Risk factors associated with Hepatitis B virus infection among pregnant women attending public hospitals in Addis Ababa, Ethiopia.

BACKGROUND: Hepatitis B Virus (HBV) infection is one of the serious public health problems worldwide and is a major cause of morbidity and mortality. Viral hepatitis during pregnancy poses problems like a high risk of maternal complications, mother-to-child transmission (MTCT), and challenges in the management of drugs. This study aimed to determine the magnitude of HBV infection and associated risk factors among pregnant women who attended public hospitals in Addis Ababa, Ethiopia. METHOD: A multicenter prospective cohort study with a nested case-control was conducted from January 2019 to December 2020 in 5 public hospitals with maternal and child health care services in Addis Ababa. Three hundred pregnant women whose screening results for Hepatitis B surface antigen (HBsAg) were positive and another 300 with negative HBsAg were involved. Laboratory test results of blood samples and structured questionnaires were used to collect the data. Data was entered and analyzed by SPSS version 20 software using descriptive and logistic regression analyses. RESULTS: Of the 12,138 pregnant women who screened for HBsAg as routine antenatal care (ANC), 369 (3.04%) were positive. All of the sociodemographic characteristics did not significantly differ in both the cases and the controls. Body tattooing (AOR = 1.66; 95 CI: 1.008-2.728), multiple sexual partners (AOR = 2.5; 95% CI: 1.604-3.901), family history of HBV (AOR = 2.62; 95% CI: 1.239-5.547), and sharing sharp materials (AOR = 3.02; 95% CI: 1.87-4.87) were factors associated with increased risk of HBV infection. CONCLUSIONS: An intermediate endemicity of HBV infection was detected among pregnant women. Body tattooing, having multiple sexual partners, family history of HBV, and sharing sharp materials were significantly associated with HBV infection. Awareness creation on the mode of transmission and early screening of all pregnant women for HBsAg must be strengthened to minimize and control the spread of the infection.

Co-infection of HIV or HCV among HBsAg positive delivering mothers and its associated factors in governmental hospitals in Addis Ababa, Ethiopia: A cross-sectional study.

BACKGROUND: Blood borne viral infections such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency virus (HIV) cause substantial mortality and morbidity worldwide. Viral hepatitis during pregnancy is closely related to high risks of maternal and neonatal complications. In Ethiopia, only a little information is available on co-infection of HCV or HIV among Hepatitis B surface Antigen (HBsAg) positive pregnant mothers. Thus, the study aimed to determine HIV or HCV co-infection and associated risk factors among HBsAg positive delivering mothers. METHOD: A health facility-based cross-sectional study was conducted in five governmental hospitals in Addis Ababa among 265 HBsAg positive delivering mothers in the year 2019 and 2020. A purposive sampling technique was used to select the study participants. Structured questionnaires and laboratory test results were used to collect the data. SPSS version 20 software was used to enter and analyze the data. Multivariable logistic regression was used to identify independent predictors of HIV or HCV co-infections. RESULTS: Of the HBsAg positive delivering mothers, 9 (3.4%) and 3 (1.1%) were co-infected with HIV and HCV, respectively. None of them were with triplex infection. All of the socio-demographic characteristics were not significantly associated with both HIV and HCV co-infections. Mothers who had a history of sexually transmitted diseases (STDs) were 9.3 times more likely to have HBV-HIV co-infection (AOR = 9.3; 95% CI: 1.84-47.1). Mothers who had multiple sexual partners were 5.96 times more likely to have HIV co-infection (AOR = 5.96; 95% CI: 1.074-33.104). The odds of having HBV-HIV co-infection were 5.5 times higher among mothers who had a history of sharing shavers, razors, and earrings (AOR = 5.5;95% CI: 1.014-29.69). HCV co-infection was not significantly associated with any of the potential risk factors. CONCLUSION: This dual infection rate of HBsAg positive delivering mother with HIV or HCV indicates that a substantial number of infants born in Ethiopia are at high risk of mother-to-child transmission (MTCT) of HBV, HIV, and HCV. Thus, all pregnant mothers need to be screened for HBV, HCV, and HIV during antenatal care, and also need implementation of prevention mechanisms of MTCT of these viral infections.

Performance of visual Inspection With Acetic Acid for Cervical Cancer Screening as Compared to Human papillomavirus Deoxyribonucleic acid Testing Among Women With HIV in Ethiopia: A Comparative Cross-sectional Study.

OBJECTIVES: The aim of this study was to evaluate the performance of visual inspection with acetic acid compared with Human papillomavirus Deoxyribonucleic acid (HPV DNA) testing among women with HIV in Ethiopia. METHODS: A comparative cross-sectional study was conducted to address the aforementioned objective. Data were collected from January to October 2021, to compare the performance of these two screening modalities. Trained clinicians collected cervical specimens and immediately applied acetic acid for visual inspection. The HPV DNA testing was done using Abbott m2000rt/SP by trained laboratory professionals in accredited laboratories. A total of 578 women with HIV aged 25-49 years were included. RESULTS: Test positivity was 8.9% using visual inspection with acetic acid (VIA) and 23.3% using HPV DNA test. The sensitivity and specificity of the VIA test were 19.2% and 95.1%, respectively. The strength of agreement between the two screening methods was poor (k = .184). The burden of genetic distribution of high risk HPV16 was 6.1%, and HPV18 was 1.1%. Other high risk HPV types (ie non-HPV 16/18 high risk HPV genotypes) were predominant in this study (18.6%). CONCLUSION: The higher positivity result using HPV DNA testing compared with VIA, and low sensitivity of VIA are indicating that the implementation of HPV DNA testing as the primary screening strategy is likely to reduce cervical cancer cases and deaths of women in the country.

Molecular epidemiology of human papillomavirus among HIV infected women in developing countries: systematic review and meta-analysis.

BACKGROUND: Although, there is a variable burden of human papillomavirus (HPV) in women infected with HIV in developing countries, there are few studies that attempted to surmise such variable evidences. This review aimed to estimate the pooled prevalence of HPV genotype distribution and risk factors contributing to HPV infection among women infected with HIV in low- and middle-income countries. METHODS: We conducted a systematic review and meta-analysis of studies conducted in developing countries and reported HPV prevalence. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Excerpta Medical Database from Elsevier, Web of science, Cumulative Index of Nursing and allied Health Sciences and Google scholar databases to retrieve primary studies published in English language till 11th August 2019. We used random-effects model to estimate the pooled prevalence of HPV genotypes, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42019123549. RESULTS: We included nineteen studies with a total of 8,175 participants in this review. The prevalence of HPV was extremely heterogeneous across the studies (χ2= 3782.80, p value < 0.001, I2 = 99.6%). The estimated pooled prevalence of all HPV genotypes was 63.0% (95% CI: 48.0-78.0) while the pooled prevalence of high risk and low risk HPV genotypes were 51.0% (95% CI: 38.0-63.0) and 28.0% (95% CI: 12.0-43.0), respectively. The pooled prevalence of HPV genotype 16 was 20%, while genotype 18 and 52 were 15% and 13%, respectively. Different risk factors reported for HPV infection and the frequently reported were low CD4 count below 200 cells/mm3 and high HIV viral load. CONCLUSION: The pooled prevalence of HPV among HIV infected women in low- and middle-income countries was considerable and the proportion of high risk HPV genotypes were high when compared with low risk genotypes. Therefore, it is essential for the HPV prevention program to prevent the double burden of HPV and HIV in women.