Abstract

BackgroundChronic hepatitis B Virus (HBV) infection affects 80–100 million people in sub-Saharan Africa and accounts for an estimated 650,000 deaths annually. The prevalence of active hepatitis B virus infection among women aged 15–64 in mid-Northern Uganda is about 5%. Lira district is among the high prevalence areas where government embarked on mass HBV screening since 2015 as a gateway for access to prevention, treatment services, and an effective response to the hepatitis B epidemic. The current proportion of pregnant women screened and the factors associated with prenatal HBVscreening in Lira are not known despite the fact that women contribute largely to both vertical and horizontal transmission of HBV. This study aimed at determining the proportion of pregnant women screened for HBV and factors associated with prenatal HBV screening in Lira district.MethodsThis was a community based cross sectional study conducted among 423 pregnant women in the sub counties of Aromo and Agweng in Lira district. Data were collected using open data kit and analysed using STATA version 14. The outcome variable was prenatal HBV screening while predictor variables were community, individual and health facility factors associated with HBV screening. Multivariable logistic regression was used to determine factors associated with prenatal HBV screening.ResultsThirty five women (8.3%) had been screened for HBV during the current pregnancy. Factors associated with prenatal HBV screening in Lira included perceived risk (Adjusted Odds Ratio (AOR) 3.78, 95% CI 1.01–6.14), respondent’s age (AOR = 3.98, 95% CI 1.39–5.09), husband/partner’s education (AOR = 3.34, 95% CI 1.10–5.12) and past failure to access to HBV screening services at government health facilities (AOR = 6.44, 95% CI 2.10–8.02).ConclusionThe level of HBV screening among pregnant women in Lira was low and is mainly associated with perceived risk, age, access to HBV screening services and spousal education level. More effort is needed in creating mass awareness on the need and importance of HBV screening most especially among pregnant women.

Highlights

  • Chronic hepatitis B Virus (HBV) infection affects 80–100 million people in sub-Saharan Africa and accounts for an estimated 650,000 deaths annually

  • Globally, about 248 million people are living with chronic Hepatitis B Virus (HBV) infection and the burden of HBV remains disproportionately high in low and middle-income countries (LMICs), in Asia and Africa [1]

  • Information accessed from the District Health Information System (DHIS) shows that in Lira district, 13609 people were screened for HBV out of whom 8.5% (1150) tested positive between June 2017 and June 2018

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Summary

Introduction

Chronic hepatitis B Virus (HBV) infection affects 80–100 million people in sub-Saharan Africa and accounts for an estimated 650,000 deaths annually. Routine Hepatitis B surface antigen (HBsAg) serological testing of all pregnant women in antenatal clinics and linkage to prevention, care and treatment services is the recommended standard way of controlling and reducing neonatal HBV transmission in settings where HBsAg seroprevalence in the general population exceeds 2% [1]. To this effect, the Ministry of Health in Uganda embarked on mass screening in addition to opening up specialized HBV clinics in several high prevalence areas including Lira district [4]. Information accessed from the District Health Information System (DHIS) shows that in Lira district, 13609 people were screened for HBV out of whom 8.5% (1150) tested positive between June 2017 and June 2018

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