Prevalence of Hepatitis B Virus Infection and Factors Associated with Hepatitis B Virus Infection Among Pregnant Women Presented to Antenatal Care Clinics at Adigrat General Hospital in Northern Ethiopia

Seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia

BACKGROUND

Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infections are global issues that disproportionately affect developing countries. Pregnancy-related HBV and HCV infections are associated with a high risk of vertical transmission and complications for the mother as well as the newborn. Therefore, this study aims to determine the seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia.

METHODS

A hospital-based retrospective study was conducted from July to September 2022 on HBV and HCV registered books from September 1, 2017, to August 30, 2019, for a year. The presence of HBsAg and anti-HCV in serum was detected using the One Step Cassette Style HBsAg and anti-HCV antibody test kit. Data were analyzed using SPSS version 26 software.

RESULTS

In this study, a total of 2252 participants for HBsAg and 538 participants for ant-HCV rapid tests of records in the laboratory logbook were included. The mean age of the study participants was 25.6years (± 5.8SD). The overall prevalence of HBsAg and anti-HCV was 6.0% (134/2252) and 2.4% (13/538), respectively. There were 0.4% (2/538) coinfection results between HBV and HCV among pregnant women.

CONCLUSION AND RECOMMENDATION

In this study, intermediate seroprevalence of HBV and HCV infection was detected among pregnant women attending antenatal care. The Hepatitis B virus was predominantly higher among pregnant women aged between 25 and 34 years. To manage and stop the potential vertical transmission of these viral agents during the early stages of pregnancy, routine prenatal testing for HBV and HCV infections should be taken into consideration.

Prevalence of Hepatitis B virus infection and its determinants among pregnant women in East Africa: Systematic review and Meta-analysis

INTRODUCTION

Hepatitis B virus (HBV) is one of the major public health problems globally and needs an urgent response. It is one of the most responsible causes of mortality among the five hepatitis viruses, and it affects almost every class of individuals. Different studies were conducted on the prevalence of HBV among pregnant women in East African countries, but none of them showed the pooled prevalence of HBV among the pregnant women. Thus, the main objective of this study was to determine the pooled prevalence and its determinants among pregnant women in East Africa.

METHODS

We searched studies using PubMed, Scopus, Embase, ScienceDirect, Google Scholar and grey literature that were published between January 01/2020 to January 30/2024. The studies were assessed using the Newcastle Ottawa Scale (NOS) quality assessment scale. The random-effect (DerSimonian) model was used to determine the pooled prevalence and associated factors of HBV among pregnant women. Heterogeneity were assessed by I2 statistic, sub-group analysis, and sensitivity analysis. Publication bias was assessed by Egger test, and the analysis was done using STATA version 17.

RESULT

A total of 45 studies with 35639 pregnant women were included in this systematic review and meta-analysis. The overall pooled prevalence of HBV among pregnant women in East Africa was 6.0% (95% CI: 6.0%-7.0%, I2 = 89.7%). The highest prevalence of 8% ((95% CI: 6%, 10%), I2 = 91.08%) was seen in 2021, and the lowest prevalence 5% ((95% CI: 4%, 6%) I2 = 52.52%) was observed in 2022. A pooled meta-analysis showed that history of surgical procedure (OR = 2.14 (95% CI: 1.27, 3.61)), having multiple sexual partners (OR = 3.87 (95% CI: 2.52, 5.95), history of body tattooing (OR = 2.55 (95% CI: 1.62, 4.01)), history of tooth extraction (OR = 2.09 (95% CI: 1.29, 3.39)), abortion history(OR = 2.20(95% CI: 1.38, 3.50)), history of sharing sharp material (OR = 1.88 (95% CI: 1.07, 3.31)), blood transfusion (OR = 2.41 (95% CI: 1.62, 3.57)), family history of HBV (OR = 4.87 (95% CI: 2.95, 8.05)) and history needle injury (OR = 2.62 (95% CI: 1.20, 5.72)) were significant risk factors associated with HBV infection among pregnant women.

CONCLUSIONS

The pooled prevalence of HBV infection among pregnant women in East Africa was an intermediate level and different across countries ranging from 1.5% to 22.2%. The result of this pooled prevalence was an indication of the need for screening, prevention, and control of HBV infection among pregnant women in the region. Therefore, early identification of risk factors, awareness creation on the mode of transmission HBV and implementation of preventive measures are essential in reducing the burden of HBV infection among pregnant women.

