Hepatitis B chronic infection among pregnant women attending the antenatal care in Bor State Referral Hospital, South Sudan

Introduction: Hepatitis B virus (HBV) is a major public health problem affecting 400 million people worldwide, and is a common cause of chronic liver failure (cirrhosis) and hepatocellular carcinoma. Sixty-eight percent of infected people are from the African and Pacific regions. Vertical transmission from mother to newborn baby is one of the mechanisms by which chronic hepatitis virus infection spreads, besides infections from contaminated needles and syringes and sexual contact. Hepatitis B chronic infection is endemic in many poor countries, especially in Africa. Method: A cross-sectional study was conducted between July and August 2021. Pregnant women attending the antenatal care (ANC) in Bor State referral hospital, South Sudan, were interviewed to collect information on their socio-demographic characteristics and risk factors for hepatitis B infection. The objective was to determine the seroprevalence of hepatitis B chronic infection through blood testing. Prevalence ratios for certain risk factors were calculated. Results: Two hundred pregnant women were enrolled. The Prevalence Rate for chronic infection with hepatitis B virus, diagnosed using the rapid immune-chromatographic assay for Hepatitis B surface antigen (HBsAg), was 8.5%. (95% CI; 4.7% - 12.3%). None of the suspected risk factors studied were found to be significantly associated with testing positive for HBV, except for a history of previous jaundice. Conclusion: The prevalence of HBV chronic infection among pregnant women in Bor, Jonglei State, is high hence there is a need for established public health interventions that can lead to a reduction of HBV vertical transmission. Treatment of pregnant women with HBV chronic infection using anti-viral medications during pregnancy might curb the vertical transmission rates.

Knowledge and attitude of community health officers towards hepatitis B virus infection in Rivers State, Nigeria

Background: Hepatitis B infection is endemic in Nigeria and healthcare workers are at high risk of the infection. The aim of the study therefore, was to determine the knowledge and attitude of community health officers concerning hepatitis B virus infection. Materials and Methods: Descriptive cross-sectional study conducted among 95 community health officers in Rivers State. The study tool was a self-completed questionnaire. Consenting health officer were administered the questionnaire which evaluated respondents' general knowledge about hepatitis B infection, its prevention and vaccination status. Data analysis was done with SPSS v20.Results: A total of 95 respondents participated in the study, comprising 16 (16.8%) males and 79 (83.2%) females. All the participants were aware of the HBV infection and majority 96.8% knew HBV affects the liver and 78.9% that jaundice is a feature of the infection. Most of the participants 90.5% knew HBV can be transmitted through blood and body fluids. Almost all (98.9%) the respondents knew that HBV is preventable. Most of the respondents (86.3%) associated their job with the risk of the infection and only 13.7% had not received the vaccination.Conclusion: The CHOs demonstrated adequate knowledge about HBV infection but their response to its vaccination was not absolute. The primary healthcare workers as well as other healthcare personnel should be encouraged to receive the complete dose of HBV vaccine to reduce the likelihood of transmission of the infection in healthcare settings

The status of hepatitis B control in the African region

The World Health Organization (WHO) African Region has approximately 100 million people with chronic hepatitis B virus (HBV) infection. This review describes the status of hepatitis B control in the Region. We present hepatitis B vaccine (HepB) coverage data and from available data in the published literature, the impact of HepB vaccination on hepatitis B surface antigen (HBsAg) prevalence, a marker of chronic infection, among children, HBsAg prevalence in pregnant women, and risk of perinatal transmission. Lastly, we describe challenges with HepB birth dose (HepB-BD) introduction reported in the Region, and propose strategies to increase coverage. In 2015, regional three dose HepB coverage was 76%, and 16(34%) of 47 countries reported ≥ 90% coverage. Overall, 11 countries introduced HepB-BD; only nine provide universal HepB-BD, and of these, five reported ≥ 80% coverage. From non-nationally representative serosurveys among children, HBsAg prevalence was lower among children born after HepB introduction compared to those born before HepB introduction. However, some studies still found HBsAg prevalence to be above 2%. From limited surveys among pregnant women, the median HBsAg prevalence varied by country, ranging from 1.9% (Madagascar) to 16.1% (Niger); hepatitis B e antigen (HBeAg) prevalence among HBsAg-positive women ranged from 3.3% (Zimbabwe) to 28.5% (Nigeria). Studies in three countries indicated that the risk of perinatal HBV transmission was associated with HBeAg expression or high HBV DNA viral load. Major challenges for timely HepB-BD administration were poor knowledge of or lack of national HepB-BD vaccination guidelines, high prevalence of home births, and unreliable vaccine supply. Overall, substantial progress has been made in the region. However, countries need to improve HepB3 coverage and some countries might need to consider introducing the HepB-BD to help achieve the regional hepatitis B control goal of < 2% HBsAg prevalence among children < 5 years old by 2020. To facilitate HepB-BD introduction and improve timely coverage, strategies are needed to reach both facility-based and home births. Strong political commitment, clear policy recommendations and staff training on HepB-BD administration are also required. Furthermore, high quality nationally representative serosurveys among children are needed to inform decision makers about progress towards the regional control goal

