Seroprevalence of hepatitis B and vaccine effectiveness in vertical transmission prevention: a hybrid study among pregnant mothers attending antenatal clinics in Abyei, South Sudan
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243629Keywords:
Hepatitis B, Seroprevalence, Vertical transmissionAbstract
Background: Hepatitis B virus (HBV) is a global health threat, affecting millions worldwide and causing severe liver diseases such as cirrhosis and cancer. Low and middle-income countries (LMICs), particularly South Sudan, face challenges like limited healthcare infrastructure and public awareness, leading to high HBV prevalence. Infants born of seropositive women are at heightened risk due to vertical transmission, perpetuating the infection cycle.
Methods: This study assessed HBV seroprevalence among pregnant women in Abyei, South Sudan, and evaluated vaccine effectiveness in preventing mother-to-child transmission. A hybrid study of cross-sectional and cohort design included 384 pregnant women and 94 infants. Blood samples were tested for hepatitis B surface antigen (HBsAg), while socio-demographic data and awareness levels were gathered through structured questionnaires. Qualitative insights were also collected via focus group discussions and interviews with healthcare providers. Logistic regression was used to analyze risk factors.
Results: The seroprevalence of HBV was 19% among pregnant women. Younger age, lower education levels, and unemployment were associated with higher infection rates. Vertical transmission occurred in 4.3% of infants, despite vaccine availability. Awareness of HBV was notably low among participants, underscoring gaps in public health education.
Conclusions: HBV presents a significant health burden in Abyei, South Sudan. Enhancing health education, improving access to preventive strategies, and strengthening healthcare infrastructure are critical to reducing HBV prevalence and transmission. Implementing targeted public health interventions can mitigate the virus’s impact on maternal and child health in the region.
Metrics
References
Hsu YC, Huang DQ, Nguyen MH. Global burden of hepatitis B virus: current status, missed opportunities and a call for action. Nat Rev Gastroenterol Hepatol. 2023;20(8):524-37.
Zhang W, Xu C, Rui Y, Chen J, Chen T, Dai Y, et al. Efficacy of the hepatitis B vaccine alone in the prevention of hepatitis B perinatal transmission in infants born to hepatitis B e antigen-negative carrier mothers. J Virus Erad. 2022;20:8(2).
Said ZNA, El-Sayed MH. Challenge of managing hepatitis B virus and hepatitis C virus infections in resource-limited settings. World J Hepatol. 2022;14(7):1333-43.
World Health Organization. Organisation for Health Improvement. 2021. Available at: https://www.who. int/news-room/fact-sheets/detail/hepatitis-b. Accessed on 10 June 2023.
Fofana DB, Somboro AM, Maiga M, Kampo MI, Diakité B, Cissoko Y, et al. Hepatitis B Virus in West African Children: Systematic Review and Meta-Analysis of HIV and Other Factors Associated with Hepatitis B Infection. Int J Environ Res Public Health. 2023;20(5):4142.
Kheir OO, Freeland C, Abdo AE, Yousif MEM, Altayeb EO, Mekonnen HD. Assessment of hepatitis B knowledge and awareness among the Sudanese population in Khartoum State. Pan Afr Med J. 2022;41:217.
Martyn E, Eisen S, Longley N, Harris P, Surey J, Norman J, et al. The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda. Elife. 2023;12.
World Health Organization. Hepatitis B. 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Accessed on 10 June 2023.
Al-Ismaili OM, Al-Jardani A, Al-Hinai F, Al-Shukri I, Mathew M, Al-Abri S, et al. Prevalence of Hepatitis B Infection Among Pregnant Women in Oman. J Epidemiol Glob Health. 2022;12(3):311-5.
Miyakawa M, Yoshida L, Nguyen H, Takahashi K, Le TH, Yasunami M, et al. Hepatitis B virus infection among pregnant mothers and children after the introduction of the universal vaccination program in Central Vietnam. Sci Rep. 2021;11(1):1-11.
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. Womens Health (Lond). 2024;17455057241235881.
Nnaemeka OE, Bello F, Gwamzhi LN. Seroprevalence of hepatitis B virus infection and associated factors among pregnant women attending antenatal care in Jos, Plateau State, Nigeria. Pan Afr Med J. 2020;35(2):9.
