Uptake of combined immunoprophylaxis for newborns exposed to hepatitis B virus in a high hepatitis B endemic rural setting in Northern Ghana

Abstract

Background Mother-to-Child Transmission (MTCT) is a major route of Hepatitis B Virus (HBV) transmission, accounting for a substantial proportion of new infections, particularly in highly endemic areas. The timely administration of combined immunoprophylaxis of Hepatitis B Immunoglobulin (HBIG) and hepatitis B vaccine to newborns exposed to hepatitis B virus is a crucial strategy for preventing MTCT. This study investigated the determinants of hepatitis B virus immunoprophylaxis utilization for newborns of HBV-seropositive mothers in the North-East region of Ghana. Methods A cross-sectional survey design was employed, involving 213 HBV seropositive mothers who had given birth in four selected study sites. Systematic random sampling was used to select mothers from the selected health facilities. Data was collected using a structured questionnaire. Data was coded entered and analyzed using SPSS version 26. Bivariate and multivariate analyses were undertaken, and the level of significance was set at 0.05. Results Key findings revealed that mothers aged 30–39 were less likely to ensure their newborns received both hepatitis B immunoglobulin and vaccine compared to younger mothers (aOR=0.24, 95% CI [0.09, 0.65], p=0.005). Employment status significantly influenced utilization, with salaried workers (aOR=6.78, 95% CI [1.34, 34.46], p=0.021) and self-employed mothers (aOR=3.38, 95% CI [1.39, 8.22], p=0.007) more likely to utilize immunoprophylaxis compared to unemployed mothers. Higher monthly income (501–1000 currency units) was associated with increased utilization (aOR=4.70, 95% CI [1.28, 17.32], p=0.020). Mothers with good knowledge of hepatitis B were more likely to ensure immunoprophylaxis for their newborns (aOR=3.60, 95% CI [1.72, 7.54], p=0.001). Conclusion This study found 63.4% HBV immunoprophylaxis uptake among newborns in rural Ghana, influenced by maternal age, employment, income, and knowledge. It recommends integrating immunoprophylaxis into the National Health Insurance Scheme to reduce financial barriers. Strengthening health education for mothers on HBV transmission is also crucial. Policy reforms and improved healthcare are needed to eliminate mother-to-child HBV transmission and achieve the global goal of eliminating viral hepatitis by 2030.