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Koumba Mavoungou DS, N'dilimabaka N, Elguero E, Kombila LB, Diane A, Koumba Moukouama SE, Moussa Y, Mouinga-Ondeme A, Aghokeng AF. Burden of hepatitis B virus infection in pregnant women attending antenatal clinics in the southern Gabon. IJID REGIONS 2023; 9:32-37. [PMID: 37841692 PMCID: PMC10569973 DOI: 10.1016/j.ijregi.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023]
Abstract
Objectives Hepatitis B virus (HBV) infection remains a public health threat in middle- and low-income countries, where mother-to-child transmission plays an important role. The aim of this study was to assess the burden of this infection among pregnant women in southern Gabon and the risk of vertical transmission. Methods The study was a prospective investigation conducted from April 2021 to January 2022. Study participants were pregnant women aged 18 and over attending antenatal clinics in Franceville. Blood samples were collected to test for HBV surface antigen, anti-hepatitis B core, hepatitis B e antigen, and anti-hepatitis B e markers and to assess HBV infection. Results We recruited 901 women with a median age of 26 years (interquartile range: 21-32). Overall prevalence of infection was 3.9% (confidence interval: 2.7-5.4%). 418/901 or 46.4% were anti-hepatitis B core positive. Among HBV surface antigen-positive women, 1/35 were hepatitis B e antigen-positive with a viral load >200,000 IU/ml. Over 64% of participants had no information about HBV infection, and none knew that the virus could be transmitted from mother to child. Conclusions This study reveals a low HBV prevalence in pregnant women in Gabon and a low risk of vertical transmission of the virus. However, the rate of exposure of the population to the virus remains high and calls for improving actions and interventions for potential elimination goals.
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Affiliation(s)
- Danielle S. Koumba Mavoungou
- Unité Emergence des Maladies Virales, Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Nadine N'dilimabaka
- Unité Emergence des Maladies Virales, Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Université des Sciences et Techniques de Masuku (USTM), Faculté des Sciences, Département de Biologie, Franceville, Gabon
| | - Eric Elguero
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Linda Bohou Kombila
- Unité Emergence des Maladies Virales, Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Abdoulaye Diane
- Unité des Infections Rétrovirales et Pathologies Associées Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Schedy E. Koumba Moukouama
- Unité Emergence des Maladies Virales, Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Yaro Moussa
- Unité des Infections Rétrovirales et Pathologies Associées Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Augustin Mouinga-Ondeme
- Unité des Infections Rétrovirales et Pathologies Associées Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF-SSM), Libreville, Gabon
| | - Avelin F. Aghokeng
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées Département de virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF-SSM), Libreville, Gabon
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Afolabi IB, Aremu AB, Maidoki LA, Atulomah NO. Predictors of Hepatitis B Virus Infection Vaccine Hesitancy Among Pregnant Women Attending Antenatal Care at Lubaga Hospital, Kampala, Uganda. Int J Womens Health 2022; 14:1093-1104. [PMID: 35999868 PMCID: PMC9393032 DOI: 10.2147/ijwh.s378000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background While hepatitis B virus infection may be seen as a global threat within the medical and scientific community, primary prevention via vaccination remains the most effective approach towards breaking the chain of transmission of HBV infection. However, vaccination uptake in Uganda has been modest despite a very endemic national figure resulting from the vertical transmission of this infection. This study assessed the predictors of HBV vaccine hesitancy among pregnant women attending Antenatal clinic in Central Uganda. Methodology A hospital-based cross-sectional study employing a five-sectioned pretested interviewer-administered questionnaire was conducted to obtain data from 385 consenting pregnant women. Responses for the antecedent variables were transformed into weighted aggregate scores using SPSS version 26. Multivariable logistic regression analysis was employed to ascertain the predictors of HBV vaccine hesitancy with the cut-off for hypotheses set at 5% level of significance. Results The majority of the respondents (59%) were between the ages of 18 and 28 years. Women with secondary educational attainment were predominant (42.3%). The respondents had mean scores of 5.97±6.61, 17.10±18.31, and 12.39±13.37, respectively, computed for knowledge of HBV infection, perception, and behavioral skills towards HBV prevention. Regarding vaccine hesitancy, three-quarters of the women (74%) hesitated to uptake HBV vaccine. While negative significant associations exist between marital status (AOR = 0.47, 95% CI = 0.22-1.01), knowledge (AOR = 0.79, 95% CI = 0.70-0.89), behavioral skills (AOR = 0.88, 95% CI = 0.81-0.95) and vaccine hesitancy, level of education (AOR = 1.88, 95% CI = 1.08-3.27) and perception (AOR = 1.11, 95% CI = 1.05-1.18) on the other hand, positively predicted vaccine hesitancy. Conclusion The findings reported an extremely high degree of HBV vaccine hesitancy among the expectant mothers discovered to be linked with marital status, educational attainment, HBV-specific knowledge, perception and behavioral skills. This necessitates targeted health education for married women with lower educational attainment to improve their knowledge which will in turn shape their perception and behavioral skills towards satisfactory uptake of HBV vaccine.
