Prevalence of Hepatitis B Infection among Women Attending Antenatal Clinic in the Hohoe Municipality, Ghana.

Abstract

Background: Hepatitis B infection presents a critical public health challenge because of its high transmission rates and severe health outcomes, including chronic hepatitis, liver cirrhosis, and cancer. Perinatal transmission remains a major concern in endemic regions like Ghana, where a publication estimated the prevalence at 8.4% among adults. The rate of mother-to child transmission (MTCT) during the perinatal period carries a 90% risk of infection. Despite the availability of effective vaccines and immunoglobulin, babies born to hepatitis B-positive mothers have a 70-90% chance of developing chronic infection without intervention, particularly among HBeAg-positive mothers. Objective: To investigate the prevalence of hepatitis B among pregnant women, the risk factors for hepatitis B and utilization of immunoglobulin and hepatitis vaccines at the Volta Regional Hospital. Methods: A concurrent mixed-method approach. Data was extracted focusing on pregnant women tested for hepatitis B and newborns who received immunoglobulin. Key informant interviews were conducted among healthcare providers. Quantitative data was analyzed using STATA v14.0 for descriptive statistics and logistic regression. Qualitative data was audio recorded, transcribed, and thematically analyzed using Atlas.ti software. Ethical approval was obtained from the Ghana Health Service Ethics Review Committee. Results: The study revealed a 5.2% prevalence of hepatitis B out of 8,304, records of pregnant women tested between 2019-2023. Women aged 20-24years were more likely to screen for hepatitis B as compared to those below 20 years (aOR=1.79, 95% CI=1.39-2.29) and the odds of screening increased with increasing educational level. Those with tertiary education were almost two times more likely to screen for hepatitis B as compared to those with no formal education (aOR=2.47, 95% CI=1.69-3.63). The risk of having hepatis B infection increased with increased number of pregnancies. The Volta Regional Hospital administered 99 doses of hepatitis B immunoglobulin over a five-year period. However, challenges affecting immunoglobulin and vaccine utilization included high costs, and limited awareness. Conclusion/Implications: There is a high prevalence of hepatitis B among pregnant women in Hohoe. A significant concern is the low utilization of hepatitis B immunoglobulin (HBIG), largely attributed to financial constraints and lack of awareness. Targeted interventions are necessary, including the integration of HBIG into the Expanded Program on Immunization (EPI) and that younger women who are rural residents and have lower educational levels have tailored educational programs on hepatitis B screening.