Elimination of Vertical Transmission of Hepatitis B in Africa: A Review of Available Tools and New Opportunities

Dionne-Odom, Jodie; Njei, Basile; Tita, Alan T.N.

doi:10.1016/j.clinthera.2018.05.016

Cited by 35 publications

(62 citation statements)

References 124 publications

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“…There is a need for stronger commitment and further research to design cost-effective public health and clinical interventions to improve the situation. Health authorities from Sub-Saharan African countries must develop national strategies to combat HBV that should be well resourced, sustainable, supported by the community and linked to other antenatal measures 10…”

Section: Discussionmentioning

confidence: 99%

Seropositivity rate and sociodemographic factors associated to HIV, HBV, HCV and syphilis among parturients from Irene Neto Maternity of Lubango city, Angola

et al. 2020

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ObjectivesTo characterise infections by HIV, Treponema pallidum, hepatitis B (HBV) and C virus (HCV) in parturients admitted to Irene Neto Maternity, Lubango city, Huíla province, Angola, namely its seropositivity rate and its association with sociodemographic factors.MethodsAn observational, cross-sectional and analytical facility-based survey was conducted among 500 parturients at Irene Neto Maternity, from October 2016 to September 2017. Women in labour were screened for antibodies against HIV-1/2, T. pallidum and HCV. Antigen detection was used to diagnose HBV infections. Sociodemographic data were also collected. The seropositivity rate and respective CIs were estimated at a level of 95%. Multivariable logistic regression models were performed to explore the association between the studied infections and sociodemographic factors.ResultsIn 11.8% of the parturients (95% CI 9.3 to 14.9), at least one infection was detected. HBV infection was the most common (8.6%), followed by HIV infection (3.0%) and syphilis (1.0%). Coinfection with HBV and HIV was observed in two parturients (0.4%) and HBV, HIV and T. pallidum were all detected in one parturient (0.2%). No HCV infection was detected. For each additional year of formal education, pregnant women had a 10.0% lower chance of being infected with HBV (adjusted OR=0.900, 95% CI 0.816 to 0.992).ConclusionsThis study is one of the few reports contributing for the knowledge of some sexually transmitted infections epidemiology in Angola. The seropositivity rate of the studied infections is of concern, especially the high endemicity of HBV. There is a need for a stronger commitment and further research to design cost-effective public health and clinical interventions to improve the situation.

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Section: Discussionmentioning

confidence: 99%

Seropositivity rate and sociodemographic factors associated to HIV, HBV, HCV and syphilis among parturients from Irene Neto Maternity of Lubango city, Angola

et al. 2020

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“…We have previously reported poor HBV knowledge and awareness in this region (35). This may be partially due to sub-optimal, even absent, hepatitis B services for pregnant women in most of SSA (13,36). Without testing pregnant women for HBV, it becomes a challenge, not only to identify infected women who require further follow-up testing to ascertain those eligible for anti-viral treatment, but also to plan for timely birth dose vaccination of newborns of these women.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Prevalence among Pregnant Women in Central and West Nile regions of Uganda: Is there a Need to prioritize Prevention of Mother to Child hepatitis B transmission?

