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European Journal of Applied Sciences – Vol. 11, No. 5
Publication Date: October 25, 2023
DOI:10.14738/aivp.115.15529
Melisa, D. A., Chukwu, O. O. C., Otumala, J. E., Pam, D. L., & Barde, I. J. (2023).Serological and Molecular Detection of Hepatitis B
Virus Among Pregnant Women in Bokkos L.G.A, Plateau State.European Journal of Applied Sciences, Vol - 11(5). 401-419.
Services for Science and Education – United Kingdom
Serological and Molecular Detection of Hepatitis B Virus Among
Pregnant Women in Bokkos L.G.A, Plateau State
Melisa, David Adoro
Department of Microbiology, Faculty of Natural Sciences,
University of Jos, Nigeria
Chukwu, O.O. Chukwu
Federal College of Veterinary and Medical Laboratory
Technology Vom, Plateau State, Nigeria
Otumala, John Egbere
Department of Microbiology, Faculty of Natural Sciences,
University of Jos, Nigeria and Optima Kings Research Centre
and Laboratories, Jos Nigeria
Pam, Dachung Luka
Biotechnology Centre, National Veterinary Research Institute
Vom, Plateau State, Nigeria
Barde, Israel Joshua
Veterinary Pathology Division, National Veterinary Research
Institute Vom, Plateau State, Nigeria
ABSTRACT
Hepatitis B virus is a partially double stranded DNA virus that belongs to the family
Hepadnaviridae. It is transmitted majorly by vertical/perinatal and horizontal
transmission. HBV in pregnancy is of great public health concern as it exposes the
infant to higher risk of chronic hepatitis infection, low birth weight and
prematurity, resulting to morbidity and mortality. This study was aimed at
determining the prevalence ofhepatitis B virus among pregnant women in Bokkos
Local Government Area of Plateau State, Nigeria. Five (5) mls of venous blood
samples were collected from each of the 200 participants that consented to this
study, both those attending antenatal clinic and those who do not. A questionnaire
was used to collect participant’s data prior to sample collection. Gynecology unit of
Dung Hospital, Primary Health Center, and Cottage Hospital were used as sample
collection units. All samples collected were transported to and analyzed at the
molecular laboratory unit (Biotechnology unit) of National Veterinary Research
Institute (NVRI), Vom. Blood sample from each participant was screened for HBsAg,
using HBsAg rapid test kit (PROMED HBSAG test strip, Manufactured for Fittrust NIG
Ltd, China). All HBsAg positive samples were further analyzed for the presence of
HBeAg and HBV DNA via conventional PCR. The overall sero- prevalence of hepatitis
B virus among pregnant women in Bokkos Local Government Area was 10%
(20/200). Prevalence of HBeAg among sero-positive pregnant women was 10%
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European Journal of Applied Sciences (EJAS) Vol. 11, Issue 5, October-2023
(2/20). And 35% (7/20) of the sero-positive samples were positive for HBV DNA
test. Age group of 30-39 years has the highest prevalence rate of HBV infection
(18.8%). Age, marital status, educational level and occupation showed no
significant association with HBV infection, as analyzed by chi-square test (P>0.05).
Contact with infected blood or body fluid, blood transfusion, unprotected sex,
exposure to environmental objects, born of HBV positive mother and HBV status of
sex partner showed no significant association with HBV, (P>0.05). However,
significant association with HBV infection was observed in having close relation
with HBV infection (P=0.002, (P<0.05)), with highest prevalence of 20% in those
who admitted to having a close relation with HBV infection and prevalence of 5.7%
in those who do not have close relations with HBV. HBV vaccination status of
participants was significantly associated with HBV infection (P=0.017, (P<0.05)),
with higher prevalence of 7.4% among those who have not been vaccinated and 0%
in those vaccinated. In conclusion, the high prevalence rate of HBV among pregnant
women within the sexually active and fertile age group in this study indicates high
risk of vertical transmission. This may contribute greatly to the rate of developing
chronic hepatitis B infection, not just in Bokkos Local government area but in the
country at large. Hence the needs for the implementation of stringent measures by
the health care providers and the governments towards breaking this route of
transmission and the management of this infection. This will contribute greatly
towards the achievement of the WHO’s goal of eliminating viral hepatitis B by 2030.
INTRODUCTION
Hepatitis is the Inflammation of the liver that is caused by viral infections such as the hepatitis
B virus; a disease condition originally termed serum hepatitis, (Kurdi et al., 2014). The
causative agent of hepatitis B was discovered and acknowledged by the use of an electron
microscope which reveals numerous particles of the virus termed the Dane particles, which
were seen using this microscope, (Kurdi et al., 2014). The Dane particle was the Hepatitis B
virus and has been shown to react with anti-sera to Australian antigen; therefore, the
constituent on the surface of the virus was termed the hepatitis B surface antigen, (Kurdi et al.,
2014). Hepatitis B virus (HBV) belongs to the family Hepadnaviridae, and it is a partially double- stranded DNA virus, (Afzali et al., 2015; Ibrahim et al., 2020).
