Seroprevalence of Hepatitis B, Hepatitis C, and HIV Infections Among Pregnant Women and Newborns in Mogadishu, Somalia: A Four-Year Retrospective Study

Abstract

In Somalia, the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections have different distributions according to gender, age, geographical regions of the country with different conditions, and subgroups of the population which have different characteristics or a specific disease. After the increasing number of general prevalence studies across the country in recent years, the need to examine the prevalence of relevant viral infections in subgroups of the society, which are especially important for public health, has arisen. In this study, it was aimed to investigate the frequency and epidemiological characteristics of HBV, HCV, and HIV infections in pregnant women and children under one year of age who admitted to our hospital. In our study, between 2015-November and 2019-November, 4,274 pregnant women (Group 1; mean age of 26.3±5.697 and an age range of 15-49) who were followed up or delivered in our hospital, 1,534 non-pregnant female patients with various diseases (Group 2; mean age 34.5±12.589 years, age range 15-95), and 1,059 infants under one age were retrospectively investigated. Newborn (<1 month) in the third group were also examined as a subgroup. The seroprevalence of anti-HBs, HBsAg, anti-HCV, and anti-HIV, which are viral infection markers, in pregnant women were found as 17.2% (n=644), 2.8% (n=116), 0.17% (n=7), and 0.14% (n=6), respectively. In non-pregnant women, the seroprevalence of anti-HBs, HBsAg, and anti-HCV were found as 27% (n=324), 6.4% (n=95), and 1% (n=14), respectively, and these rates were significantly higher than in pregnant women (Group 1) (p<0.001). The anti-HIV seropositivity rate in non-pregnant women (Group 2) was 0.07% (n=1), and this value was lower than the incidence in pregnant women (p=0.6881). In infants (Group 3), the seroprevalence of anti-HBs, HBsAg, anti-HCV, and anti-HIV was found as 35.6% (n=320), 0.8% (n=9), 1.4% (n=14), and 0.4% (n=4), respectively. High anti-HBs seropositivity was associated with the vaccination campaign carried out across the country and in our hospital. While HBsAg seroprevalence in infants was very low compared to hospital-wide data (0.8% vs. 8.1%), anti-HCV seroprevalence (1.4%) was similar to hospital-wide data (1.41%). Anti-HIV seroprevalence in infants (0.4%) was higher than both hospital-wide data (0.32%) and prevalence data for under 15s (0.15%). The high rate of anti-HBs due to vaccination was also notable in the newborns subgroup, however three (1.09%) newborn babies were HBsAg positive, indicating vertical maternal transmission. Similarly, two out of four HIV-infected infants (50%) were diagnosed in the neonatal period, indicating mother-to-child transmission. Our study data show that in Mogadishu, a region where access to treatment is easier than in the rest of the country, the impact of HBV infection tends to decrease, however HBV and HCV infections and HIV infections, although at low prevalence, continue to be transmitted from mothers to their babies. We think that the results of this study are valuable, especially in terms of revealing the changing trends in the epidemiology of infections in the region.