Abstract
IntroductionHepatitis B virus infection is a major public health problem worldwide and in Africa. This would be the first ever documented study on epidemiology of Hepatitis B infections in the newly formed Republic of South Sudan. This study was designed to estimate the sero-prevalence of Hepatitis B virus infection amongst pregnant women attending antenatal services in Juba.MethodsA cross-sectional study was conducted among pregnant women attending antenatal clinic services in Juba Teaching Hospital, in the period between December 2012 and March 2013. Any pregnant woman, attending antenatal care services at Juba Teaching Hospital, was included if she was a resident of Juba County for at least 1 year before pregnancy. A Hepatitis B case was defined as any women participating in the study and was found to be positive for HbsAg and confirmed by ELISA.ResultsThis study documented that the prevalence of Hepatitis B surface antigen (HBsAg) among pregnant women attending ANC in Juba was 11% (31 out of the 280 samples). Other samples tested were indeterminate (36%), naturally immune (27.1%), susceptible (23%) and the remaining 1.8% was immune due to vaccination. Significant risk factors for Hepatitis B infection were loss of partner (OR 4.4 and CI of 1.4-13.9) and history of Jaundice (OR 1.7 and CI of 1.2-2.1).ConclusionThese study findings show that only 29% of infants in Juba county are born to immune mothers (naturally or vaccine induced). The remaining 70% of babies would be at risk of infection, if a birth dose of Hepatitis B is not provided. We therefore recommended introduction of Hepatitis B Vaccine birth dose into routine infants’ vaccination series to eliminate this risk.
Highlights
Hepatitis B virus infection is a major public health problem worldwide and in Africa
Vertical transmission of Hepatitis B virus (HBV) is the main cause of chronic HBV infection and is a problem in endemic areas, such as the Far East and Africa [2,3,4,5,6,7,8]
These study findings suggest that only 30% of infants in Juba county are born to immune mothers
Summary
Hepatitis B virus infection is a major public health problem worldwide and in Africa. This study was designed to estimate the sero-prevalence of Hepatitis B virus infection amongst pregnant women attending antenatal services in Juba. The Strategic Advisory Group of Experts (SAGE) on immunization meeting in October documented that 185 (95%) countries worldwide had introduced hepatitis B vaccination in their infant schedules with only 97 (49%) countries providing the recommended birth dose [9]. South Sudan introduced hepatitis B vaccination into the National infant Immunization program using the Pentavalent (DTP-HepB-Hib) vaccine formulation. While this policy option was considered operationally more feasible, it negates the plight of several children born with high risk of vertical transmission. Evidence from South Sudan is scanty, HBV sero-markers studies in Khartoum using ELISA (and not DNA techniques) suggests that 5.6% of pregnant Sudanese mothers were positive for HBVsAg irrespective of their age, parity and socio-demographic characteristics [10]
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