A systematic review and meta-analysis of the prevalence of hepatitis B virus infection among pregnant women in Nigeria.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 11 08 2021
accepted: 14 10 2021
entrez: 29 10 2021
pubmed: 30 10 2021
medline: 15 12 2021
Statut: epublish

Résumé

Nigeria has a high burden of hepatitis B virus (HBV) infection, commonly acquired through vertical transmission. However, there is a lack of an efficient surveillance system for monitoring and understanding the epidemiology of HBV among pregnant women. Building on a previous review on the prevalence of HBV in Nigeria (2000-2013), we conducted a systematic review and meta-analysis of HBV prevalence among pregnant women in Nigeria. Four electronic databases PubMed, Embase, Global Health, and Scopus were systematically searched from January 2014 to February 2021. We also searched the African Journal Online and manually scanned the reference lists of the identified studies for potentially eligible articles. Observational studies that reported the prevalence of HBsAg and/or HBeAg among pregnant women in peer-reviewed journals were included in the study. We performed a meta-analysis using a random-effects model. We defined HBV infection as a positive test to HBsAg. From the 158 studies identified, 20 studies with a total sample size of 26, 548 were included in the meta-analysis. The pooled prevalence of HBV infection among pregnant women across the studies was 6.49% (95% confidence interval [CI] = 4.75-8.46%; I2 = 96.7%, p = 0.001; n = 20). The prevalence of HBV was significantly lower among pregnant women with at least secondary education compared with those with no education or primary education (prevalence ratio = 0.7, 95% CI = 0.58-0.87; n = 10). However, the prevalence of HBV was not significantly different by age, religion, marital status, or tribe. The prevalence of HBV was not significantly different among pregnant women with previous surgery, blood transfusion, multiple lifetime sex partners, tribal marks, tattoos, scarification, or sexually transmitted infections, compared with those without these risk factors. From a total sample size of 128 (n = 7), the pooled prevalence of HBeAg among HBV-infected pregnant women was 14.59% (95% CI = 4.58-27.99%; I2 = 65.5%, p = 0.01). Subgroup analyses of HBV infection by study region and screening method, and meta-regression analysis of the study year, sample size, and quality rating were not statistically significant. There is an intermediate endemicity of HBV infection among pregnant women in Nigeria. Interventions, such as routine antenatal HBV screening, antiviral prophylaxis for eligible pregnant women, and infant HBV vaccination should be scaled up for the prevention of perinatal transmission of HBV infection in Nigeria.

Sections du résumé

BACKGROUND
Nigeria has a high burden of hepatitis B virus (HBV) infection, commonly acquired through vertical transmission. However, there is a lack of an efficient surveillance system for monitoring and understanding the epidemiology of HBV among pregnant women. Building on a previous review on the prevalence of HBV in Nigeria (2000-2013), we conducted a systematic review and meta-analysis of HBV prevalence among pregnant women in Nigeria.
METHODS
Four electronic databases PubMed, Embase, Global Health, and Scopus were systematically searched from January 2014 to February 2021. We also searched the African Journal Online and manually scanned the reference lists of the identified studies for potentially eligible articles. Observational studies that reported the prevalence of HBsAg and/or HBeAg among pregnant women in peer-reviewed journals were included in the study. We performed a meta-analysis using a random-effects model. We defined HBV infection as a positive test to HBsAg.
RESULTS
From the 158 studies identified, 20 studies with a total sample size of 26, 548 were included in the meta-analysis. The pooled prevalence of HBV infection among pregnant women across the studies was 6.49% (95% confidence interval [CI] = 4.75-8.46%; I2 = 96.7%, p = 0.001; n = 20). The prevalence of HBV was significantly lower among pregnant women with at least secondary education compared with those with no education or primary education (prevalence ratio = 0.7, 95% CI = 0.58-0.87; n = 10). However, the prevalence of HBV was not significantly different by age, religion, marital status, or tribe. The prevalence of HBV was not significantly different among pregnant women with previous surgery, blood transfusion, multiple lifetime sex partners, tribal marks, tattoos, scarification, or sexually transmitted infections, compared with those without these risk factors. From a total sample size of 128 (n = 7), the pooled prevalence of HBeAg among HBV-infected pregnant women was 14.59% (95% CI = 4.58-27.99%; I2 = 65.5%, p = 0.01). Subgroup analyses of HBV infection by study region and screening method, and meta-regression analysis of the study year, sample size, and quality rating were not statistically significant.
CONCLUSIONS
There is an intermediate endemicity of HBV infection among pregnant women in Nigeria. Interventions, such as routine antenatal HBV screening, antiviral prophylaxis for eligible pregnant women, and infant HBV vaccination should be scaled up for the prevention of perinatal transmission of HBV infection in Nigeria.

Identifiants

pubmed: 34714888
doi: 10.1371/journal.pone.0259218
pii: PONE-D-21-25950
pmc: PMC8555786
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0259218

Déclaration de conflit d'intérêts

OAU currently serves as an Academic Editor for PLOS One.

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Auteurs

Babayemi O Olakunde (BO)

Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria.
Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria.

Daniel A Adeyinka (DA)

Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja, Nigeria.
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.

Olubunmi A Olakunde (OA)

Department of Disease Control and Immunization, Ondo State Primary Health Care Development Agency, Ondo, Nigeria.

Olalekan A Uthman (OA)

Warwick Centre for Global Health, Division of Health Sciences, University of Warwick Medical School, Coventry, United Kingdom.
Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.

Florence O Bada (FO)

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.

Yvonne A Nartey (YA)

Department of Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.

Dorcas Obiri-Yeboah (D)

Department of Microbiology and Immunology, University of Cape Coast, Cape Coast, Ghana.

Elijah Paintsil (E)

Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.
Department of Pharmacology, Yale School of Medicine, New Haven, Connecticut, United States of America.

Echezona E Ezeanolue (EE)

Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria.
Healthy Sunrise Foundation, Las Vegas, Nevada, United States of America.

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