Njau Agnes Fridomu, Robert Masanja, Rwebembera Anath, Kisendi Renatus, Maro Chacha, Dennis Grace, Nyamhagatta Mukome, Msangi Michael
Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania.
Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLoS One. 2025 Aug 1;20(8):e0329068. doi: 10.1371/journal.pone.0329068. eCollection 2025.
Coinfection with HIV, hepatitis B virus (HBV) and syphilis increases the risk of vertical transmission. Hence, affecting overall maternal health and child health outcomes. The Tanzanian government is planning to add HBV screening to the existing Prevention of Mother to Child Transmission (PMTCT) of HIV and syphilis program; however, the burden of coinfections in the country is unknown. Therefore, this study aimed to determine the prevalence of HIV, HBV and syphilis coinfections and their associated factors among pregnant women receiving antenatal care in Tanzania.
A facility-based cross-sectional study design was conducted, utilizing data from the national feasibility study of triple testing for HIV, syphilis and HBV among pregnant women. The data were analysed via STATA version 16.1, and bivariate and multivariate logistic regressions were used to check for associations. Variables with a P value of < 0.05 were considered statistically significant.
A total of 7,828 pregnant women were enrolled, 0.4% (95% CI 0.3-0.6) of whom were coinfected. The prevalence rates for HIV/HBV, HIV/syphilis, HBV/syphilis and HIV/HBV/syphilis coinfections were 0.1% (95% CI 0.1-0.2), 0.2% (95% CI 0.1-0.4), 0.1% (95% CI 0.0-0.2) and 0.0% (95% CI 0.0-0.1), respectively. History of multiple sexual partners (AOR 6.1; 95% CI: 1.3-29.7, P = 0.025) was associated with HIV/HBV coinfection. Age 25-49 years (AOR 13.5; 95% CI 1.8-103.8, P = 0.012) and marital status (AOR 0.2; 95% CI 0.1-0.8, P = 0.018) were associated with HIV/syphilis coinfection. For HBV/syphilis coinfection, marital status (AOR 0.1; 95% CI 0.0-0.9, P = 0.036) and history of multiple sexual partners (AOR 16.8; 95% CI 2.5-114.9, P = 0.004) were independently associated.
Coinfections are present among pregnant women in Tanzania; therefore, it is important to include hepatitis B screening in the existing PMTCT of HIV and syphilis program. Interventions should focus on single, child-bearing women with multiple sexual partners.
人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和梅毒合并感染会增加垂直传播的风险。因此，会影响孕产妇的整体健康和儿童健康结局。坦桑尼亚政府计划在现有的HIV和梅毒母婴传播预防（PMTCT）项目中增加HBV筛查；然而，该国合并感染的负担尚不清楚。因此，本研究旨在确定坦桑尼亚接受产前护理的孕妇中HIV、HBV和梅毒合并感染的患病率及其相关因素。
采用基于机构的横断面研究设计，利用全国孕妇HIV、梅毒和HBV三联检测可行性研究的数据。数据通过STATA 16.1版本进行分析，并使用二元和多元逻辑回归来检验相关性。P值<0.05的变量被认为具有统计学意义。
共纳入7828名孕妇，其中0.4%（95%CI 0.3-0.6）为合并感染。HIV/HBV、HIV/梅毒、HBV/梅毒和HIV/HBV/梅毒合并感染的患病率分别为0.1%（95%CI 0.1-0.2）、0.2%（95%CI 0.1-0.4）、0.1%（95%CI 0.0-0.2）和0.0%（'95%CI 0.0-0.1）。多个性伴侣史（调整后比值比[AOR]6.1；95%CI：1.3-29.7，P = 0.025）与HIV/HBV合并感染相关。25-49岁年龄组（AOR 13.5；95%CI 1.8-103.8，P = 0.012）和婚姻状况（AOR 0.2；95%CI 0.1-0.8，P = 0.018）与HIV/梅毒合并感染相关。对于HBV/梅毒合并感染，婚姻状况（AOR 0.1；95%CI 0.0-0.9，P = 0.036）和多个性伴侣史（AOR 16.8；95%CI 2.5-114.9，P = 0.004）与之独立相关。
坦桑尼亚孕妇中存在合并感染；因此，在现有的HIV和梅毒PMTCT项目中纳入乙型肝炎筛查很重要。干预措施应聚焦于有多个性伴侣的单身育龄妇女。
