Prevalence of Hepatitis B and Associated Factors among Pregnant Women in N'djamena, Chad

Author(s): Nalda Debsikréo, Birwé Léon Mankréo, Azoukalné Moukenet, Anna Julienne Selbé Ndiaye, Nafissatou Leye Diouf, Gora LO, Merwa Ouangkake, Madjikoula Jotham, Ali Mahamat Moussa, Ndèye Coumba Toure-Kane, Françoise Lunel-Fabiani

Background: Hepatitis B virus (HBV) infection is a major global health problem. It is thus a high priority to develop strategies to reduce HBV transmission, especially mother to child transmission (MTCT), by incorporating birth dose HBV vaccination and if possible additional preventive interventions. However, the prevalence and risk factors of hepatitis B among pregnant women in N'Djamena are not yet documented. The aims of this study were to determine the prevalence of HBV and to identify the risk factors associated with hepatitis B among pregnant women.

Methods: A cross-sectional survey was conducted among pregnant women in eight health facilities in the city of N'Djamena (Chad) from 4 April to 2 August 2021. Pregnant women were included in the study using quota sampling, and participants were recruited consecutively. Blood samples were collected, and serum was tested for hepatitis B surface antigen (HBsAg) using a rapid test, confirmed by a chemiluminescent microparticle immunoassay (CMIA). HBV Viral load was also quantified using real-time PCR. Descriptive analysis, binary and multivariate logistic regressions were used to examine the relationship between dependent variables and socio-demographic factors including other associated factors.

Results: A total of 458 pregnant women were included in the study. The mean age of the participants was 25 years (95% CI: 20 - 30 years) and the prevalence of HBV infection was 7.2% (95% CI, 5.0 - 9.9). HBV DNA was detectable in 51.51% of HBsAg positive serum samples, of which 35.29% had viral DNA titers >200,000 IU/ml. Most participants, 454 (99.12%), were married and 341 (74.45%) were from monogamous households. The majority (274, 59.82%) were housewives. Of the participants, 73.58% were unaware of their HBV status. Having an HBsAg+ mother (AOR: 20.70 95%CI: 3.63-117.05, p=0.001) and a history of HBV screening (AOR: 4.3395%CI: 1.81-10.56, p=0.001) were associated with a higher risk of HBV infection.

Conclusion: We found a prevalence of HBsAg of 7.2% in pregnant women, indicating an intermediate endemicity rate. Having an HBsAg+ mother and a history of HBV screening were factors associated with HBV infection in pregnant women. A policy of free hepatitis B screening of pregnant women and newborn HBV vaccination should be implemented together with training of health personnel on hepatitis B risks and prevention measures.