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乌干达北部利拉高流行区的产前乙型肝炎筛查及相关因素:一项社区横断面研究。

Prenatal hepatitis B screening and associated factors in a high prevalence district of Lira, northern Uganda: a community based cross sectional study.

机构信息

College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda.

出版信息

BMC Public Health. 2019 Jul 26;19(1):1004. doi: 10.1186/s12889-019-7344-6.

Abstract

BACKGROUND

Chronic hepatitis B Virus (HBV) infection affects 80-100 million people in sub-Saharan Africa and accounts for an estimated 650,000 deaths annually. The prevalence of active hepatitis B virus infection among women aged 15-64 in mid-Northern Uganda is about 5%. Lira district is among the high prevalence areas where government embarked on mass HBV screening since 2015 as a gateway for access to prevention, treatment services, and an effective response to the hepatitis B epidemic. The current proportion of pregnant women screened and the factors associated with prenatal HBVscreening in Lira are not known despite the fact that women contribute largely to both vertical and horizontal transmission of HBV. This study aimed at determining the proportion of pregnant women screened for HBV and factors associated with prenatal HBV screening in Lira district.

METHODS

This was a community based cross sectional study conducted among 423 pregnant women in the sub counties of Aromo and Agweng in Lira district. Data were collected using open data kit and analysed using STATA version 14. The outcome variable was prenatal HBV screening while predictor variables were community, individual and health facility factors associated with HBV screening. Multivariable logistic regression was used to determine factors associated with prenatal HBV screening.

RESULTS

Thirty five women (8.3%) had been screened for HBV during the current pregnancy. Factors associated with prenatal HBV screening in Lira included perceived risk (Adjusted Odds Ratio (AOR) 3.78, 95% CI 1.01-6.14), respondent's age (AOR = 3.98, 95% CI 1.39-5.09), husband/partner's education (AOR = 3.34, 95% CI 1.10-5.12) and past failure to access to HBV screening services at government health facilities (AOR = 6.44, 95% CI 2.10-8.02).

CONCLUSION

The level of HBV screening among pregnant women in Lira was low and is mainly associated with perceived risk, age, access to HBV screening services and spousal education level. More effort is needed in creating mass awareness on the need and importance of HBV screening most especially among pregnant women.

摘要

背景

慢性乙型肝炎病毒(HBV)感染影响撒哈拉以南非洲地区的 8000 万至 1 亿人,每年估计造成 65 万人死亡。乌干达中北部地区 15-64 岁女性中活跃的乙型肝炎病毒感染流行率约为 5%。利拉区是高流行地区之一,自 2015 年以来,政府开始对该地区进行大规模乙型肝炎病毒筛查,作为预防、治疗服务的切入点,并对乙型肝炎疫情做出有效应对。尽管女性在乙型肝炎病毒的垂直和水平传播中起着重要作用,但目前尚不清楚在利拉区接受筛查的孕妇比例以及与产前乙型肝炎病毒筛查相关的因素。本研究旨在确定利拉区接受乙型肝炎病毒筛查的孕妇比例以及与产前乙型肝炎病毒筛查相关的因素。

方法

这是一项在利拉区阿罗莫和阿格旺次县的 423 名孕妇中进行的基于社区的横断面研究。使用开放数据工具收集数据,并使用 STATA 版本 14 进行分析。因变量为产前乙型肝炎病毒筛查,而预测变量为与乙型肝炎病毒筛查相关的社区、个体和卫生设施因素。多变量逻辑回归用于确定与产前乙型肝炎病毒筛查相关的因素。

结果

在本次妊娠中,有 35 名妇女(8.3%)接受了乙型肝炎病毒筛查。在利拉区与产前乙型肝炎病毒筛查相关的因素包括感知风险(调整后的优势比(AOR)3.78,95%置信区间 1.01-6.14)、受访者年龄(AOR=3.98,95%置信区间 1.39-5.09)、丈夫/伴侣的教育程度(AOR=3.34,95%置信区间 1.10-5.12)和过去未能在政府卫生机构获得乙型肝炎病毒筛查服务(AOR=6.44,95%置信区间 2.10-8.02)。

结论

利拉区孕妇的乙型肝炎病毒筛查率较低,主要与感知风险、年龄、获得乙型肝炎病毒筛查服务和配偶教育程度有关。需要进一步加大力度,特别是在孕妇中,提高对乙型肝炎病毒筛查的必要性和重要性的认识。

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