| BMC Pregnancy and Childbirth | |
| Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon? | |
| Takang William1  Mve V Koh1  Philip Nana2  Judith N Torimiro4  Frederick LI Morfaw4  Nelson J Fomulu3  | |
| [1] ‘Chantal Biya’ International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon;Department of Obstetrics and Gynaecology, Faculty of Medicines and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon;Centre Hospitalier et Universitaire de Yaounde (CHUY), Yaounde, Cameroon;Centre for the Study and Control of Communicable Disease (CSCCD), Faculty of Medicines and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon | |
| 关键词: Low resource setting; Risk factors; Prevalence; Pregnancy; Hepatitis B; | |
| Others : 1137922 DOI : 10.1186/1471-2393-13-158 |
|
| received in 2012-12-14, accepted in 2013-08-05, 发布年份 2013 | |
PDF
|
|
【 摘 要 】
Background
Few studies have evaluated the prevalence of HBV in the general Cameroonian population or among antenatal attendants. The aim of this study was to determine the prevalence, correlates and patterns of Hepatitis B surface antigen among pregnant women attending antenatal care in Yaounde-Cameroon.
Methods
This was a cross-sectional multicenter study carried out in a referral hospital and two secondary hospitals in Yaounde, the capital of Cameroon. The study lasted 15 months (March 2011 to June 2012), and recruited 959 pregnant women. Patient recruitment was consecutive. The HBsAg was tested using the Monalisa HBsAg Ultra ELISA kit. Other hepatitis B markers were equally tested.
We used the statistical package for social sciences (SPSS) version 14.0 software to conduct a quantitative analysis of the derived data. Simple descriptive statistics such as means, standard deviations, and proportions were used to describe the data. We tested for association in categorical variables using the chi-squared (χ2) test. The odds ratio (OR) and the corresponding 95% confidence intervals (95% CI) were used to summarise the strength of association between specific binary exposure and outcome variables. The level of statistical significance for the study was set at p < 0.05.
Results
The prevalence of hepatitis B infection (HBsAg) among antenatal clinic attenders in our setting was 7.7%. Amongst these women, just 5.4% were previously aware of their HBsAg status. The rate of HBV infectivity was high, with 28% of HBsAg positive women having evidence of HBeAg in their plasma, and up to 45.8% of these women lacking antibodies against hepatitis B e antigen (anti-HBe). About 41% of the pregnant women had had previous contact with HBV as evidenced by the positive status for anti-HBc.
Just 2.7% of the pregnant women had previously been vaccinated against HBV. The mean age for HBsAg positivity in our setting was 26.9 ±4.7 years, and the most affected age group was the 25 – 29 years age group. There was no statistically significant association between age or other socio-demographic risk factors and HBsAg status. Numerous risk factors for HBV acquisition exists in our settings, but amongst these, only a history of a contact with hepatitis B infection was found to be significantly associated with HBsAg positivity (OR 1.63, 95% C.I 1.15-2.30). Finally, the coinfection rate of HBV/HIV was 0.74%.
Conclusion
The prevalence of hepatitis B among pregnant women in Cameroon is high, and the pattern tends towards high infectivity and therefore increased risk of perinatal HBV transmission. These highlight the need to step up preventive efforts against hepatitis B infection and perinatal HBV transmission in our community.
【 授权许可】
2013 Fomulu et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150318075852947.pdf | 246KB | ||
| Figure 1. | 29KB | Image |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Department of Health (UK): Immunization against Infectious Disease - “The Green Book”. 2006, 161-184. [Hepatitis B] Ref Type: Generic
- [2]Weinbaum CM, Williams I, Mast EE, Wang SA, Finelli L, Centers for Disease Control and Prevention, et al.: Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR 2008, 57:1-20.
- [3]Andre F: Hepatitis B: a comprehensive prevention, diagnosis and treatment program - past, present and future. J Gastroenterol Hepatol 2004, 19:1-4.
- [4]Jonas MM: Hepatitis B, and pregnancy: an underestimated issue. Liver Int 2009, 29(Suppl 1):133-139.
- [5]World Health Assembly Immunization and Vaccine Quality: Expanded programme on immunization. Global advisory group--Part I. Weekly Epidemiological Record 1992, 67(3):11-15.
- [6]Kane MA: Global status of hepatitis B immunisation. Lancet 1996, 348:696.
- [7]Lavanchy D: Hepatitis B, virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004, 11:97-107.
- [8]Rumi MA, Begum K, Hassan MS, Hasan SM, Azam MG, Hasan KN, et al.: Detection of hepatitis B surface antigen in pregnant women attending a public hospital for delivery: implication for vaccination strategy in Bangladesh. Am J Trop Med Hyg 1998, 59(2):318-322.
- [9]Shiraki K, Yoshihara N, Kawana T, Yasui H, Sakurai M: Hepatitis B surface antigen and chronic hepatitis in infants born to asymptomatic carrier mothers. Am J Dis Child 1977, 131(6):644-647.