DFT/TDDFT calculations of geometry optimization, electronic structure and spectral properties of clevudine and telbivudine for treatment of chronic hepatitis B

Chronic hepatitis B remains a worldwide health concern. Presently, many drugs, such as Clevudine and Telbivudine, are recommended for the treatment of chronic hepatitis B disease. For this purpose, the quantum chemical analysis of ELUMO-HOMO (Egap), ionization potential (IP), electron affinity (EA), electronegativity (EN), chemical hardness (η), chemical potential (μ), chemical softness (S), electrophilicity index (ω), electron accepting capability (ω+), electron-donating capability (ω-), Nucleophilicity index (N), additional electronic charge (∆Nmax), Optical softness (σ0) and Dipole Moment, IR and UV-Vis spectra, molecular electrostatic potential (MEP) profile, Mulliken charge analysis, natural bond orbital (NBO) were examined in this study. The dipole moment of the compounds suggests their binding pose and predicted binding affinity. The electrophilic and nucleophilic regions were identified, and techniques such as NBO, UV-Vis, and IR were used to gain insights into the molecular structure, electronic transitions, and potential drug design for Hepatitis B treatment. Calculations for this study were carried out using the Gaussian 09 program package coupled with the DFT/TDDFT technique. The hybrid B3LYP functional method and the 6-311++G(d, p) basis set were used for the calculations.

Seroprevalence of hepatitis B virus infection and factors associated among pregnant women in Ethiopia: A systematic review and meta-analysis

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.

Triple sexually transmitted infections among pregnant woman in the context of Elimination of mother to child transmission in Southern Ethiopia: Reports from a survey of questionnaires and laboratory studies

Introduction

Sexually transmitted infections (STIs) cause a wide range of public health problems if left untreated. They can lead to adverse birth outcomes, including stillbirth, fetal loss, neonatal death, preterm birth, and low birth weight. Although great efforts have been made to reduce STIs nationally, their incidence remains high in Ethiopia, and their co-infection calls for urgent action. Therefore, this study aimed to identify the determinants of three STIs among pregnant women attending antenatal care (ANC) in the context of the elimination of mother-to-child transmission in public health facilities in Sawla Town, Gofa zone, Southern Ethiopia.

Methods

A cross-sectional study design was conducted among pregnant women attending antenatal care in public health facilities in Sawla Town, Southern Ethiopia, from May to July 2022. Data were collected from pregnant women's serum using an HIV rapid test, an HBsAg rapid test device, and a VDRL for HIV, HBV, and syphilis, respectively. Descriptive statistics, such as frequencies and percentages, were used to describe each relevant variable. Logistic regression analyses were used to identify the determinants of STIs.

Results

A total of 484 pregnant women attending antenatal care were screened. The mean age of the women was 24.0 ± 4.6 years, and nearly half of the participants had completed secondary school or higher. The overall seroprevalence of three STIs (HIV, HBV, and syphilis) among pregnant women was 6.8%. These three sexually transmitted infections were shown to be more common among pregnant women who were not able to read and write, had tattoos, had previously had an abortion, and had a history of multiple sexual partners.

Conclusions

The seroprevalence found in this study was intermediate in comparison with the WHO standard. Efforts should be made to strengthen the existing health education and RH service integration on STI screening, and treatment that further eliminates vertical infection.

Forthcoming Developments in Models to Study the Hepatitis B Virus Replication Cycle, Pathogenesis, and Pharmacological Advancements

Hepatitis, liver cirrhosis, and hepatocellular carcinoma are all manifestations of chronic hepatitis B. Its pathogenesis and molecular mechanism remain mysterious. As medical science progresses, different models are being used to study the disease from the physiological and molecular levels. Animal models have played an unprecedented role in achieving in-depth knowledge of the disease while posing no risk of harming humans throughout the study. The scarcity of acceptable animal models has slowed progress in hepatitis B virus (HBV) research and preclinical testing of antiviral medicines since HBV has a narrow species tropism and exclusively infects humans and higher primates. The development of human chimeric mice was supported by a better understanding of the obstacles to interspecies transmission, which has substantially opened the way for HBV research in vivo and the evaluation of possible chronic hepatitis B therapeutics. Animal models are cumbersome to handle, not accessible, and expensive. Hence, it is herculean to investigate the HBV replication cycle in animal models. Therefore, it becomes essential to build a splendid in vitro cell culture system to demonstrate the mechanisms attained by the HBV for its multiplication and sustenance. We also addressed the advantages and caveats associated with different models in examining HBV.

