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      Prevalence, socio-demographic features and risk factors of Hepatitis B virus infection among pregnant women in Southwestern Nigeria

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          Abstract

          Introduction

          Hepatitis B virus is responsible for 50%-80% of Hepatocellular carcinoma cases worldwide. In Nigeria, vertical transmission remains a major route of Hepatitis B virus infection. Primary (vaccines and post-exposure prophylaxis) and secondary prevention of HBV transmission by appropriate sexual and sanitary practices are not yet optimal in the country yet measures for early detection (serological, molecular) and treatment of infected pregnant women is not a practice. This study aimed at identifying the prevalence and risk factors for Hepatitis B virus infection among pregnant women in Ibadan, Southwestern Nigeria.

          Methods

          A cross-sectional study was done at the Ante-natal clinic of the University College Hospital Ibadan. One hundred and eighty pregnant women were recruited from March to August 2013, and tested for Hepatitis B surface antigen (BIORAD FRANCE) using third generation ELISA, as well as HIV-1 and 2 using Uni-Gold Recombigen and ALERE determine (a rapid immunoassay designed to detect antibodies to HIV 1 and/or 2). Positive HBsAg samples were tested for Hepatitis B envelope antigen, antibody and Hepatitis B core antibody (DIAPRO Italy) while serum HBV DNA was detected using PCR. Data were obtained using questionnaires to establish and analysis was performed using SPSS version 20.

          Results

          The seroprevalence of HBsAg was 8.3% out of which 26.7% were positive for HBeAg, 53.3% had HBeAb, 20% had neither HBeAg nor HBeAb, 100% had total HBcAb and 86.7% had HBV DNA in their serum. The mean age was 32.1years, the highest HBV infection rate occurred in 25-29 year age group. Multiple sexual partners (OR- 3.987, P- value=0.026) and early age at sexual debut (OR 11.996, P- value=0.022) were independent risk factors for HBV infection.

          Conclusion

          Hepatitis B virus infection is of high endemicity in Nigeria thus early detection, treatment of infected pregnant women, immunoprophylaxis for exposed newborns and surveillance for those with chronic infection is essential. Health education programs on prevention and control measures must be instituted.

          Most cited references49

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          Worldwide epidemiology of HBV infection, disease burden, and vaccine prevention.

          D Lavanchy (2005)
          Worldwide, hepatitis B virus (HBV) is the most common among those hepatitis viruses that cause chronic infections of the liver in humans, and it represents a global public health problem. Chronic hepatitis caused by HBV is the major cause of hepatocellular carcinoma (HCC) worldwide, and remains therefore a major public health problem globally. This fact is related to both the continuing occurrence of frequent new infections and to the presence of a large reservoir of persons chronically infected, which may develop severe and fatal complications of chronic liver disease. Hepatitis B and all of the complications resulting from it, as well hepatitis D (HDV) and its complications, are globally preventable by hepatitis B vaccination, and therefore elimination of HBV transmission and of new acute and chronic infections is a feasible goal.
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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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              Epidemiology of hepatitis B in Europe and worldwide.

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                24 April 2015
                2015
                : 20
                : 406
                Affiliations
                [1 ]Institute of Human Virology Nigeria, FCT, Abuja, Nigeria
                [2 ]Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Oyo State, Nigeria
                [3 ]Institute of Child Health, College of Medicine, University of Ibadan, Oyo State, Nigeria
                [4 ]Department of Medical Microbiology and Parasitology, University of Ibadan, Oyo State, Nigeria
                Author notes
                [& ]Corresponding author: Chinenye Gloria Anaedobe, Institute of Human Virology Nigeria, FCT, Abuja, Nigeria
                Article
                PAMJ-20-406
                10.11604/pamj.2015.20.406.6206
                4524914
                26301010
                5f7ed070-190a-44be-a809-6304bc531e39
                © Chinenye Gloria Anaedobe et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 January 2015
                : 09 February 2015
                Categories
                Research

                Medicine
                hepatitis b virus,hepatocellular cancer,prevalence,risk factors,pregnancy,vertical transmission,serology,molecular,ibadan

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