Abstract
Background The overlap of malaria and Hepatitis B Virus (HBV) infections present a major threat to public health throughout endemic countries of tropical and sub-Saharan Africa. There is a paucity of data on the prevalence and associated factors of malaria and HBV infections among pregnant women in Ejule, a semiurban area of Nigeria. Therefore, the current study was designed to assess the seroprevalence of malaria and HBV among pregnant women attending antenatal clinics in Ejule Metropolis. Materials and Methods In a hospital-based cross-sectional study, blood samples collected from 200 apparently healthy pregnant women at the Ilemona Clinic were screened for Plasmodium falciparum (P. falciparum) and HBsAg using histidine-rich protein 2 (HRP2) and hepatitis B surface antigen (HBsAg) rapid diagnostic tests (RDTs), respectively. Relevant sociodemographic and putative risk factor information was obtained with structured questionnaires. Results The prevalence of the infections was 44 (22%), 5 (2.5%), and 1 (0.5%) for P. falciparum monoinfection and HBV monoinfection and coinfection, respectively. Single and concurrent infections peaked at ages 31–40 years but decreased with older ages. High P. falciparum, 31 (59.62%), and HBV 2 (3.85%) infection were observed among those without formal education. Contrary to ages, occupation, and knowledge of infection, malaria parasitemia differed significantly with lower educational qualification (p ≤ 0.001), being single (p=0.001), and inconsistent use of insecticide-treated bed nets (ITNs) (p=0.04, OR = 5, CI: 0.10–0.47). History of blood donation (OR = 5, p=0.04, CI: 1.10–32.80) and multiple sex partners (OR = 11.9, p=0.01, CI: 0.01–0.93) were found to be significantly associated with hepatitis B surface antigenemia rate during pregnancy. No evidence of HBV infection was observed in women with a history of HBV vaccination. Conclusions Malaria is still highly prevalent among pregnant women due to high illiteracy and noncompliance to using ITNs. Therefore, routine screening and educating pregnant mothers are crucial in eliminating malaria in endemic settings. The low rate of hepatitis B and coinfection with malaria shows that further improvement in HBV vaccination could considerably reduce the disease burden among pregnant women.
Highlights
Malaria remains a disease of major public health concern globally
Malaria and hepatitis B virus infections are both common and life-threatening infectious diseases in developing countries including Nigeria, and the endemicity of these infections overlaps frequently due to geographical coincidence. eir high prevalence as monoinfection shows their infectious ability as coinfections
Both infections can influence each other from a clinical perspective because of some common developmental stages within the hepatocytes, which had been likened to impaired clearance of the liver stages of malaria parasites due to hepatocytes damage in hepatitis B virus infection [9, 16]
Summary
Malaria remains a disease of major public health concern globally. A world health report in 2020 showed malaria was responsible for about 229 million cases and 409 000 deaths worldwide [1]. Malaria and HBV coinfection may pose a serious public health problem among pregnant women in developing countries where both infectious diseases are endemic [8]. E current study aimed to evaluate seropositivity to HBsAg and malaria parasite antigen singly and concurrently among pregnant women attending the antenatal clinic in Ejule metropolis, Kogi State, Nigeria.
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