Carrier rate of hepatitis B surface antigen (HBsAg) among urban pregnant women in a secondary health facility in Maiduguri, Northeastern Nigeria

David Nadeba Bukbuk, Maxwell Bayo Samaila, Akawu Denue Ballah, Ibrahim Musa Kida, Chima Iwuoha

Department of Biological Sciences, Faculty of Science, Essien Udom Court, University of Maiduguri, Maiduguri, Nigeria.
Department of Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Department of Microbiology, Faculty of Science, Essien Udom Court, University of Maiduguri, Maiduguri, Nigeria.

DOI: 10.4236/wjcd.2013.38081                

Abstract

A serological survey conducted among 196 pregnant women resident in and around Maiduguri, an urban town in north eastern Nigeria showed that 33 (16.8%) were asymptomatic carriers of hepatitis B virus surface antigen (HBsAg). They are within the age range of 14-40 years with mean (± SD) age of 24.7 (± 6.3). The women attend antenatal clinic at the State Specialist Hospital, a secondary health facility in Maiduguri, Borno state. The women are all heterosexuals. The distribution of HBsAg carrier rate according to age of women studied showed a significant (p = 0.0061) increase of the prevalence of HBsAg from 4 (8.7%) in the lower age group (<20 years) to 1 (50%) among those in the higher age group (>39 years). According to the number of pregnancies, the prevalence of HBsAg infection increased significantly from 6 (9.2%) among primiparous to 13 (13.7%) and 14 (38.9%) among multiparous and grand multiparous respectively. The carrier rate of HBsAg infection among the pregnant women studied based on their duration of pregnancies and their social class showed no significant differences. However, according to the factors known to be commonly associated with the highest risk of transmission of HBV such as history of blood transfusion, Tribal marks/tattooing, use of sharps, sharing of articles, history of jaundice in the women and husbands, history of sexually transmitted infections (STIs) of the women and husbands and the type of marriage (monogamous or polygamous), number of sexual relationships per week, only the history of blood transfusion was significantly associated with HBsAg carrier rate (RR = 3.71., 95% Confidence Interval (C.I.), 1.89-7.30, p = 0.0078). The study confirms that pregnant women who attend antenatal clinic in this secondary health facility are at higher risk of being infected with the HBV, which could lead to both prenatal and post natal transmission to their newborns.

