Analysis of the Relationship between Traditional Birth Attendant Service and the Risk of Hepatitis B Transmission among Pregnant Women at the Indonesian Rural Community

Abstract

Childbirth assistance with traditional birth attendant (TBA) is carried out without regard to the sterilization factor that the transmission of the hepatitis virus could occur. This study aims to determine the likelihood of Hepatitis B transmission in pregnant women based on the history of delivery assistance by traditional birth attendants. The study design was a case-control study of 120 cases for each of positive and negative HVBsAg pregnant women controls gaining from the HVB screening program of Health Centres, Bulukumba District, Indonesia. Binary logistic regression analysis was carried out to determine the magnitude of the relationship between risk factors of labour history on TBA and HVB infection. Bivariate logistic regression model found that pregnant women with a history of childbirth by TBA had a risk of transmitting HVB 1.8 times greater (OR= 1.78; 95% CI 1.07-2.98) compared to those who had no labour history on TBA. The multivariate logistic regression model showed that pregnant women who received TBA with a history of blood transfusion and surgical treatment had a risk of contracting HVB by 1.8 times greater than those delivered by midwives or other skilled health workers (OR=1.882; 95% CI 1,078-3,080). TBA services that pay less attention to sterilization in childbirth services have a risk of HVB transmission, especially if it occurs in those who have a history of blood transfusion and surgery.