Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis

Abstract

Background Although Africa is a region of hyper endemicity to viral hepatitis B (HBV) and C (HCV) infections, there is limited data on their related burden among pregnant women. The present systematic review and meta-analysis aimed to determine the magnitude of these infections among pregnant women living in Africa and investigate its association with gender-related human development indicators. Main text We searched PubMed, Embase, Web of Science, Africa Journal Online, and Global Index Medicus, with no language restriction, to identify observational studies on HBV and HCV infections in pregnant women residing in Africa published from January 1, 2000 until December 31, 2017. Eligible studies reported the prevalence of HBV and/or HCV infection(s) (HBs antigen and HCV antibodies) and/or infectivity (HBe antigen or detectable HCV viral load). Each study was independently reviewed for methodological quality. We used a random-effects model meta-analysis to pool studies. In total, 145 studies (258 251 participants, 30 countries) were included, of which 120 (82.8%) had a low, 24 (16.5%) a moderate, and one (0.7%) had a high risk of bias. The prevalence of HBV and HCV infections was 6.8% (95% confidence interval [ CI ]: 6.1–7.6, 113 studies) and 3.4% (95% CI : 2.6–4.2, 58 studies), respectively. The prevalence of HBe antigen and HCV detectable viral load was 18.9% (95% CI : 14.4–23.9) and 62.3% (95% CI : 51.6–72.5) in HBV positive and HCV positive pregnant women, respectively. The multivariable meta-regression analysis showed that the prevalence of HBV infection increased with decreasing gender development index, males’ level of education and females’ expected years of schooling. Furthermore, this prevalence was higher in rural areas and in western and central Africa. The prevalence of HCV infection increased with decreasing proportion of seats held by women in parliament. Conclusions To address the burden of HBV and HCV infections, beyond well-known risk factors at the individual-level, macro-level factors including gender-related human development indicators and dwelling in rural areas should be considered. In Africa, HBV or HCV infected mothers seems to have high potential of transmission to their children. Electronic supplementary material The online version of this article (10.1186/s40249-019-0526-8) contains supplementary material, which is available to authorized users.

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Prevalence and associated factors of hepatitis B virus infection among pregnant women attending antenatal care at Agena health center, South Ethiopia, 2019: a cross sectional study

“…HBsAg prevalence among pregnant women was 3.1% in Shenyang, China. Only 23.4% and 17.7% of pregnant women knew their HBV status before gestation and before delivery respectively [10].The prevalence of HBV infections among pregnant women in Africa was 6.8% and child vaccination, routine and universal antenatal hepatitis B virus screening program is very important [11]. The prevalence of HBV infections among pregnant women was 16.5% and 9.2% in Osogbo, Nigeria and Gambia respectively [12,13].…”

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“…Infected mothers have a high potential for transmission to their children. 1 Screening for the presence of HCV, with selection of individuals on the basis of demographics, possible exposure, high-risk behavior, and medical conditions, is very important. Screening is justified by high HCV prevalence in particular populations, the association of treatment with a reduction of the risk of hepatocellular carcinoma and of all-cause mortality, and the public-health benefits of limiting HCV transmission by early treatment, viral clearance, and modification of risk behaviors.…”