Guingané Alice Nanelin, Kaboré Rémi, Shimakawa Yusuke, Somé Eric Nagaonlé, Kania Dramane, Pisoni Amandine, Nagot Nicolas, King Rachel, Sombié Roger, Meda Nicolas, Van de Perre Philippe, Tuaillon Edouard
Hepato-Gastroenterology Department, Bogodogo University Hospital Center, 01 BP 3479 Ouagadougou 01, Burkina Faso.
Institut de Santé Publique d'Épidémiologie et du Développement, Université de Bordeaux, Bordeaux, France.
Bull World Health Organ. 2022 Apr 1;100(4):256-267. doi: 10.2471/BLT.21.287015. Epub 2022 Feb 22.
To evaluate the implementation of a screening strategy for the partners and children of pregnant women with hepatitis B virus (HBV) attending antenatal care.
We identified pregnant women positive for HBV surface antigen (HBsAg) at antenatal consultation in Ouagadougou, Burkina Faso. At post-test counselling, women were advised to disclose their HBV status to partners and to encourage their partner and children to be screened for HBsAg. We used multivariable logistic regression to explore factors associated with uptake of screening and HBsAg positivity among family members.
Of 1000 HBsAg-positive women, 436/1000 partners and 215/1281 children were screened. HBsAg was detected in 55 (12.6%) partners and 24 (11.2%) children. After adjusting for confounders, uptake of screening was higher in partners who were married, who attended the woman's first post-test consultation and to whom the woman had disclosed her HBV status. In children, HBsAg positivity was associated with being born before the introduction of infant hepatitis B vaccination in Burkina Faso (not significant in the multivariable analysis), having a mother positive for HBV e-antigen (adjusted OR: 8.57; 95% CI: 2.49-29.48) or having a mother with HBV DNA level ≥ 200 000 IU/mL (OR: 6.83; 95% CI: 1.61-29.00).
In low-income countries, the antenatal consultation provides a cost-effective opportunity to identify HBV-infected household contacts and link them to care. Children born before the introduction of infant hepatitis B vaccination and whose mother has higher viral load or infectivity should be a priority for testing and linkage to care.
评估针对参加产前护理的乙型肝炎病毒（HBV）感染孕妇的伴侣及子女实施筛查策略的情况。
我们在布基纳法索瓦加杜古的产前咨询中确定了HBV表面抗原（HBsAg）呈阳性的孕妇。在检测后咨询时，建议这些女性向伴侣披露自己的HBV感染状况，并鼓励伴侣及子女进行HBsAg筛查。我们使用多变量逻辑回归来探究与家庭成员接受筛查及HBsAg阳性相关的因素。
在1000名HBsAg呈阳性的女性中，对436名伴侣及215名子女进行了筛查。在55名（12.6%）伴侣及24名（11.2%）子女中检测到了HBsAg。在对混杂因素进行调整后，已婚伴侣、参加女性首次检测后咨询且女性已向其披露HBV感染状况的伴侣接受筛查的比例更高。在子女中，HBsAg阳性与在布基纳法索引入婴儿乙肝疫苗之前出生（多变量分析中不显著）、母亲HBV e抗原呈阳性（调整后的比值比：8.57；95%置信区间：2.49 - 29.48）或母亲HBV DNA水平≥200 000 IU/mL（比值比：6.83；95%置信区间：1.61 - 29.00）相关。
在低收入国家，产前咨询为识别HBV感染的家庭接触者并将他们与医疗服务联系起来提供了一个具有成本效益的机会。在引入婴儿乙肝疫苗之前出生且母亲病毒载量较高或传染性较强的儿童应作为检测及与医疗服务联系的优先对象。