Mustapha GU, Ibrahim A, Balogun MS, Umeokonkwo CD, Mamman AI. Seroprevalence of hepatitis B virus among antenatal clinic attendees in Gamawa Local Government Area, Bauchi State, Nigeria. BMC Infect Dis. 2020;20:194.
Liu J, Liu J, Liu M, Pang Q, Wen, Y. Prevalence of hepatitis B virus infection and its associated factors among 15,461 pregnant women in Yunnan province, China. Ann Epidemiol. 2020;49:13-9.
Ali S A, Donahue RMJ, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis. 2019;79:117-9.
Pandey S, Lohani P, Roy R, Bhar D, Ranjan A, Kumar P, et al. Prevalence and knowledge of hepatitis B infection in pregnant women in a primary health center of Patna district, Bihar. J Family Med Prim Care. 2021;10(10):3675-81.
Huang Z, Liu T, Qin Y, Chen J, Ou Z, Min, X. A cross-sectional survey on the rate of awareness of hepatitis B virus (HBV) infection and the prevention of mother-to-child transmission among hepatitis B surface antigen (HBsAg)-positive pregnant women. Ann Transl Med. 2022;10(14):773.
Nkhoma DE, Lin CP, Katengeza HL, Soko CJ, Estinfort W, Wang YC, et al. Girls' Empowerment and Adolescent Pregnancy: A Systematic Review. Int J Environ Res Public Health. 2020;17(5):1664.
Eleje GU, Akaba GO, Mbachu II, Rabiu A, Loto OM, Usman HA, et al; Triplex Infection in Pregnancy Collaboration Group. Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study. Ther Adv Vaccines Immunother. 2021;9:25151355211032595.
Kampe A, Abbai KM, Tilahun D, Daka D, Aliyo A, Dedecha W, et al. Seroprevalence of Hepatitis B Virus Infection and Associated Factors Among Pregnant Women Attending Antenatal Care At Public Hospitals in Borena Zone, Southern Ethiopia. Health Serv Res Manag Epidemiol. 2023;10:1-10.
Matthews P C, Ocama P, Wang S, El-Sayed M, Turkova A, Ford D, et al. Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus. JHEP Rep. 2023;5(8):24.
Solomon-Rakiep T, Olivier J, Amponsah-Dacosta E. Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?-A Scoping Review. Trop Med Infect Dis. 2023;8(10):474.
Ofori-Asenso R, Agyeman AA. Hepatitis B in Ghana: a systematic review & meta-analysis of prevalence studies (1995-2015). BMC Infect Dis. 2016;18:130.
Daka D, Hailemeskel G, Fenta DA. Seroprevalence of Hepatitis B Virus and Associated Factors Among Female Sex Workers Using Respondent-Driven Sampling in Hawassa City, Ethiopia. Infect Drug Resist. 2021;14:4301-11.
Thahir S, Muhindo E, Turigye B, Kabagambe K, Thompson P, Mulogo EM, et al. Implementation of Hepatitis B Screening Into Routine Antenatal Care to Prevent Mother-to-Child Transmission in Rural Western Uganda. Open Forum Infect Dis. 2023;10(9):25.
Mutyoba J N, Wandera C, Ejalu D, Seremba E, Beyagira R, Amandua J, et al. Feasibility and acceptability of integrating hepatitis B care into routine HIV services: a qualitative study among health care providers and patients in West Nile region, Uganda. BMC Health Serv Res. 2023;23(1):59.
Andersson MI, Amponsah-Dacosta E, Wiysonge CS. Antiviral treatment for the prevention of mother to child transmission of hepatitis B virus infection. Cochrane Database Syst Rev. 2024;9(4):CD014278.
Abbas Z, Abbas M. Challenges in Formulation and Implementation of Hepatitis B Elimination Programs. Cureus. 2021;13(4):24.
Gebrecherkos T, Girmay G, Lemma M, Negash M. Knowledge, Attitude, and Practice towards Hepatitis B Virus among Pregnant Women Attending Antenatal Care at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Int J Hepatol. 2020;15:5617603.
