Prevalence and associated factors for hepatitis B virus infection among pregnant women in Banadir hospital, Mogadishu, Somalia.

Abstract

Introduction: There are about 65 million individuals who carry HBV in Africa, with a 25% mortality risk. In sub-Saharan Africa, the prevalence of HBV infection ranges from 9-20%. Pregnant mothers who test positive for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) have 70–90% risk of transmitting the infection to their new-born infants and about 10–40% risk if they test positive for only HBsAg. Therefore, pregnant women should be routinely screened for HBsAg and hepatitis B vaccine administered at birth to the infants whose mothers test positive. The study aimed to assess the prevalence of hepatitis B (HBsAg) and its associated factors among pregnant women in Banadir hospital, Mogadishu, Somalia. Methods: A hospital-based, cross-sectional study was conducted among 421 pregnant women that were consecutively sampled. A pretested, structured interviewer administered questionnaire, was used in addition to collection of a blood sample for HBsAg testing. Data was entered into the Epi Data version (3.0), cleaned and checked for outliers and missingness. It was then exported into the Stata SE version (14) for analysis. Binary logistic regression was used to determine the measures of association between the risk factors for HBV infection and the outcome variable (HBsAg). A p-value <0.05 was used as level of statistical significance. Multivariable logistic regression was done to take into account potential confounding. Results: Out of the 421 study participants 82.4% (347/421) were married, 64.5% (238/421) reached secondary and half 50.2% (211/421) earned more than 100 dollars per month. Average age was 25.5 years. 16.9% (71/421) of the samples were positive with hepatitis B, of which over half 53.5% (38/71) were aged 18-25 years. Additionally, 12.6% of the pregnant women were vaccinated against hepatitis B virus. On bivariable regression analysis, vaccination against hepatitis B, history of blood transfusion, surgical procedure, knowledge about hepatitis B, local leaders mobilizing for HepB vaccination, female genital mutilation, distance from home to health facility and frequency of screening & testing were significantly associated with HepB prevalence among study respondents. Upon multivariable regression analysis, history of blood transfusion, knowledge about HepB, female genital mutilation and frequency of testing & screening were significantly associated with HepB infection among study participants. Study participants who underwent blood transfusion prior to the study [AOR=2.90, 95%CI=1.05-8.06, P-value=0.04] were 2.9 times more likely to test positive with hepatitis B infection as compared to those that didn’t undergo blood transfusion. Odds of testing positive for hepatitis B [AOR=12.34, 95%CI=6.01-19.66, P-value=0.001] was 12.3 higher among those who had no knowledge about hepatitis B infection compared to those that had knowledge about the virus. Those who underwent female genital mutilation [AOR=3.58, 95%CI=1.35-10.37, P-value=0.008] were 3.6 times more likely to test positive with hepatitis B infection as compared to those that did not under go female genital mutilation. Conclusions: There was generally high prevalence of hepatitis B virus (16.9%) among pregnant women in the study area. History of blood transfusion, knowledge about HepB, female genital mutilation and frequency of testing & screening were the significant risk factors associated with HepB infection among study participants. Interventions to address the problem should focus on these factors.