Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2024 Jul 12;19(7):e0307102. doi: 10.1371/journal.pone.0307102. eCollection 2024.
Hepatitis B virus (HBV) is one of the major public health problems globally and needs an urgent response. It is one of the most responsible causes of mortality among the five hepatitis viruses, and it affects almost every class of individuals. Different studies were conducted on the prevalence of HBV among pregnant women in East African countries, but none of them showed the pooled prevalence of HBV among the pregnant women. Thus, the main objective of this study was to determine the pooled prevalence and its determinants among pregnant women in East Africa.
We searched studies using PubMed, Scopus, Embase, ScienceDirect, Google Scholar and grey literature that were published between January 01/2020 to January 30/2024. The studies were assessed using the Newcastle Ottawa Scale (NOS) quality assessment scale. The random-effect (DerSimonian) model was used to determine the pooled prevalence and associated factors of HBV among pregnant women. Heterogeneity were assessed by I2 statistic, sub-group analysis, and sensitivity analysis. Publication bias was assessed by Egger test, and the analysis was done using STATA version 17.
A total of 45 studies with 35639 pregnant women were included in this systematic review and meta-analysis. The overall pooled prevalence of HBV among pregnant women in East Africa was 6.0% (95% CI: 6.0%-7.0%, I2 = 89.7%). The highest prevalence of 8% ((95% CI: 6%, 10%), I2 = 91.08%) was seen in 2021, and the lowest prevalence 5% ((95% CI: 4%, 6%) I2 = 52.52%) was observed in 2022. A pooled meta-analysis showed that history of surgical procedure (OR = 2.14 (95% CI: 1.27, 3.61)), having multiple sexual partners (OR = 3.87 (95% CI: 2.52, 5.95), history of body tattooing (OR = 2.55 (95% CI: 1.62, 4.01)), history of tooth extraction (OR = 2.09 (95% CI: 1.29, 3.39)), abortion history(OR = 2.20(95% CI: 1.38, 3.50)), history of sharing sharp material (OR = 1.88 (95% CI: 1.07, 3.31)), blood transfusion (OR = 2.41 (95% CI: 1.62, 3.57)), family history of HBV (OR = 4.87 (95% CI: 2.95, 8.05)) and history needle injury (OR = 2.62 (95% CI: 1.20, 5.72)) were significant risk factors associated with HBV infection among pregnant women.
The pooled prevalence of HBV infection among pregnant women in East Africa was an intermediate level and different across countries ranging from 1.5% to 22.2%. The result of this pooled prevalence was an indication of the need for screening, prevention, and control of HBV infection among pregnant women in the region. Therefore, early identification of risk factors, awareness creation on the mode of transmission HBV and implementation of preventive measures are essential in reducing the burden of HBV infection among pregnant women.
乙型肝炎病毒（HBV）是全球主要的公共卫生问题之一，需要紧急应对。它是五种肝炎病毒中导致死亡率最高的原因之一，几乎影响到各个年龄段的个体。东非国家的不同研究已经对孕妇中 HBV 的流行情况进行了研究，但没有一项研究显示了东非孕妇中 HBV 的总流行率。因此，本研究的主要目的是确定东非孕妇中 HBV 的总流行率及其决定因素。
我们使用 PubMed、Scopus、Embase、ScienceDirect、Google Scholar 和灰色文献搜索了 2020 年 1 月 1 日至 2024 年 1 月 30 日期间发表的研究。使用纽卡斯尔-渥太华量表（NOS）质量评估量表对研究进行评估。使用随机效应（DerSimonian）模型来确定 HBV 在东非孕妇中的总流行率及其相关因素。使用 I2 统计量、亚组分析和敏感性分析来评估异质性。使用 Egger 检验评估发表偏倚，并使用 STATA 版本 17 进行分析。
共有 45 项研究，涉及 35639 名孕妇，包括在本次系统评价和荟萃分析中。东非孕妇中 HBV 的总流行率为 6.0%（95%CI：6.0%-7.0%，I2=89.7%）。2021 年 HBV 最高流行率为 8%（95%CI：6%，10%，I2=91.08%），2022 年最低流行率为 5%（95%CI：4%，6%，I2=52.52%）。荟萃分析显示，手术史（OR=2.14（95%CI：1.27，3.61））、多个性伴侣（OR=3.87（95%CI：2.52，5.95））、纹身史（OR=2.55（95%CI：1.62，4.01））、拔牙史（OR=2.09（95%CI：1.29，3.39））、流产史（OR=2.20（95%CI：1.38，3.50））、共用锐器史（OR=1.88（95%CI：1.07，3.31））、输血史（OR=2.41（95%CI：1.62，3.57））、HBV 家族史（OR=4.87（95%CI：2.95，8.05））和针伤史（OR=2.62（95%CI：1.20，5.72））是 HBV 感染的显著危险因素。
东非孕妇 HBV 感染的总流行率处于中等水平，不同国家的流行率存在差异，范围从 1.5%到 22.2%。这一流行率的结果表明，该地区需要对孕妇进行 HBV 感染的筛查、预防和控制。因此，早期识别危险因素、提高对 HBV 传播途径的认识以及实施预防措施对于降低孕妇 HBV 感染的负担至关重要。
