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加纳瓦市产前诊所就诊孕妇的乙型肝炎感染相关因素。

Correlates of Hepatitis B infection in pregnant women attending antenatal clinics in Wa Municipality, Ghana.

作者信息

Awiah Emmanuel Anebakwo, Aabalekuu Simon, Dun-Dery Frederick, Dun-Dery Elvis, Bayor Fidelis, Adokiya Martin Nyaaba, Bessing Barnabas

机构信息

Wa Municipal Health Administration, Upper West Region, Wa, Ghana.

Department of Public Health, Regional Health Directorate, Upper West Region, Wa, Ghana.

出版信息

PLOS Glob Public Health. 2024 Sep 10;4(9):e0002447. doi: 10.1371/journal.pgph.0002447. eCollection 2024.

Abstract

Despite the availability of an effective vaccine against viral hepatitis B infection, it remains prevalent, highly transmissible especially through mother-to-child, life-threatening, and a major public health challenge. A positive Hepatitis B e-Antigen (HBeAg) mother has a 90% risk of transmitting the virus to the unborn child in the perinatal period. This study sought to determine the prevalence and risk of Hepatitis B infection among pregnant women in the Wa Municipality of Ghana. A cross-sectional study employing systematic random sampling was conducted among 183 consented pregnant women who went for antenatal care in nine health facilities in the Wa Municipality. A structured validated questionnaire was used to collect information about socio-demographic and obstetric characteristics, awareness of Hepatitis B Virus (HBV) transmission and its prevention. Blood samples (3.0 mls) were collected from each participant to test for HBV serum markers using a Wondfo One Step HBV rapid immunochromatographic assay (Catalog number W003) for the Hepatitis B surface antigen (HBsAg). We conducted descriptive statistics including the prevalence and used multivariable logistic regression to determine the risk of Hepatitis B among study participants. Data was analysed using Stata/SE 15. About 20.2% of the 183 pregnant women screened tested positive for HBsAg. Generally, compared with younger pregnant women, older (> = 25) pregnant women were >9 times less likely to test positive for both chronic Hepatitis B core antibody (HBcAb) and (HBeAg) Hepatitis B infections. However, pregnant women in polygamous relationship were more likely to test positive for both (HBcAb) and (HBsAg and HBeAg) Hepatitis B infections compared with those in monogamous relationship. In a multivariable analysis, pregnant women in a polygamous relationships were about 5 times more likely to test positive for HBsAg (AOR = 4.61, 95% CI: 2.06-9.89) and HBcAb (AOR = 4.89, 95% CI:1.52-6.81) and HBeAg (AOR = 4.62, 95% CI:1.21-6.39) compared with those in a monogamous relationship. This study highlights a high HBsAg prevalence among pregnant women with those in polygamous relationship and younger age more likely to test positive. Facility and community-based health services should emphasize the need for regular screening, education, and vaccination of pregnant women, especially those at high risk, to prevent mother-to-child transmission of viral hepatitis B.

摘要

尽管已有有效的乙型肝炎病毒感染疫苗,但该疾病仍然普遍存在,传播性很强,尤其是母婴传播,会危及生命,是一项重大的公共卫生挑战。乙型肝炎e抗原(HBeAg)呈阳性的母亲在围产期将病毒传染给未出生孩子的风险为90%。本研究旨在确定加纳瓦市孕妇中乙型肝炎感染的患病率和风险。我们采用系统随机抽样方法,对瓦市九家医疗机构中183名同意参与的孕妇进行了横断面研究。使用一份经过验证的结构化问卷收集社会人口统计学和产科特征、对乙型肝炎病毒(HBV)传播及其预防的认知等信息。从每位参与者采集3.0毫升血液样本,使用万孚一步法HBV快速免疫层析检测法(产品目录编号W003)检测乙型肝炎表面抗原(HBsAg),以检测HBV血清标志物。我们进行了描述性统计,包括患病率,并使用多变量逻辑回归来确定研究参与者中乙型肝炎的风险。使用Stata/SE 15对数据进行分析。在接受筛查的183名孕妇中,约20.2%的人HBsAg检测呈阳性。总体而言,与年轻孕妇相比,年龄较大(>=25岁)的孕妇慢性乙型肝炎核心抗体(HBcAb)和(HBeAg)乙型肝炎感染检测呈阳性的可能性要低9倍以上。然而,与一夫一妻制关系的孕妇相比,处于一夫多妻制关系的孕妇(HBcAb)以及(HBsAg和HBeAg)乙型肝炎感染检测呈阳性的可能性更高。在多变量分析中,与一夫一妻制关系的孕妇相比,处于一夫多妻制关系的孕妇HBsAg检测呈阳性的可能性高约5倍(比值比[AOR]=4.61,95%置信区间[CI]:2.06 - 9.89),HBcAb检测呈阳性的可能性高约5倍(AOR = 4.89,95% CI:1.52 - 6.81),HBeAg检测呈阳性的可能性高约5倍(AOR = 4.62,95% CI:1.21 - 6.39)。本研究凸显了孕妇中HBsAg的高患病率,一夫多妻制关系的孕妇以及年龄较小的孕妇检测呈阳性的可能性更高。基于医疗机构和社区的卫生服务应强调对孕妇,尤其是高危孕妇进行定期筛查、教育和接种疫苗的必要性,以预防乙型肝炎病毒的母婴传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a52/11386425/afe4a2cdcb09/pgph.0002447.g001.jpg

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