Seroepidemiology and associated risk factors of hepatitis B and C virus infections among pregnant women attending maternity wards at two hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan

Abstract

Background & aim Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan. Methodology From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant. Results The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively. Conclusion & recommendation HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.

High Seroprevalence of Hepatitis B and C Virus Infections among Pregnant Women Attending Antenatal Clinic in Borumeda General Hospital, Northeast Ethiopia

“…A cross-sectional study in Tanzania also reported consistent HBV infection rates among pregnant women [ 33 ]. Some other research findings in Ethiopia and abroad revealed that the seroprevalence of HBV among the same study subjects was lower than that of the current study [ 6 , 13 , 19 , 20 , 34 ]. On the contrary, some other studies showed higher HBV infection rate among different population groups and among pregnant mothers.…”

“…The overall seroprevalence of HBV and HCV among pregnant women in the current study was found to be 14 (11.3%). This rate of infection was higher than those in studies conducted in the northwestern part of Ethiopia and in Pakistan [ 17 , 19 ]. A study conducted in Egypt indicated that only 1.2% of pregnant women were found to be infected with either HBV or HCV [ 7 ], whereas a study conducted in East Wollega, Ethiopia, showed comparable results in which 10.2% of study participants were infected with either HBV or HCV [ 9 ].…”

“…In the present study, there were no any study participants who were infected with both of these viruses. A similar scenario in which the absence of HBV and HCV coinfectivity was documented in a lot of research work [ 17 , 19 , 44 , 45 ]. Some other similar studies showed slight coinfectivity rate between the two viruses [ 43 ], and still, there are very few studies that indicate high rate of coinfectivity [ 42 ].…”

“…Some studies about the associated factors of HCV among pregnant women also revealed different determinants influence the seroepidemiology of the virus. A study conducted in Pakistan showed a history of surgical procedure, and maternal age determines the prevalence of HCV [ 19 ]. Even though it is not statistically supported, the prevalence of both HBV and HCV was higher among pregnant women who are living in the rural area [ 19 – 21 ].…”

“…A study conducted in Pakistan showed a history of surgical procedure, and maternal age determines the prevalence of HCV [ 19 ]. Even though it is not statistically supported, the prevalence of both HBV and HCV was higher among pregnant women who are living in the rural area [ 19 – 21 ].…”