- [10]Beasley RP, Shiao IS, Wu TC, Hwang LY: Hepatoma in an HBsAg carrier–seven years after perinatal infection. J Pediatr 1982, 101(1):83-84.
- [11]Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA, et al.: A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep 2005, 54(RR-16):1-31.
- [12]Kane MA, Hadler SC, Margolis HS, Maynard JE: Routine prenatal screening for hepatitis B surface antigen. JAMA 1988, 259(3):408-409.
- [13]Wong VC, Ip HM, Reesink HW, Lelie PN, Reerink-Brongers EE, Yeung CY, et al.: Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study. Lancet 1984, 1(8383):921-926.
- [14]World Health Organisation (WHO): Hepatitis B vaccines. Wkly Epidemiol Rec 2009, 84:405-420.
- [15]Chiaramonte M, Stroffolini T, Ngatchu T, Rapicetta M, Lantum D, Kaptue L, et al.: Hepatitis B virus infection in Cameroon: a seroepidemiological survey in city school children. J Med Virol 1991, 33(2):95-99.
- [16]Ndumbe PM, Njie TK: Hepatitis A and B infections in Yaounde, Cameroon. Res Virol 1989, 140(3):253-261.
- [17]Ndumbe PM, Skalsky J, Joller-Jemelka HI: Seroprevalence of hepatitis and HIV infection among rural pregnant women in Cameroon. APMIS 1994, 102(9):662-666.
- [18]Kfutwah AK, Tejiokem MC, Njouom R: A low proportion of HBeAg among HBsAg-positive pregnant women with known HIV status could suggest low perinatal transmission of HBV in Cameroon. Virol J 2012, 9:62. BioMed Central Full Text
- [19]Eke AC, Eke UA, Okafor CI, Ezebialu IU, Ogbuagu C: Prevalence, correlates and pattern of hepatitis B surface antigen in a low resource setting. Virol J 2011, 8:12. BioMed Central Full Text
- [20]Biesheuvel CJ, Vergouwe Y, Oudega R, Hoes AW, Grobbee DE, Moons KGM: Advantages of the nested case–control design in diagnostic research. BMC Med Res Methodol 2008, 8(48):1-7.
- [21]Noah DN, Njouom R, Bonny A, Pirsou P, Meli J, Biwole-Sida M: HBs antigene prevalence in blood donors and the risk of transfusion of hepatitis b at the central hospital of Yaounde, Cameroon. Open Journal of Gastroenterology 2011, 1(2):23-27.
- [22]Mbanya DN, Takam D, Ndumbe PM: Serological findings amongst first-time blood donors in Yaounde, Cameroon: is safe donation a reality or a myth? Transfus Med 2003, 13(5):267-273.
- [23]Fouelifack FY, Keugoung B, Fouedjio JH, Kouam N, Mendibi S, Dongsta Mabou J: High rates of hepatitis B and C and HIV infections among blood donors in Cameroon: a proposed blood screening algorithm for blood donors in resource-limited settings. Journal of Blood Transfusion 2012, 2012:1-7.
- [24]Luka SA, Ibrahim MB, Iliya SN: Sero-prevalence of Hepatitis B surface antigen among pregnant women attending Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Nigerian Journal of Parasitology 2008, 29(1):38-41.
- [25]Acquaye JK, Mingle JA: Hepatitis B viral markers in Ghanaian pregnant women. West Afr J Med 1994, 13(3):134-137.
- [26]Itoua-Ngaporo A, Sapoulou MV, Ibara JR, Iloki LH, Denis F: [Prevalence of hepatitis B viral markers in a population of pregnant women in Brazzaville (Congo)]. J Gynecol Obstet Biol Reprod (Paris) 1995, 24(5):534-536.
- [27]Okoth F, Mbuthia J, Gatheru Z, Murila F, Kanyingi F, Mugo F, et al.: Seroprevalence of hepatitis B markers in pregnant women in Kenya. East Afr Med J 2006, 83(9):485-493.
- [28]Nacro B, Dao B, Dahourou H, Hien F, Charpentier-Gautier L, Meda N, et al.: [HBs antigen carrier state in pregnant women in Bobo Dioulasso (Burkina Faso)]. Dakar Med 2000, 45(2):188-190.
- [29]Madzime S, Adem M, Mahomed K, Woelk GB, Mudzamiri S, Williams MA: Hepatitis B virus infection among pregnant women delivering at Harare Maternity Hospital, Harare Zimbabwe, 1996 to 1997. Cent Afr J Med 1999, 45(8):195-198.
- [30]Guidozzi F, Schoub BD, Johnson S, Song E: Should pregnant urban south African women be screened for hepatitis B? S Afr Med J 1993, 83(2):103-105.
