PREVALENCE OF HEPATITIS B AMONG PREGNANT WOMEN IN GHANA

ABSTRACT

Background: Hepatitis is a disease defined by the inflammation of the liver and it is characterized by the existence of inflammatory cells in the tissues of the liver leading to fibrosis or cirrhosis. Viral hepatitis has become a global public health threat affecting millions of people yearly, causing disability and mortality. There are an estimated five hundred million people who are chronically infected with hepatitis B virus (HBV) or Hepatitis C virus (HCV). Reliable data is required by policy making health officials on regular basis in planning and improving of relevant interventions. However, a common challenge health care-planners face often is lack of data and if data is available at all they are imperfect. A review of the national health facilities viral hepatitis data in Ghana indicated that 60% of viral hepatitis data are untyped. Currently the extent of the prevalence of Hepatitis B among sections of the Ghanaian population like pregnant women and the level of endemicity of Hepatitis B is unknown in Ghana. Therefore this study aimed to determine the prevalence of Hepatitis B Surface Antigen (HBsAg), Hepatitis B Core Antibody (HBcAb) and Hepatitis B envlope-Antigen (HbeAg) among pregnant women in Ghana. And determine the prevalence of Hepatitis B in rural and urban HSS sites and to estimate the endemicity of hepatitis B in Ghana.

Method: A laboratory base cross sectional study involving the use of archived samples from the 2010 HSS was conducted in Ghana. Archived samples from the 2010 HSS were screened for HBV markers. Univeriate analysis was expressed as frequencies and percentages. Results were presented using appropriate chart and tables.

Results: In this study the overall prevalence HBsAg among pregnant women was estimated to be 14.33%. Prevalence of HBcAb was 75.3%; prevalence of HBeAg was 1.23%. HBsAg prevalence rate was highest in the northern sector {14.80% (95% CI 0.13, 0.17)} and

vi

followed by the southern sector {14.70% (95% CI 0.13, 0.17)}. HBsAg prevalence rate in the middle sector was 13.20% (95% CI 0.11, 0.15), the lowest HBsAg prevalence rate among the sectors. However, there was no significant difference in the hepatitis B prevalence in the sectors (p= 0.518). There was also no significant difference between the prevalence of hepatitis B virus infection among pregnant women in rural and urban sites (p= 0.374). Hepatitis B prevalence rate was 15.35% among age group 25-29; this was the highest prevalence rate among all the age groups. There was no significant difference in hepatitis B prevalence among the age groups (p=0.279). The overall HBeAg prevalence rate was 1.23%.

Conclusion: The HBsAg and HBcAb prevalence rate among pregnant women in this study. Because hepatitis B prevalence does not differ between pregnant women and the general adult population this shows that a higher proportion of population of Ghana has ever been exposed to hepatitis B virus obtained in this study shows Ghana is a highly endemic country for hepatitis B.. Further, the northern sector recorded the highest prevalence of all Hepatitis B markers tested. Additionally, this study determined that there is no significant difference between hepatitis B viral infection between rural and urban sites. On the other hand, HBeAg prevalence is low, indicating a lower contribution of vertical transmission of HBV in Ghana.

Recommendations: Immunization of children against HBV infection should be scaled up to capture children who are not delivered in the hospital and those who do not get postnatal care. Current hepatitis B testing strategies should be changed to include other Hepatitis B virus markers in hospital blood bank units.

Key words: Ghana, Hepatitis B, HBsAg, HBcAb, HBeAg,