Low coverage of hepatitis B vaccine and determinants among health professionals working in Amhara regional state hospitals, Ethiopia

More than two billion people have been infected with hepatitis B virus (HBV), 360 million have chronic infection and 600,000 die each year from HBV-related liver disease or hepatocellular carcinoma. Each year more than 66,000 health professionals are infected by hepatitis b virus and vaccination against hepatitis B saves the life's of these health professionals. The aim of this study was to determine the prevalence and associated factors of hepatitis B vaccine coverage in a resource limited settings. A cross sectional study design was conducted. The study was conducted on 1184 health professionals at Amhara national regional state, Ethiopia. Simple random sampling technique was used. Structured questionnaire was used to collect the data. Descriptive statistics were used to identify the prevalence while Binary logistic regression was used to assess the determinants of hepatitis B vaccine coverage. The coverage of hepatitis B vaccine was 4%. Vaccination were affected by work load (AOR=0.19, 95%CI= 0.08-0.46; P<0.01), negligence (AOR=0.04, 95%CI=0.01- 0.11: P<0.01), universal precaution training (AOR=14.75, 95%CI=5.66-38.44: P<0.01), perception that they are not at risk of infection (AOR=0.34, 95%CI=0.15-0.79: P=0.01), unaffordable cost (AOR=0.12, 95%CI=0.05-0.28: P<0.01), awareness about the vaccine (AOR=4.55, 95%CI=1.53-13.49: P<0.01), peer pressure (AOR=3.8, 95%CI=1.34-10.74: P=0.01), knowledge about where to get the vaccine (AOR=5.13, 95%CI=1.87-14.11: P=0.02), unavailability of the vaccine (AOR=0.25, 95%CI=0.1-0.63: P=0.03), year of experience (AOR=7.27, 95%CI=2.23-23.72: P<0.01). Low hepatitis B vaccine coverage was observed. The ministry of health should avail the vaccine to all those health professionals, develop awareness on HBV and improve the affordability of the vaccine

Immunogenicity of plasma derived vaccine in Ethiopian Hospital Personnel

Immunogenicity of plasma derived hepatitis B vaccine; serological markers (HBsAg; anti HBc and anti HBs) were determined in 432 hospital employees by the Hepanostika microenzyme linked immunoassay method (ELISA) using kits obtained from Organon Technika Laboratories (Holland). Three doses of Pasteur plasma derived vaccine (Hevac B); containing 4 mcg of HBsAg; were administered intramuscularly at one month intervals to 80 of the 102 marker negatives. A booster dose was given at one year. Hepatitis B markers (HBsAg; anti HBc and anti HBs) were determined at 4; 12; 13 and 24 months by ELISA method. Titration for anti HBs were performed at T4; T12 and T13 by the radio-immunoassay method. Of 80 vaccinees; 2 discontinued after the first injection. Sero-conversion to anti HBs occured at 4 months in 57 0f 80 (71.3 per cent); at 12 months in 64 of 73 tested (87.7 per cent) and at months 13 and 24 in 66 and 69 tested (95.6 per cent). Protective levels of anti HBs were achieved in titrated sera collected from sero-converters in 89 per cent; 88.5 per cent and 100 per cent at months; 4; 12 and 13 respectively. No vaccinee developed any evidence of hepatitis B infection during the two years of follow up. A female developed generalized skin rash and a pregnant woman aborted; both following the first injection. The authors conclude that derived hepatitis B vaccine administered to adult Ethiopian hospital personnel is highly immunogenic and protective with minimal side effects