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      Prevalence of Hepatitis B Surface Antigen in Pregnant Women in Beheshti Hospital of Kashan, Isfahan

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          Abstract

          Background:

          The transmission of hepatitis B virus (HBV) is parenteral, sexual and prenatal. Prevention of vertical transmission of HBV is extremely important, because HBV infection in early life usually results in a chronic carrier state. There has been so much debate about hepatitis B surface antigen (HBsAg) screening in pregnant women.

          Objectives:

          The aim of this study was to determine the prevalence of HBsAg+ among pregnant women referred to Beheshti hospital in Kashan in 2012.

          Patients and Methods:

          This descriptive study was carried out on 768 pregnant women, hospitalized in Beheshti Hospital of Kashan in 2012. After obtaining consent forms, the questionnaires including demographic and HBV infection-associated risk factors were filled through interview and then 5 mL blood was taken from each patient and HBsAg was examined by the enzyme-linked immunosorbent assay (ELISA) method. These data were analyzed by statistical package for the social science (SPSS) software.

          Results:

          A total of 12 (1.56%) out of 768 pregnant women were HBsAg+. The mean age of HBsAg+ cases was 24.5 ± 4 years. Most of the HBsAg+ cases (66.6%) were uneducated; 17.7% of the pregnant women were not Iranian, of which 7.4% were HBsAg+. There was no high-risk job, recent dentistry interruption or skin tattoo among the HBsAg+ cases.

          Conclusions:

          In this study, 1.56% of pregnant women were HBsAg+, which was higher than the previous studies. This increasing prevalence may be due to the increase of non-Iranians’ migrations to Iran. Control of migration and screening and vaccination of these groups should be considered by health policy makers.

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          Most cited references29

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          Hepatitis B and pregnancy: an underestimated issue.

          Hepatitis B infection during pregnancy presents a unique set of management issues. Aspects of care that must be considered include maternal and fetal effects of hepatitis B, effects of pregnancy itself on the course of hepatitis B infection and its complications, treatment of hepatitis B during pregnancy and prevention of perinatal infection. There are insufficient studies to date regarding these concerns; most are from the Far East, and many have important limitations, but some have yielded valuable data. Pregnant women with acute hepatitis B virus (HBV) infection typically have a course not very different from that in the general adult population, but the risk of transmission of HBV to neonates increases the later in gestation the acute infection occurs. Chronic HBV infection is usually mild in pregnant women, but may flare shortly after delivery. The risk of perinatal transmission is highest in women with high levels of viraemia; this may be a factor in the small but reproducible failure rate of current immunoprophylaxis strategies. Obstetrical policies must be assessed with respect to detection of maternal infection and liver disease, as well as with respect to perinatal transmission risk. In addition to the usual issues of drug efficacy and safety in the affected individuals, effects on the developing fetus must be considered. This paper reviews the current experience in each of these areas, and highlights the need for further investigation into this critical but often underestimated topic.
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            Prevalence, correlates and pattern of hepatitis B surface antigen in a low resource setting

            Background Hepatitis B virus (HBV) infection in Nigeria has remained a Public Health issue. It is a major cause of mortality, especially in developing countries. Vertical transmission of hepatitis B virus infection is thought to be a major route of transmission in low resource areas. In spite of this, routine antenatal screening for hepatitis B infection is not yet practiced in many Nigerian hospitals. This paper present the findings of a study conducted among antenatal women in Nnewi, Nigeria. Methods It was a cross-sectional study carried out over a 3-month period (August - October, 2009). Recruitment of 480 women attending antenatal clinics in Nnewi, Nigeria was done by simple random sampling using computer generated random numbers. HBsAg screening was done using rapid ELISA Kits. Statistical analysis was computed using STATA 11 package. The results were subjected to analysis using cross tabulations to explore statistical relationships between variables. Chi square test was used to explore proportional relationship between groups. The level of statistical significance was set at p < 0.05 (providing 95% confidence interval). Results Four hundred and eighty pregnant women were recruited into the study. Of these, 40 tested positive to HBsAg, accounting for 8.3% of the sample population. The age of the subjects studied varied from 14 to 45 years (mean age - 24.3 years) while the mean parity was 2.18. The HIV/HBV co-infection rate was 4.2%. The vertical transmission rate was 51.6%. There were statistically significant relationships between HBV infection and previous history of tribal marks/tattoos (χ2 = 27.39, P = 0.001, df = 1), history of contact with previously infected HBV patients (χ2 = 23.11, P = 0.001, df = 1) and occupation of the women (χ2 = 51.22, P = 0.001, df = 1). Multiple sexual partners, blood transfusion, dental manipulations, sharing of sharps/needles, and circumcision were not significant modes of transmission. There was no statistically significant relationship between maternal age, educational level and HBV infection. Conclusion The authors argued that hepatitis B screening in pregnancy should be made routine practice in Nigeria because of the low pick up rate of the infection based only on risk factors for the disease.
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              Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon?

              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.
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                Author and article information

                Journal
                Iran Red Crescent Med J
                Iran Red Crescent Med J
                10.5812/ircmj
                Kowsar
                Iranian Red Crescent Medical Journal
                Kowsar
                2074-1804
                2074-1812
                22 July 2015
                July 2015
                : 17
                : 7
                : e20598
                Affiliations
                [1 ]Department of Infectious Disease, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
                [2 ]Department of Medicine Community, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
                [3 ]Kashan University of Medical Sciences, Kashan, IR Iran
                Author notes
                [* ]Corresponding Author: Mansooreh Momen Heravi, Department of Infectious Disease, Faculty of Medicine, Kashan University of Medical Sciences, P. O. Box: 8715985131, Kashan, IR Iran. Tel: +98-9133611017, E-mail: momenheravi_m@ 123456kaums.ac.ir mansoreheravi@ 123456yahoo.com
                Article
                10.5812/ircmj.20598v2
                4584256
                3be01990-68dd-4d15-b8eb-c4c89cf2a67e
                Copyright © 2015, Iranian Red Crescent Medical Journal.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 24 May 2014
                : 28 November 2014
                : 15 May 2015
                Categories
                Research Article

                Medicine
                prevalence,hepatitis b virus,hepatitis b surface antigen,pregnant women
                Medicine
                prevalence, hepatitis b virus, hepatitis b surface antigen, pregnant women

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