Spatio-temporal distribution characteristics of the risk of viral hepatitis B incidence based on INLA in 14 prefectures of Xinjiang from 2004 to 2019

This study aimed to explore the spatio-temporal distribution characteristics and risk factors of hepatitis B (HB) in 14 prefectures of Xinjiang, China, and to provide a relevant reference basis for the prevention and treatment of HB. Based on HB incidence data and risk factor indicators in 14 prefectures in Xinjiang from 2004 to 2019, we explored the distribution characteristics of the risk of HB incidence using global trend analysis and spatial autocorrelation analysis and established a Bayesian spatiotemporal model to identify the risk factors of HB and their spatio-temporal distribution to fit and extrapolate the Bayesian spatiotemporal model using the Integrated Nested Laplace Approximation (INLA) method. There was spatial autocorrelation in the risk of HB and an overall increasing trend from west to east and north to south. The natural growth rate, per capita GDP, number of students, and number of hospital beds per 10, 000 people were all significantly associated with the risk of HB incidence. From 2004 to 2019, the risk of HB increased annually in 14 prefectures in Xinjiang, with Changji Hui Autonomous Prefecture, Urumqi City, Karamay City, and Bayangol Mongol Autonomous Prefecture having the highest rates.

Mathematical Model of Hepatitis B Disease with Optimal Control and Cost-Effectiveness Analysis

In this paper, a mathematical model of hepatitis B disease with a two-dose vaccine series has been formulated and analyzed. We demonstrated that the model’s disease-free equilibrium is globally asymptotically stable when the basic reproduction number $\left(R_0\right)$ is less than one, whereas the model’s endemic equilibrium is locally asymptotically stable when $R_0$ is greater than one. Sensitivity analysis is performed, and based on its results, the model is extended to an optimal control problem by incorporating two control interventions, namely, prevention and enhanced newborn vaccination. Finally, simulation analyses of the model are conducted to illustrate the theoretical findings and effectiveness of each strategy, which indicates that the use of prevention efforts is the most cost-saving strategy.

Seroprevalence of hepatitis B virus among pregnant women attending Antenatal care in Dilla University Referral Hospital Gedio Zone, Ethiopia; health facility based cross-sectional study

INTRODUCTION

A pregnancy that has been complicated with Hepatitis B virus (HBV) infection results in typical management problems for both the mother and the newborn. One of the universal efforts in tackling the impact of chronic HBV is the prevention of mother-to-child transmission during Antenatal care via prompt screening as the majority of chronic infections globally harbored during this period. Rewarding result have been achieved in reducing this problem at this period of life through maternal screening programs and universal vaccination of infants. This study was aimed at assessing the seroprevalence and associated risk factor of HBV among pregnant women attending Antenatal Care (ANC) in Dilla University Referral Hospital (DURH), Southern Ethiopia.

METHOD

A facility- based cross- sectional study was conducted from December 01 to May 30, 2017 among pregnant women attending ANC. A total of 236 pregnant women were included in this study. All Pregnant women who were attending antenatal clinic and were volunteer during the study period were included, whereas those women who were unable to communicate due to any problem, and not volunteer to give informed consent were excluded. Volunteer participants were asked to complete a questionnaire and had offered to test for HBsAg infection. The data was analyzed using SPSS version 20 software. Logistic regression was used to determine the association between dependent and independent variables.

RESULTS

From 215 pregnant women attending ANC, the prevalence of HBsAg by the rapid test was found to be 11 (5.1%). Among the study participants, 91.1% (215) were tested for HIV antibody during the ANC visit, with the positivity rate of 4.5%. The result showed 1.86% of the study participants who were tested for HIV were also positive for HBsAg. Among those factors affecting the transmission of HBV infection, multiple partners and HIV confection have significant association at P-value less than 0.05.

CONCLUSION

The Seropositivity of Hepatitis B Virus among Pregnant Women was found to be significant and hence, routine screening of pregnant mother at Antenatal care for this virus, and subsequent management according to the guideline for both the mother and child is recommended.