SERO-PREVALENCE AND RISK FACTORS FOR HEPATITIS B INFECTION AMONG WOMEN ATTENDING ANTENATAL CARE AT ST. ORSOLA HOSPITAL, THARAKA NITHI COUNTY, KENYA. A CROSS-SECTIONAL STUDY

Abstract

Background: Like many Sub-Saharan African countries, Hepatitis B virus (HBV) is endemic in Kenya, where diagnosis and patient management remain challenging, particularly in cases involving HBV comorbidities. However, the burden of the disease among pregnant women in Kenya remains unclear.
Objectives: To determine the prevalence, disease stages and associated risk factors for HBV infection among women attending Antenatal care (ANC) at St. Orsola Hospital in Tharaka Nithi County, Kenya.
Design: A cross-sectional study was conducted on women attending Antenatal care.
Subjects: Pregnant mothers attending ANC between September to December 2023. Main outcome measures: For each woman, age, marital status, occupation, level of education and risk factors were captured using a questionnaire after consenting. Hepatitis B serological markers; hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), and hepatitis B envelope antigen (HBeAg) were also profiled.
Results: The overall prevalence of HBsAg was 6.5% (25/385; 95% CI: 4.3%–9.4%), indicating intermediate endemicity. Most infected participants were classified as inactive carriers 72% (n=18), while 16% (n=4) were chronically infected, 8% (n=2) had acute infection and 4% (n=1) were in recovery. Multivariable logistic regression analysis identified history of liver disease (AOR = 5.21; 95% CI: 1.11–24.43; p = 0.036), HIV infection (AOR = 9.84; 95% CI: 1.02–94.51; p = 0.047) and education level (AOR = 11.8; 95% CI: 1.5–93.4; p = 0.019), as independent predictors of HBV infection. Other factors including blood transfusion, dental procedures, tattooing, caesarean section, abortion and female genital mutilation were not significantly associated with HBV infection.
Conclusion: HBV remain endemic in this region like rest of the country with age, education levels, liver problems and human immunodeficiency virus (HIV) status being risk factors among pregnant women. The outcome of this research indicated a need for increased awareness and preventive measures not just among gravid women but also on entire population.