Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Hepatitis B virus (HBV) is an infectious and a global public health problem. The prevalence of HBV infection among pregnant women is between 2.3% and 7.9%. HBV infection during pregnancy is associated with prenatal transmission to the fetus. HBV has an effective vaccine which reduces up to 96% of the transmission. Although different studies were conducted in Ethiopia, none of them showed the national prevalence of HBV infection among pregnant women. Therefore, this study was conducted to determine the pooled prevalence of HBV and its associated factors in Ethiopia. Methods. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles. All observational published studies were retrieved using relevant search terms in Google Scholar, African Online Journal, CINAHL, and PubMed databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 statistics were used to test heterogeneity whereas Begg’s and Egger’s tests were used to assess publication bias. Odds ratio (OR) with a 95% confidence interval (CI) was presented using the forest plot. Results. A total of twenty-three studies were included in this systematic review and meta-analysis. The pooled prevalence of HBV in Ethiopia was 4.75% (95% CI: 4.06, 5.44). The subgroup analysis showed a higher prevalence of HBV infection among pregnant women in Gambella (7.9%) and the lowest in Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (2.3%). Associated factors with HBV infection include history of multiple sexual partner (OR=6.02 (95%CI=3.86, 9.36)), blood transfusion history (OR=5.71 (95%CI=3.25, 10.04)), abortion history (OR=3.58 (95%CI=2.10, 6.09)), and history of body tattoo (OR=2.83 (95%CI=1.55, 5.17)). Conclusions. HBV infection among pregnant women is a common public health problem in Ethiopia. Multiple sexual partners, abortion history, blood transfusion history, and body tattoo were significantly associated with HBV infection. Policies and strategies should focus on factors identified in this study to improve the prevention of HBV among pregnant women.

Sero-Prevalence of Hepatitis B Virus Infection and Associated Factors Among Pregnant Women Attending Antenatal Care Services in Gedeo Zone, Southern Ethiopia

“…The prevalence was the highest across the country compared to the pooled prevalence as showed by 26 recently. Previous studies in different regions of Ethiopia reported lower proportions, from the lowest prevalence (3.7%) in Jimma town to the highest (8.4%) in Dire Dawa.…”

“…32 In this study area, the overall sero-prevalence of HBsAg among pregnant women was 9.2%, which could be considered as a high endemicity area (with sero-positivity ≥8% seropositive), based on WHO classification criteria of endemicity of HBV infection. 13 The prevalence was the highest across the country compared to the pooled prevalence as showed by 26 recently. Previous studies in different regions of Ethiopia reported lower proportions, from the lowest prevalence (3.7%) in Jimma town to the highest (8.4%) in Dire Dawa.…”

“…25 Different factors, such as having a history of blood transfusion, history of use of sharp materials, having multiple sexual partners, ear piercing, history of abortion, place of delivery, the practice of female genital mutilation, history of tooth extraction, cesarean section, and tattooing, were some major risk factors associated with HBV Ag sero-positivity in previous studies in similar settings. 19 - 30…”

Prevalence of Hepatitis B Virus Among Pregnant Women on Antenatal Care Follow-Up at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia

“…10,19 A meta-analysis conducted in Ethiopia also reported a positive association between multiple sexual partners and HBV infection. 22 The association between these two variables shows that women need to take necessary care including limiting the number of sexual partners/one to one sexual practice and increasing condom use behavior so as to minimize/avoid the chance of contracting HBV.…”

Sero-prevalence of Hepatitis B virus infection and associated factors among pregnant women attending antenatal care service in health institutions in Gedeo Zone, Southern Ethiopia

“…The pooled prevalence for HBV among pregnant mothers in Ethiopia was 4.75% [30]. Different factors, such as having a history of blood transfusion, history of use of sharp materials, having multiple sexual partners, ear pricing, history of abortion, place of delivery, the practice of female genital mutilation, history of tooth extraction, cesarean section, and tattooing, were some of the major risk factors associated with HBV Ag seropositivity in previous studies in similar settings [23][24][25][26][27][28][29][30][31][32][33][34].…”