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Affiliation(s)
- Ismail Bamidele Afolabi
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
| | - Abdulmujeeb Babatunde Aremu
- Faculty of Health Sciences, Department of Human Anatomy, Islamic University in Uganda, Kampala Campus, Kampala, Uganda
| | - Lawal Abdurraheem Maidoki
- Faculty of Science and Technology, Department of Public Health, Cavendish University, Kampala, Uganda
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Ajuwon BI, Yujuico I, Roper K, Richardson A, Sheel M, Lidbury BA. Hepatitis B virus infection in Nigeria: a systematic review and meta-analysis of data published between 2010 and 2019. BMC Infect Dis 2021; 21:1120. [PMID: 34717586 PMCID: PMC8556927 DOI: 10.1186/s12879-021-06800-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background Hepatitis B virus (HBV) is an infectious disease of global significance, causing a significant health burden in Africa due to complications associated with infection, such as cirrhosis and liver cancer. In Nigeria, which is considered a high prevalence country, estimates of HBV cases are inconsistent, and therefore additional clarity is required to manage HBV-associated public health challenges. Methods A systematic review of the literature (via PubMed, Advanced Google Scholar, African Index Medicus) was conducted to retrieve primary studies published between 1 January 2010 and 31 December 2019, with a random-effects model based on proportions used to estimate the population-based prevalence of HBV in the Nigerian population. Results The final analyses included 47 studies with 21,702 participants that revealed a pooled prevalence of 9.5%. A prevalence estimate above 8% in a population is classified as high. Sub-group analyses revealed the highest HBV prevalence in rural settings (10.7%). The North West region had the highest prevalence (12.1%) among Nigeria’s six geopolitical zones/regions. The estimate of total variation between studies indicated substantial heterogeneity. These variations could be explained by setting and geographical region. The statistical test for Egger’s regression showed no evidence of publication bias (p = 0.879). Conclusions We present an up-to-date review on the prevalence of HBV in Nigeria, which will provide critical data to optimise and assess the impact of current prevention and control strategies, including disease surveillance and diagnoses, vaccination policies and management for those infected. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06800-6.
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Affiliation(s)
- Busayo I Ajuwon
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia. .,Department of Biosciences and Biotechnology, Faculty of Pure and Applied Sciences, Kwara State University, Malete, Nigeria.
| | - Isabelle Yujuico
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Katrina Roper
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Acton, ACT, Australia
| | - Meru Sheel
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| | - Brett A Lidbury
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Australia.,Department of Health Evidence, Radboud UMC, 6500 HB, Nijmegen, The Netherlands
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Adeyemi OA, Itanyi IU, Ozigbu CE, Stadnick N, Tsuyuki K, Olayiwola O, Ogidi AG, Eze C, Aarons GA, Onoka CA, Ezeanolue EE. Sero-prevalence and determinants of Hepatitis B among a cohort of HIV-infected women of reproductive age in Nigeria. PLoS One 2020; 15:e0236456. [PMID: 32941424 PMCID: PMC7498243 DOI: 10.1371/journal.pone.0236456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/05/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sub-Saharan Africa houses over two-thirds of the 37 million people living with human immunodeficiency virus (HIV) globally and of this, 5-20% are co-infected with Hepatitis B virus (HBV). This is double jeopardy, especially for women of reproductive age in these settings, who can transmit both viruses vertically as well as horizontally to their children. The objectives of this study were to investigate the prevalence and determinants of HBV among women of reproductive age living with HIV. METHODS This was a cross-sectional study of HIV-infected women of reproductive age in Benue State, Nigeria. Participants were eligible for the study if they were HIV-infected women (ages 18-45 years) receiving care from any of the selected study sites. A global rapid hepatitis B surface antigen (HBsAg) antibody test strip was used to test for HBsAg in plasma. A pretested questionnaire was used to collect data on sociodemographic, clinical and lifestyle characteristics of participants. We estimated prevalence of HBV infection and used multivariable logistic regression to determine factors associated with the infection at a significance level of <0.05. RESULTS A total of 6577 women were screened for HBsAg. The prevalence of HBV was 10.3% (95% CI: 9.5-10.9%). Age, parity and male partner's HIV status were found to be associated with having HBV infection. Compared to women older than 40 years, the odds of HBV infection increased significantly with increasing age until age 35 years and decreased significantly with increasing parity (versus no parity). Women with HIV-infected partners and those without a partner had higher odds of HBV infection compared to women with HIV-negative partners. CONCLUSION HBV is hyperendemic among HIV-infected women of reproductive age in North Central Nigeria. Specific programs targeting HBV testing, vaccination and treatment of all women of reproductive age need to be developed in this resource-limited, high-need setting.
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Affiliation(s)
- Olusegun Adewale Adeyemi
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Epidemiology and Public Health, Graduate Program In Life Sciences, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Chamberline Ekene Ozigbu
- Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, United States of America
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, California, United States of America
- UC San Diego Dissemination and Implementation Science Center, San Diego, California, United States of America
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California, San Diego, California, United States of America
| | | | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Chuka Eze
- Vitira Health, Arlington, Virginia United States of America
| | - Gregory Alan Aarons
- Department of Psychiatry, University of California, San Diego, California, United States of America
- UC San Diego Dissemination and Implementation Science Center, San Diego, California, United States of America
| | - Chima Ariel Onoka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Las Vegas, Nevada, United States of America
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