Abstract
BackgroundHepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. The objective of this study was to estimate the prevalence of HBV among childbearing women and infants born to HBV positive mothers in Togo.MethodsA national cross-sectional study was carried out in six cities in Togo in the six health regions in Togo. Mother-child pairs were recruited from immunization centers or pediatric wards in LomĂŠ, TsĂŠviĂŠ, AtakpamĂŠ, SokodĂŠ, Kara and Dapaong in 2017. Women aged 18 and over with one child of at least 6 months old were included. A standardized questionnaire was used for data collection and HBV screening was performed using DetermineÂŽ rapid tests. The prevalence of HBV, defined by a positive HBV surface antigen (HBsAg), was estimated in mothers and then in infants of mothers who were positive for HBsAg. Logistic regression model was performed to identify risk factors for HBsAg positivity in mothers.ResultsA total of 2105 mothers-pairs child were recruited. The median age of mothers and infants was 29 years, interquartile range (IQR) [25â33] and 2.1 years, IQR [1â3] respectively. About 35% of women were screened for HBV during antenatal care and 85% of infants received three doses of HBV immunization. Among mothers, the prevalence of HBV was 10.6, 95% confidence interval (95% CI) [9.4â12.0%], and 177 had detectable HBV viral load (> 10 IU/mL). Among mothers with positive HBsAg, three infants also had positive HBsAg, a prevalence of 1.3, 95% CI [0.2â3.8%]. In multivariable analysis, HIV-infection (aOR = 2.19; p = 0.018), having at least three pregnancies (aOR = 1.46; p = 0.025) and living in TsĂŠviĂŠ (aOR = 0.31; p < 0.001) compared to those living in LomĂŠ, were associated to HBV infection in mothers.ConclusionIn this study, one out of 10 childbearing women were infected with HBV, but less than 2% of infant born to HBV positive mothers under 5 yearsâ old who received immunization under the Expanded Program on Immunization were infected. Improving antenatal screening and providing targeted interventions in babies could help eliminate HBV in Togo.
Highlights
Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth
Socio-demographic and clinical characteristics of mothers and infants A total of 2105 mother-infant couples were enrolled in six cities in Togo
HIV and HBV history testing in antenatal care Data recorded from maternal health card or immunization card show that 1459 (69.4%) mothers had performed HIV testing and among them, 5.4% were HIV-infected
Summary
Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. Hepatitis B virus (HBV) infection is a global public health problem with 257 million people who are chronically infected in the world [1]. Without effective interventions and an accelerated response, the number of people living with HBV is expected to remain at the current high levels, with a cumulative 20 million deaths between 2015 and 2030 [1]. These deaths will mainly occur in developing countries of Asia and Africa. Elimination of HBV will not be achieved without controlling perinatal transmission of HBV, which is among the five core intervention areas for the global health sector strategy on viral hepatitis 2016â2021 [1]
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