Prevalence of Hepatitis B Virus among Postpartum Women and Determinants of Child Vaccine Uptake in Four Selected Hospitals in Tamale

Abstract

INTRODUCTION: Globally, 257 million people are infected with Hepatitis B virus (HBV), with Ghana considered as a highly endemic country. Higher maternal HBV infection and low vaccine uptake in children poses great challenges in reducing HBV burden. The purpose of this study was to determine the prevalence of HBV among postpartum women, and identify factors that affect HBV vaccination uptake in children. METHODS: A cross-sectional study, was conducted in four hospitals in the Tamale Metropolis, involving 210 postpartum women, using systematic random sampling. Socio-demographic characteristics, data on sexual and obstetric history and HBV status were collected using a semi-structured questionnaire. HBV+ mothers were asked about their children’s HBIG and Hep B vaccination status and the time of vaccination, and those who could not vaccinate their children were interviewed on why they could or did not. Data was entered into Excel and transferred into STATA statistical software version 15 for analysis. RESULTS: Overall, seroprevalence of HBV among postpartum women was 10.9% (95%CI=7.3–16.0). Among children born to participants, 68.1% (n=143) had received the first dose of Hep B, with only 4.2% of children having received it within the first 24 hours. Among children born to HB+ mothers, 82.6% (95%CI=59.7-93.8) received the HBIG, and 26.3% of children received it after 24 hours. Among the 17.4% HBV+ women who could not vaccinate their children with the HBIG, high cost and unavailability of the vaccine were the main reasons for the failure. The study found a positive association between history of Caesarean section (C/S) and HBV status of postpartum women (aOR=3.47, 95%CI=1.36–8.85). CONCLUSION: The prevalence of HBV among postpartum women in Tamale is high. Although vaccination coverage in Ghana is high, there is a deficiency in the timely administration of the Hep B birth-dose. The study recommends including HBIG in the Expanded Programme on Immunization (EPI), intensifying screening, and strict adherence to aseptic technique in C/S. Keywords: Hepatitis B Virus, Seroprevalence, Postpartum, HBIG, MTCT.