Keywords

Carrier Rate; HBsAg; Urban; Pregnant Women; SSH; Borno State; Nigeria

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Gust, I.D. (1985) Viral hepatitis. In: Warren, K.S. and Mohammed, A.A.F. Eds., Tropical Geographical Medicines, McGraw-Hill Books Company, New York, 572-585.
[2]	Drosten, C., Nippraschk, T., Manegold, C., Meisel, H., Brixner, V., Roth, W.K. Apedjinou, A. and Gunther, S. (2004) Prevalence of hepatitis B virus DNA in anti-HBC-positive/HBsAg-negative sera correlates with HCV but not HIV serostatus. Journal of Clinical Virology, 29, 59-68. http://dx.doi.org/10.1016/S1386-6532(03)00090-8
[3]	Mulders, M.N., Venard, V., Njayou, M., Edorh, A.P., Oyefolu, A.O.B., Kehinde, M.O., Tamfum, J.J.M., Nebie, Y.K., Maiga, I., Ammerlaan, W., Fack, F., Omilabu, S.A., Fau, le A. and Muller, C.P. (2004) Low genetic diversity despite hyperendemicity of hepatitis B virus genotype E throughout West Africa. The Journal of Infectious Diseases, 190, 400-408. http://dx.doi.org/10.1086/421502
[4]	Maynard, J.E., Kane, M., Alter, M.J. and Hadlex, S. (1988) Control of hepatitis B by immunization. In: Zuckerman, A.J. Ed., Global Perspective on Viral Hepatitis and Liver Disease, Alan R. Liss, New York, 967-969.
[5]	Toukan, A. (1990) Strategy for the control of hepatitis B virus infection in the Middle East and North Africa. Vaccine, 8, S117-S128. http://dx.doi.org/10.1016/0264-410X(90)90231-A
[6]	Ghendon Y. (1987) Perinatal transmission of hepatitis B virus in high incidence countries. Journal of Virological Methods, 17, 69-79. http://dx.doi.org/10.1016/0166-0934(87)90070-X
[7]	Yeoh, E.K. (1990) Hepatitis B virus infection in children. Vaccine, 8, S29-S30. http://dx.doi.org/10.1016/0264-410X(90)90212-5
[8]	Chainuvati, T. (1988) Prevention of hepatitis B infection in Thailand. Handbook of the International Symposium on Hepatocellular Carcinoma, Bangkok, 9-10 February 1988, 55-63.
[9]	Kiire, G.F. (1990) Hepatitis B infection in sub-Saharan Africa. Vaccine, 8, S107-S112. http://dx.doi.org/10.1016/0264-410X(90)90229-F
[10]	West, D.J., Calandra, G.B. and Ellis, R.W. (1990) Vaccination of infants and children against hepatitis B. Pediatric Clinics of North America, 37, 585-601.
[11]	Steffen, R. (1991) The epidemiological basis for the practice of travel medicine. 2nd Conference on International Travel Medicine, Altanta, 9-12 May 1991.
[12]	Sirisena, N.D., Njoku, M.O., Idoko, J.A., Isamade, E., Barau, C., Jelpe, D., Zamani, A. and Otowo, S. (2002) Carriage rate of hepatitis B surface antigen (HBsAg) in an urban community in Jos, Plateau state, Nigeria. Nigerian Postgraduate Medical Journal, 9, 7-10.
[13]	Hodges, M., Sanders, E. and Aitken, C. (1998) Seroprevalence of hepatitis markers: HAV, HBV, HCV and HEV amongst primary school pupils in Freetown, West African Journal of Medicine, 17, 36-37.
[14]	Beasley, R.P and Hwang, L.Y. (1984) Hepatocellular carcinoma and hepatitis B virus. Seminars in Liver Disease, 4, 113-121. http://dx.doi.org/10.1055/s-2008-1040651
[15]	World Health Organization (1990) Consultation on heaptitis B as a sexually transmitted disease. Report of a WHO consultation, 1990, WHO/MIM/VDT/91.457.
[16]	Gashau, M. (1988) Hepatocellular carcinoma in Maiduguri: A prospective clinical study. Thesis submitted for the Fellowship of the West African College of Physicians, 1988.
[17]	Harry, T.O., Bajani, M.D. and Moses, A.E. (1994) Hepatitis B virus infection among blood donors and pregnant women in Maiduguri, Nigeria. East African Medical Journal, 71, 32-33.
[18]	Bukbuk, D.N. and Udoh, E. (1997) The relationship of blood groups and hepatitis B virus surface antigen carrier state among blood donors in Maiduguri, Nigeria. Nigerian Medical Practitioner, 33, 335-337.
[19]	Bukbuk, D.N., Bassi, A.P. and Mangoro, Z.M. (2005) Seroprevalence of hepatitis B surface antigen among primary school pupils in Hawal valley, Borno state, Nigeria. Journal of Community Medicine & Primary Health Care, 17, 20-23.
[20]	Denny, P. (2006) Hepatitis Delta virus genetic variability: From genotypes I, II, III to eight major clades? Current Topics in Microbiology and Immunology, 307, 151-171.
[21]	Stevens, C.E., Beasley, R.P., Tsui, J. et al. (1975) Vertical transmission of hepatitis B antigen in Taiwan. The New England Journal of Medicine, 292, 771-774. http://dx.doi.org/10.1056/NEJM197504102921503
[22]	Acquaye, J.K and Mingle, J.A. (1994) Hepatitis B viral markers in Ghanaian pregnant women. West African Journal of Medicine, 13, 134-137.
[23]	Ayoola, E.A., Ogunbode, O and Odelola, H.A. (1981) Congenital transmission of hepatitis B antigen in Nigerians. Archives of Virology, 67, 97-99. http://dx.doi.org/10.1007/BF01314607
[24]	Abiodun, P.O., Olomu, A.O., Okolo, S.N., Obasohan, A and Freeman, O. (1994) The prevalence of hepatitis B antigen and anti-HBe in adults in Benin City. West African Journal of Medicine, 13, 171-174.
[25]	Olusanya, O. and Amiegheme, N. (1989) Biosocial factors in maternal mortality. A study from a Nigerian Mission Hospital. West African Journal of Medicine, 8, 160-165.
[26]	Olusanya, O. (1984) An original system of social classification for use in Nigeria and other developing countries. 24th Annual Conference of the West African College of Surgeons Freetown, Sierra Leone, 1984.
[27]	Olusanya, O., Okpere, E. and Ezimokhai, M. (1985) The importance of social class in voluntary fertility control in a developing country. West African Journal of Medicine, 4, 205-212.
[28]	Stevens, C.E., Neurath, R.A., Beasley, R.P. and Szmuness, W. (1979) HBeAg and anti-HBe detection by radioimmunoassay: Correlation with vertical transmission of hepatitis B virus in Taiwan. Journal of Medical Virology, 3, 237-241
[29]	Fakunle, Y.M., Addulrahman, M.B. and Whittle, H.C. (1980) Hepatitis B. virus infection in children and adults in Northern Nigeria: A preliminary survey. Transactions of the Royal Society of Tropical Medicine and Hygiene, 75, 626-629. http://dx.doi.org/10.1016/0035-9203(81)90133-4
[30]	Nasidi, A., Harry, T.O., Yazou, S.O., Munube, G.M.R., Azzan, B.B. and Ananier, V.A. (1983) Prevalence of hepatitis B infection markers in two different geographical areas of Nigeria. Proceedings of the First International Conference on Viral and Bacterial Vaccines, Paris, December 1983, 213-217.
[31]	United Nations System in Nigeria (2001) Nigerian common country assessment. World Health Organization, Geneva.