The hepatitis B virus (HBV) infection is considered to be among the most common viral
infections all over the world and it leads to mortality and morbidity in developing countries,
(Tajbakhsh et al., 2010). Hepatitis B virus can be transmitted through contact with infected
blood or body fluids which can be through sexual contact, needles, dialysis, blood transfusion
as well as from infected mother to child at birth (vertical transmission), (Tajbakhsh et al., 2010).
The hepatitis B viral infection usually results to complications leading to liver cirrhosis,
including hepatocellular carcinoma (liver cancer), (Kurdi et al., and 2014).
About 400 million individuals have been estimated to be chronically infected with hepatitis B
virus globally. The hepatitis B virus is the commonest cause of chronic liver disease and liver
cancer, (Kirbak et al., 2017). More than 2 million of the world’s population has been estimated
to be infected with the hepatitis B virus, (Amsalu et al., 2018). According to the World Health
Organization (WHO, 2019), about 780,000 individuals die annually due to hepatitis B virus
related diseases such as liver cancer and liver cirrhosis. The hepatitis B virus is considered the
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Melisa, D. A., Chukwu, O. O. C., Otumala, J. E., Pam, D. L., & Barde, I. J. (2023). Serological and Molecular Detection of Hepatitis B Virus Among
Pregnant Women in Bokkos L.G.A, Plateau State. European Journal of Applied Sciences, Vol - 11(5). 401-419.
URL: http://dx.doi.org/10.14738/aivp.115.15529
most serious form of viral hepatitis, and the virus has a survival time of at least seven days on
environmental surfaces (e.g., surgical equipment, sex toys etc.) outside the body (WHO, 2022).
Mother to child transmission or vertical transmission is considered to be the major form in
which hepatitis B virus is transmitted in endemic areas such as the sub-Saharan Africa and
Nigeria, (Anaedobe et al.,2015; Asaye et al., 2021). About half of hepatitis B chronic carriers got
infected, either via mother to child transmission or in their early stage of livelihood, (Anaedobe
et al., 2015). The rate of developing chronic hepatitis B infection is as high as 95% when
exposed at infancy and as low as 5% when exposed at adult age, (Navabakhsh et al., 2011).
According to a study that was conducted on mother to child transmission of hepatitis B virus,
in Juba, Southern Sudan, it was documented that 5 out of 9 infants born to hepatitis B positive
mothers were infected, (Kirbak et al., 2017). Vertical transmission is common in endemic region
with infection rate greater than 5%, and a major cause of chronic hepatitis B infection, (Amsalu
et al., 2018).
The risk of mother to child transmission varies from 10% to 40% in mothers who are negative
to hepatitis B envelop antigen, while the risk is about 90% in mothers’ positive to hepatitis B
envelop antigen (HBeAg), (Amsalu et al., 2018). This viral infection in pregnancy is a major
public health problem as it exposes the infant to higher risk of chronic hepatitis infection, low
birth weight and prematurity resulting to morbidity and mortality, (Amsalu et al., 2018).
Therefore, proper screening of pregnant women and the provision of vaccines is important for
proper management and control of the infection. There is paucity of data on hepatitis B
infection among pregnant women in Bokkos local government area, hence the need for this
study.
Aim of the Study
To detect hepatitis B virus among pregnant women in Bokkos Local Government Area of
Plateau State, Nigeria
Objectives of the Study
1. To determine the sero-prevalence of hepatitis B virus among pregnant women in
Bokkos Local Government Area
2. To determine the prevalence of hepatitis B, envelop antigen among sero-positive
pregnant women within the study area
3. To detect the presence of HBV DNA in sero-positive samples
Statement of Problem
Hepatitis B viral infection in pregnancy is the major cause of chronic hepatitis as the rate of
developing chronic hepatitis B infection is as high as 95% when exposed at infancy,
(Navabakhsh et al., 2011). Viral hepatitis during pregnancy is associated with high risk of
maternal complications (low birth weight and prematurity) and has become a leading cause of
foetal morbidity and motility especially where vaccines is either unreliable or inaccessible,
(Amsalu et al., 2018). Maternal hepatitis B viral infection is also associated with miscarriage,
pregnancy induced hypertension and preeclampsia, (Asaye et al., 2021). There is lack of
information on hepatitis B virus infection among pregnant women in Bokkos Local government,
hence the need for this study.