Nankya-Mutyoba

Aizire

Makumbi

et al. 2019

Preprint

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Introduction Within sub-Saharan Africa (SSA), the burden of chronic hepatitis B (HBV) is unacceptably high in several countries including Uganda. Elimination of HBV in the context of inadequate resources and several competing health issues, faces challenges including limited data on disease burden in important population sub-groups. In order to optimize available resources, reliable data on HBV among pregnant women is useful to guide policies on prevention. This study estimated HBV prevalence and related factors among pregnant women in Central and West Nile regions of Uganda Methods Using a two-stage sampling approach, we selected a random sample of 310 pregnant women, 18 years or older from public health facility antenatal clinics in central and west Nile, North-western Uganda. Consenting women were interviewed to obtain data on HBV vaccination status, HIV status, selected sexual and lifestyle factors and socio-demographic information. In addition, they underwent phlebotomy to obtain blood for testing for hepatitis B surface antigen, (HBsAg) antibodies to the surface antigen (anti-HBs), and antibodies to the core (anti-HBc), as indicators of chronic infection, prior exposure, and susceptibility (anti-HBs <10 mIU /mL), respectively. Results Out of 310 women, prevalence of chronic HBV infection was 6.2%. Prevalence in the West Nile region was notably higher than in the Central region (11.0% vs. 1.3%), p<0.001. In both regions, majority of pregnant women (61% West Nile region, 76% Central region) were still susceptible to HBV. Overall, proportion who had been tested for HBV and those who reported having been vaccinated was only 5.8% and 11.3% respectively. Conclusion Our findings reveal the burden of HBV in Ugandan pregnant women is still high, with marked regional differences in disease prevalence, and poor levels of HBV testing and vaccination. These data suggest that HBV prevention programs and policies in resource-limited settings like Uganda may need to consider the differential HBV prevalence, as optimizing HBV prevention services in higher prevalence regions may provide greater impact and thereby align with the WHO recommendation on HBV elimination strategy in SSA.

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“…Indeed, the most common cause of cirrhosis in Cameroon is chronic HBV infection, which affects mostly young people [9]. In this area of high endemicity for HBV infection, high prevalence of the HBV infection has mainly been attributed to HBV transmission occurring predominantly early in the life either through mother to child transmission or horizontal transmission [11] [12].…”

Section: Age and Sexmentioning

confidence: 99%

Clinical Aspects and Precipitating Factors of Hepatic Encephalopathy Associated with Cirrhosis in a Cameroonian Population

Kowo¹,

Yimagou²,

Andoulo³

et al. 2019

OJGas

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Background: Hepatic Encephalopathy (HE), a common complication of cirrhosis, is associated with a pejorative prognosis. This study aims to describe the clinical presentation, precipitating factors and outcome of HE. Methods: This was a cross-sectional multicenter inpatient study in cirrhotic patients admitted for HE in four tertiary hospitals in Yaoundé (Cameroon) from December 2016 to May 2017. The diagnosis of HE was based on West Haven clinical criteria. The diagnosis of cirrhosis was made using clinical and/or biological, endoscopic and/or ultrasonography signs. Results: A total of 53 patients with HE (mean age: 49.9 ± 18.9 years, 35 Males) were included. The frequency of hospital admission for HE was 4.9%. HE grade III was the most common (37.7%), followed by grades I and II (26.4% and 26.4%, respectively). Grade IV was present in 9.4% of cases. According to the Child-Pugh score, 72.1% of the patients were at stage C and 27.9% at stage B. The main precipitating factors found were: constipation (38.5%), hyponatremia (35.9%), hepatocellular carcinoma (HCC) (31.7%), herbal medicine (28.3%), hypokalemia (25.6%), gastrointestinal bleeding (22.6%) and ascitic fluid infection (spontaneous bacterial peritonitis) (13.8%). In 5.7% of cases, no factor was identified. Mortality rate during hospitalization was 45.3% and was significantly associated with stage III (RR = 11.1; 95% CI: 1.

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Elimination of Vertical Transmission of Hepatitis B in Africa: A Review of Available Tools and New Opportunities

Cited by 35 publications

References 124 publications

Seropositivity rate and sociodemographic factors associated to HIV, HBV, HCV and syphilis among parturients from Irene Neto Maternity of Lubango city, Angola

Seropositivity rate and sociodemographic factors associated to HIV, HBV, HCV and syphilis among parturients from Irene Neto Maternity of Lubango city, Angola

Hepatitis B Prevalence among Pregnant Women in Central and West Nile regions of Uganda: Is there a Need to prioritize Prevention of Mother to Child hepatitis B transmission?

Clinical Aspects and Precipitating Factors of Hepatic Encephalopathy Associated with Cirrhosis in a Cameroonian Population

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