Background: HIV/AIDS and HBV are major health problems in Sub-Saharan Africa affecting all age groups. In 2010, an estimated 68% (22.9 million) of all HIV cases and 66% of all deaths (1.2 million) occurred in the region while hepatitis B is estimated to affect 2 billion people worldwide, of which 350 million people have chronic infection and 10% of these are in Sub-Saharan Africa and East Asia. These chronically infected patients may develop liver cirrhosis or Hepatocellular carcinoma. Both pregnant women and infants. Since 1991, the World Health Organization recommended screening of pregnant women for HBV infection. However, this is not current practiced in Tanzania. This study was conducted to investigate the prevalence of HIV and HBV and associated risk factors among pregnant women attending antenatal clinic at Kambarage health center of Shinyanga urban district and provide suggestion of appropriate measures.
Methodology: This was a cross sectional study that was conducted from August to October 2014 in Shinyanga urban district among 200 pregnant women aged from 15 years to 45 years attending ANC in Kambarage HC. Participants were enrolled consecutively after consenting and interviewed using standard structured questionnaire to obtain information regarding potential risk factors. Blood was collected and screened for hepatitis B using instant-view HbsAg ONE-STEP serum Test (Dip-Strip) for screening Hepatitis B surface antigen (HbsAg) in human serum, for participant whose blood sample tested positive was referred to Shinyanga referral hospital for detection of Hepatitis B e antigen (HBeAg) and serum hepatitis B virus DNA level and further management. HIV was tested using Alere Determine HIV-1/2 for detection of antibodies to HIV-1 and HIV-2 in human serum and positive sample was confirmed by The Trinity Biotech Uni-Gold HIV test. Pregnant women who tested positive for HIV were counseled and referred to CTC of Kambarage HC for further management, data was coded, entered, cleaned. Validated and analyzed using SPSS software version 17.0
Results: A total of 200 pregnant women were interviewed and screened for both HbsAg and HIV during the study, the mean age of the study subjects was 25.16 years (SD=5.771) and mode age was 20 years, the youngest study respondent was 17 years with the oldest being 43 years. About ten pregnant women (5%) had serological evidence of infection whereby four (2%) had HBV infection and three (1.5%) had HIV infection while three (1.5%) had HIV/HBV co infection. The risk factors for HBV and HIV were age group 30-34 years, marital status (polygamy and widow), parity (multipara), family history of HBV infection and ear piercing (Phi = 0.318 and p = 0.001, Phi = 0.243 and p = 0.038, Phi = -340 and p = 0.000, Corr. Sig. 0.05 and p = 0.030, Corr. Sig. 0.05 and p = 0.020 respectively.
Conclusion and recommendations: This study found that Shinyanga urban district in northwestern Tanzania has the sero prevalence of hepatitis B surface antigen of 2%, which lies within the intermediate endemic area (2-7%) of Hepatitis B infection according to World Health Organization criteria for endemicity however; the prevalence of HIV and HIV/HBV co infection found to be very low (1.5%). There is a need of screening all pregnant women on their routine ANC visit for both HbsAg and HBeAg together with HIV in order to prevent this HBV endemicity and HIV low prevalence from becoming high.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O. Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz