevalence of HIV and syphilis was high. Low husband educational status was a risk factor for HIV and syphilis. Therefore, substantial efforts have to be made to reinforce prevention strategies and to screen as early as possible to prevent mother-to-child and further horizontal transmission.
Collapse
Affiliation(s)
- Mulugeta Melku
- Department of Hematology and Immuohematology, School of Biomedical and Laboratory Sciences, University of Gondar Teaching Hospital, Gondar, Ethiopia
| | - Asmarie Kebede
- Department of Nursing, University of Gondar Teaching Hospital, Gondar, Ethiopia
| | - Zelalem Addis
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
30
|
Matthews PC, Geretti AM, Goulder PJR, Klenerman P. Epidemiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa. J Clin Virol 2014; 61:20-33. [PMID: 24973812 DOI: 10.1016/j.jcv.2014.05.018] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 05/22/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023]
Abstract
Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research.
Collapse
Affiliation(s)
- Philippa C Matthews
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK
| | - Philip J R Goulder
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Paediatrics, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Paul Klenerman
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK; NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| |
Collapse
|
31
|
Howell J, Lemoine M, Thursz M. Prevention of materno-foetal transmission of hepatitis B in sub-Saharan Africa: the evidence, current practice and future challenges. J Viral Hepat 2014; 21:381-96. [PMID: 24827901 DOI: 10.1111/jvh.12263] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/01/2014] [Indexed: 12/14/2022]
Abstract
Hepatitis B (HBV) infection is highly endemic in sub-Saharan Africa (SSA), where more than 8% of the population remain chronic HBV carriers. SSA has one of the highest HBV-related liver cancer rates in the world (CA Cancer J Clin, 55, 2005, 74) and HBV-related liver cancer is the most common cause of premature death in West Africa (Lancet Oncol, 9, 2008, 683; Hepatology, 39, 2004, 211). As such, HBV represents a significant global threat to health in the African continent. Most SSA countries have elected to vaccinate all children against HBV through the WHO-sponsored Expanded Program of Immunization and the current recommendation from WHO-AFRO is for birth-dose HBV vaccination to prevent maternal/child transmission (MFT) and early horizontal transmission of HBV. However, in Africa, HBV vaccine coverage remains low and HBV birth-dose vaccination has not been implemented. HBV transmission from mother to child in the early perinatal period therefore remains a significant contributor to the burden of HBV-related disease in SSA. This review explores the evidence for materno-foetal transmission of HBV in SSA, outlining current practice for HBV MFT prevention and identifying the significant challenges to implementation of HBV prevention in SSA.
Collapse
Affiliation(s)
- J Howell
- Department of Medicine, Imperial College London, London, UK; Department of Hepatology, St Mary's Hospital, London, UK; The Macfarlane-Burnet Institute, Melbourne, Vic., Australia; Department of Medicine, The University of Melbourne, Melbourne, Vic., Australia
| | | | | |
Collapse
|
32
|
Tegegne D, Desta K, Tegbaru B, Tilahun T. Seroprevalence and transmission of Hepatitis B virus among delivering women and their new born in selected health facilities, Addis Ababa, Ethiopia: a cross sectional study. BMC Res Notes 2014; 7:239. [PMID: 24731794 PMCID: PMC3991867 DOI: 10.1186/1756-0500-7-239] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 04/11/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Hepatitis B Virus is a major public health problem worldwide. In 2012 alone, over 350 million chronic carriers and 1. 2 million annual deaths were occurred. Hepatitis B Virus causes 60 to 80% of the world's primary liver cancer and nearly 90% infants infected due to vertical transmission are at higher risk of developing chronic liver disease and cancer. Hence determining the burden of maternal and neonatal Hepatitis B Virus infection is a priority. METHODS A cross sectional study was conducted from July - September 2012 at St. Paul's Hospital Millennium Medical College and Selam Health Center, Addis Ababa, Ethiopia. Blood samples from delivering mothers (n = 265) and their corresponding cords (n = 265) were collected. A pretested questionnaire was used to collect data. Hepatitis B Virus surface antigen was detected using Enzyme Linked Immunosorbent Assay. Frequency analysis and logistic regression test was used to identify the potential risk factors associated with Hepatitis B Virus positivity using SPSS Version -15. RESULTS A total of 265 delivering women with the mean age of 25.8 years were enrolled in the study. Of these delivering women, 8 (3.0%) of mothers were positive for Hepatitis B Virus surface antigen, whereas 6 (2.3%) of cord bloods were positives with 75% concordance rate of exposed infants with sero-positive mothers. However, only one maternal positive case was observed for Hepatitis B e Ag test. Only 11% of the mothers know their Hepatitis B Virus status. Of the total mothers assessed for possible risk factors, 69 (26%) had only one type, while 161 (60.8%) had multiple exposure factors such as ear pricing, history of tribal marks, abortion, multiple-sexual partner and history of surgical procedures experienced from high to low frequency. The remaining 35 (13.2%) of the participants had not experienced possible risk factors. CONCLUSION Though the maternal positivity rate was low, the rate of positivity in cord bloods was almost equal to those infected mothers. Therefore, screening of pregnant mothers and vaccination of infants could help to reduce the transmission. To minimize the higher overall risk exposure status of mothers, increasing awareness and intensive public health education is also recommended.
Collapse
Affiliation(s)
- Dessie Tegegne
- Department of Biomedical Science, College of Health Sciences, Samara University, Samara, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, School of Allied Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Belete Tegbaru
- Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, Ethiopia
| | - Tesfaye Tilahun
- Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, Ethiopia
| |
Collapse
|
33
|
Abstract
Pregnant women are particularly susceptible to a number of infectious diseases, such as influenza, hepatitis E, malaria, and tuberculosis. The management of many other infections-including urinary tract infections, human immunodeficiency virus, and sexually transmitted diseases-is also made more complex by pregnancy; even if some infections do not pose a great risk to the expectant mother, they can impact fetal and neonatal development, thus posing a treatment challenge to physicians. By focusing on the most important diseases that physicians may encounter in pregnant patients, this review outlines the challenges associated with managing important infectious diseases in the pregnant population and references the most recent evidence and international treatment guidelines.
Collapse
Affiliation(s)
- Hugh Adler
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | |
Collapse
|
34
|
Sero-prevalence 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; 14:118. [PMID: 24580859 PMCID: PMC3942511 DOI: 10.1186/1471-2334-14-118] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 02/17/2014] [Indexed: 01/08/2023] Open
Abstract
Background Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) are the two most important agents of infectious diseases. Both HBV and HIV share common modes of transmission and have serious effects on both pregnant women and infants. In Bahir Dar city administration, there is a scarcity of information on sero-prevalence of HIV and HBV infection among pregnant women. The main objective of this study was to assess sero-prevalence and risk factors of HIV and HBV infection among pregnant women attending antenatal care in Bahir Dar city, Northwest Ethiopia. Methods A cross-sectional study was conducted from March 2013 to April 2013. Socio-demographic and explanatory variables were collected using a structured questionnaire by face to face interview. Hepatitis B surface antigen (HBsAg) was detected using an enzyme linked immunosorbent assay (ELISA). HIV infection was also detected using the national HIV test algorithms. The results were analyzed with descriptive statistics and binary logistic regression. The odds ratio and 95% Confidence intervals were calculated. Results A total of 318 pregnant women with the mean age of 25.72 (SD. ±5.14) years old were enrolled. Overall, 21/318 (6.6%) and 12 /318 (3.8%) of the pregnant women were positive for HIV and HBsAg, respectively. Of these, HIV/HBV co-infection rate was 4 (19.0%). Previous history of blood transfusion (AOR = 3.7, 95% CI, 9.02-14.84), body tattooing (AOR = 5.7, 95% CI, 1.24-26.50), history of surgery (AOR = 11.1, 95% CI, 2.64-46.88) and unsafe injection (AOR = 5.6, 95% CI, 1.44-22.19) were significantly associated with HBV infection. Previous history of piercing with sharp materials (AOR = 3.0, 95% CI 1.17-7.80) and history of abortion (AOR = 6.6, 95% CI 2.50-17.71) were also statistically significant for HIV infection. Conclusions This study indicates that HIV and HBV infections are important public health issues in our region that need to be addressed. All pregnant women need to be screened for both HIV and HBV infections during antenatal care. Furthermore, health education about modes of transmission of HIV and HBV has to be given.
Collapse
|
35
|
Saindou M, Voirin N, Troalen D, Abaine A, Chevallier-Queyron P, Ecochard R, Vanhems P. Socio-demographic and behavioral determinants of hepatitis B vaccination and infection in pregnant women on Mayotte Island, Indian Ocean. Vaccine 2013; 31:4946-52. [PMID: 23981433 DOI: 10.1016/j.vaccine.2013.08.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/02/2013] [Accepted: 08/13/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Socio-demographic and behavioral determinants of Hepatitis B virus (HBV) vaccination and infection among pregnant women (PW) of Mayotte Island (Indian Ocean) are not well understood. METHODS Six hundred and seventy-one pregnant women presenting to public antenatal clinics on Mayotte Island were included between September 15, 2008 and September 27, 2009. Socio-demographics, sexual risk behavior characteristics, and data for HBV biomarkers were collected. Logistic regression was undertaken to study determinants of HBV vaccination and factors associated with the risk of HBV infection were assessed using a survival method adapted to interval-censored data. Due to missing data for HBV biomarkers, data were analyzed using multiple imputation (MI). RESULTS Past or recent HBV infection was observed for 35.5% (95% confidence interval (CI): 30.4-40.8) of PW and 18.6% (95% CI: 14.7-23.2) had evidence of HBV vaccination. PW with unemployed and education qualification (adjusted odds ratio (aOR) 2.65, 95% CI 1.52-4.60) and student status (aOR 4.79, 95% CI 1.63-4.07) were better vaccinated against HBV, compared to those without employment and education. Being born on Comoros was associated with a 63% reduction in HBV vaccination (aOR 0.37, 95% CI 0.21-0.65), compared to be born in Mayotte/France. Women with a history of sexually-transmitted infections in the last 5 years had an increased risk of HBV infection (adjusted hazard ratio (aHR) 3.10, 95% CI: 1.13-8.50), whereas those who sometimes used condoms had a 60% reduced risk (aHR=0.40, 95% CI: 0.23-0.69). CONCLUSIONS Socio-demographic factors were identified for HBV vaccination, while behavioral factors were observed for HBV infection. These results could help to determine priorities for intervention.
Collapse
Affiliation(s)
- Maoulide Saindou
- Université de Lyon, Université Lyon 1, CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Epidémiologie et Santé Publique, Lyon, France.
| | | | | | | | | | | | | |
Collapse
|
36
|
Pai NP, Kurji J, Singam A, Barick R, Jafari Y, Klein MB, Chhabra S, Shivkumar P. Simultaneous triple point-of-care testing for HIV, syphilis and hepatitis B virus to prevent mother-to-child transmission in India. Int J STD AIDS 2012; 23:319-24. [PMID: 22648884 DOI: 10.1258/ijsa.2011.011139] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
An innovative simultaneous triple point-of-care (STPOC) screening strategy for syphilis, hepatitis B and HIV with Determine(®) tests was offered to pregnant women presenting for antenatal care and evaluated for feasibility and preference in rural India. Of 1066 participants approached, 1046 consented, of which 1002 (96.0%) completed the strategy. Only 9% reported any history of testing in their current pregnancy. With STPOC screening, 989 women (98.7%) tested negative and 13 had preliminary positive results for infection. The total time taken was 45 minutes per participant. Mothers and infants were provided prophylaxis/treatment for HIV, syphilis and hepatitis B, with interventions initiated within 3-5 days. STPOC was preferred by 99.3% (95%CI: 98.8-99.8%) of participants, facilitated early simultaneous screening for the three infections, timely initiation of prophylaxis/treatment and was feasible in this rural setting. These data suggest that multiplexed STPOC screening for syphilis, hepatitis B and HIV in pregnancy would be desirable for women in rural India.
Collapse
Affiliation(s)
- N P Pai
- Division of Clinical Epidemiology & Division of Infectious Diseases, McGill University Health Center, Montreal, Quebec, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Ramos JM, Belda S, Reyes F, Rodríguez JC, Royo G, Gutiérrez F. Prevalence of HIV, HBV, HCV, HTLV and Treponema pallidum among patients attending a rural hospital in Southern Ethiopia. J Clin Virol 2011; 53:268-9. [PMID: 22209287 DOI: 10.1016/j.jcv.2011.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 11/26/2011] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
|