- [31]Bart PA, Jacquier P, Zuber PL, Lavanchy D, Frei PC: Seroprevalence of HBV (anti-HBc, HBsAg and anti-HBs) and HDV infections among 9006 women at delivery. Liver 1996, 16(2):110-116.
- [32]Descos B, Scotto J, Fayol V, Huet JY, Pichoud C, Hermier M, et al.: Anti-HBc screening for the prevention of perinatal transmission of hepatitis B virus in France. Infection 1987, 15(6):434-439.
- [33]Ding Y, Sheng Q, Ma L, Dou X: Chronic HBV infection among pregnant women and their infants in Shenyang, China. Virol J 2013, 10(17):1-5.
- [34]Wang Z, Zhang J, Yang H, Li X, Wen S, Guo Y, et al.: Quantitative analysis of HBV DNA level and HBeAg titer in hepatitis B surface antigen positive mothers and their babies: HBeAg passage through the placenta and the rate of decay in babies. J Med Virol 2003, 71(3):360-366.
- [35]del Canho R, Grosheide PM, Mazel JA, Heijtink RA, Hop WC, Gerards LJ, et al.: Ten-year neonatal hepatitis B vaccination program, The Netherlands, 1982–1992: protective efficacy and long-term immunogenicity. Vaccine 1997, 15(15):1624-1630.
- [36]Candotti D, Opare-Sem O, Rezvan H, Sarkodie F, Allain JP: Molecular and serological characterization of hepatitis B virus in deferred Ghanaian blood onors with and without elevated alanine aminotransferase. J Viral Hepat 2006, 13(11):715-724.
- [37]Vazquez-Martinez JL, Coreno-Juarez MO, Montano-Estrada LF, Attlan M, Gomez-Dantes H: Seroprevalence of hepatitis B in pregnant women in Mexico. Salud Publica Mex 2003, 45(3):165-170.
- [38]Summers PR, Biswas MK, Pastorek JG, Pernoll ML, Smith LG, Bean BE: The pregnant hepatitis B carrier: evidence favoring comprehensive antepartum screening. Obstet Gynecol 1987, 69(5):701-704.
- [39]Shahnaz S, Reza B, Seyed-Moayed A: Risk factors for chronic Hepatitis B infection: a case controlled study. Hepat Mon 2005, 5(4):109-115.
- [40]Ion-Nedelcu N, Mihaileanu C, Dobrescu A: The risks of transmitting viral hepatitis in a section of the city of Bucharest. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Epidemiol 1989, 34(2):155-162.
- [41]Nuchprayoon T, Chumnijarakij T: Risk factors for hepatitis B carrier status among blood donors of the National Blood Center, Thai Red Cross Society. Southeast Asian J Trop Med Public Health 1992, 23:246-253.
- [42]Akani CI, Ojule AC, Opurum HC, Ejilemele AA: Sero-prevalence of hepatitis B surface antigen (HBsAg) in pregnant women in Port Harcourt, Nigeria. Niger Postgrad Med J 2005, 12(4):266-270.
- [43]Ahmed SD, Cuevas LE, Brabin BJ, Kazembe P, Broadhead R, Verhoeff FH, et al.: Seroprevalence of hepatitis B and C and HIV in Malawian pregnant women. J Infect 1998, 37(3):248-251.
- [44]Obi CL, Anyiwo CE, Nnatu SN, Agbonlahor DE, Esumeh FI, Karpas A: A comparison of human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBs Ag) among the same group of apparently healthy pregnant women in Lagos, Nigeria: a preliminary report. Viral Immunol 1993, 6(1):43-47.
- [45]Dao B, Nacro B, Dahourou H, Meda N, de PP V: [HIV infection and hepatitis B co-infection: survey of prevalence in pregnant women in Bobo Dioulasso, Burkina Faso]. Rev Med Brux 2001, 22(2):83-86.
- [46]Onakewhor JU, Okonofua FE, Offor E: Maternal and neonatal sero-prevalence of hepatitis B surface antigen (HBsAg) in Benin City, Nigeria. J Obstet Gynaecol 2001, 21(6):583-586.
- [47]Rouet F, Chaix ML, Inwoley A, Msellati P, Viho I, Combe P, et al.: HBV and HCV prevalence and viraemia in HIV-positive and HIV-negative pregnant women in Abidjan, Cote d’Ivoire: the ANRS 1236 study. J Med Virol 2004, 74(1):34-40.
- [48]Centers for Disease Control: Update on hepatitis B prevention. MMWR 1987, 36:353-360.
- [49]Scott RM, Snitbhan R, Bancroft WH, Alter HJ, Tingpalapong M: Experimental transmission of Hepatitis B virus by semen and saliva. J Infect Dis 1980, 142:67-71.
- [50]World Health Organisation (WHO): Hepatitis B and breastfreeding. 1996. Update No. 22, November. Available at http://www.who.int/maternal_child_adolescent/documents/pdfs/hepatitis_b_and_breastfeeding.pdf webcite.
PDF