Associated Risk Factors and Seroprevalence of Hepatitis B among Pregnant Women Attending Antenatal Clinic in a Rural Setting of Cameroon (Penka-Michel)

Background: Vertical transmission is an important route of transmission for hepatitis B virus infection. Despite the introduction of HBV vaccine in the extended immunization program in 2005, Cameroon has remained a hyper-endemic area. The aim of this study was to determine the seroprevalence of hepatitis B Virus among antenatal clinic attenders in Penka-Michel-Cameroon, and to identify potential risk factors associated with the infection for a better prevention of the disease.

Study Design: The study was a case control study conducted in four reference hospitals in Penka-Michel, a rural area in west region of Cameroon during April to July 2014.

Methodology: Six hundred and forty three (643) pregnant women were recruited. The DiaSpot HBsAg in vitro diagnostic test strips were first used. Positive samples were further confirmed for HBsAg, HBeAg, anti-HBs, anti-HBe and anti-HBc using an immunoassay kit. Liver enzymes (ALT, AST and ALP) were also evaluated for HBsAg positive samples using TECO DIAGNOSTICS kit. A structured questionnaire was used to collect information on sociodemographic parameters and predisposing risk factors of hepatitis B from each patient. Data collected was analyzed using Graph Pad prism version 5.03.

Results: The prevalence of hepatitis B infection (HBsAg) in our setting was 4.7%. Fifty percent of HBsAg positive women were also HBeAg positive and 46.7% of them lack antibodies against hepatitis B e antigen. All the HBsAg positive women had previous contact with HBV and just 3.3% of them were immunized against HBV. Women in the age groups 31–35 years were significantly more affected (X2 16.95, P = .0045). Only a history of a contact with hepatitis B infection was significantly associated with HBsAg and HBeAg positivity (X2 27.45, P = .0001; X2 25.31, P = .0003).

Conclusion: Administration of HBIG in combination with hepatitis B vaccine as post-exposure prophylaxis for infants born to HBV infected mothers is of paramount importance. In addition, universal HBsAg screening of all pregnant women will greatly assist in reducing the maternal transmission of HBV in Cameroon.