Knowledge, attitudes and practices of hepatitis B prevention and immunization of pregnant women and mothers in northern Vietnam

Abstract

Background and aim Infection at birth due to mother-to-child (MTC) transmission is the most common cause of chronic hepatitis B virus (HBV) infection in Vietnam. This study was undertaken to examine the knowledge, attitudes, and practices of pregnant women and mothers in Vietnam concerning HBV prevention and immunization. Methods A cross-sectional survey was conducted in Quang Ninh and Hoa Binh provinces in 2017. A standardized questionnaire was administered to women when they received care at primary and tertiary maternal health clinics. Multivariate regression was used to identify predictors of HBV knowledge and practices. Results Among the 380 women surveyed, 50.3% were pregnant and 49.7% were postpartum. Despite 70.3% of participants reported having received information about HBV during their pregnancy, only 10.8% provided correct answers to all questions regarding HBV transmission routes and preventive measures. Around half of the participants incorrectly believed that HBV is transmitted through sneezing, contaminated water or sharing foods with chronic HBV patients. Although 86.1% of participants believed that HBV vaccination is necessary for infants, only 66.1% responded they were definitely willing to have their own child vaccinated within 24 hours. More than a third of participants expressed concern about having casual contacts or sharing foods with chronic HBV patients. In multivariate analysis, having received information about HBV during their pregnancy was significantly associated with better HBV knowledge score. Delivery at provincial level clinics was a strong predictor for perinatal HBV screening and hepatitis B birth dose administration. Conclusions The results highlight the need to prioritize educating pregnant women and mothers in future public health campaigns in order to increase knowledge, reduce misperception, and improve hepatitis B vaccine birth dose coverage in Vietnam.

Perception of and Attitude towards Hepatitis B Infection among Saudi Pregnant Females Attending Antenatal Care Unit in Al-Ahsa City, Kingdom of Saudi Arabia

“…That is to say, 80.1% of the participants were likely to allow their children's vaccination. This attitude is similar to that of Vietnam and China, 86% and 89%, respectively [19,28]. This finding could be explained by HBV vaccines being included in the vaccination schedule of children by the ministry of health.…”

“…For instance, only 47% of participants recognized that HBV is transmitted by blood compared to 85.8% in Vietnam [19], 46% to 75% in China [14,20], and 10% in Nigeria [21]. Only about 28% of the participants were aware of sexual transmission compared to 75% in Vietnam, 46% to 52% in China, and 41% in Nigeria [14,[19][20][21]. Although it is considered routine to test for HBV during the antenatal visits [22], it is necessary to educate pregnant women on the risks of infection and the means of transmission, in addition to emphasizing the benefits of vaccination.…”

Hepatitis B Infection and Mother-to-Child Transmission in Haiphong, Vietnam: A Cohort Study with Implications for Interventions

“…The rates of using preventive measures such as BDV, HBIG immunization, and HBV vaccination observed in Haiphong are higher than those observed in neighboring countries [ 28 , 30 , 38 , 39 ] and around the world [ 8 , 40 , 41 ]. They are also higher compared to recent rates reported from other provinces in Vietnam [ 18 – 20 ] or from national estimates [ 40 , 42 , 43 ]. Different studies found that despite implementation of appropriate immunization programs, about 8–30% vertical transmission still occurs in infants born to HBeAg-positive women [ 27 , 44 , 45 ].…”

“…For instance, pregnant women in the sample tend to come from the city of Haiphong, one of the largest urban agglomerations of Vietnam. Women had a higher monthly income compared to the national level of <2800 USD/capita/year in 2019 and had a higher education level compared to those observed in other population studies [ 18 – 20 ]. Several studies have shown that a low socioeconomic status was a risk factor for HBV infection [ 21 ].…”

“…Only women with a very high HBV DNA level went on to take antiviral prophylactic therapy as they were told that treatment would prevent HBV transmission to their future babies. The problematic lack of knowledge, attitude, and practice regarding HBV prevention was confirmed in recent studies on both pregnant women and healthcare workers in Vietnam [ 20 , 51 ]. Training programs for healthcare workers and educating pregnant women to increase knowledge and reduce misperception about HBV may be a key intervention to improve access to care and prevent MTCT and may help speed up reaching the objective of eliminating HBV.…”