Browsing by Author "Mwangome, Lawi Emmanuel"

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    Seroprevalence, Genetic Diversity, and Drug Resistance of Hepatitis B Virus among Gravid Women Attending Antenatal Clinic in Saretho Health Centre, Garissa, Kenya
    (Kenyatta University, 2025-10) Mwangome, Lawi Emmanuel
    The Hepatitis B Virus remains one of the global infectious diseases of public health concern. It is estimated that 2 billion people are infected worldwide with about 1.2 million mortality being reported yearly. Gravid women are considered a vulnerable group due to their immune suppression hence posing a risk for vertical transmission to their newborns. However, HBV disease burden and circulating HBV strains causing this endemic infections among gravid women remains elusive, in Garissa. Therefore, this study was aimed at determining seroprevalence, of HBV, genetic diversity, and drug resistance among gravid women attending Saretho Health Centre at Dadaab in Garissa.A cross-sectional study was conducted. A total of 186 consenting gravid women were recruited using systematic random sampling design. The study participants were recruited consecutively during the period between August to October 2023. A structured questionnaire was administered and demographic data; that includes age, level of education, marital status, ear piercing, tattooing, female genital mutilation (FGM), history of undergoing a caesarean section, history of blood transfusion, and dental procedure collected.About, 5ml venous blood was collected in EDTA tubes and screened for AntiHBs, AntiHBc, AntiHBe, HBsAg, and HBe-sero using Lumiquick HBV 5 panel kit according to the manufacturers instructions. The HBV positive samples viral DNA was extracted from separated plasma using the GeneProof pathogen free DNA isolation kit (Gene Proof, Czech Republic) as per the manufacturer’s instructions. The partial HBV pol gene was amplified and directly sequenced using Sanger sequencer platform. The genarated HBV sequences were phylogenetically analysed using MEGAx software.In addition, the HBV sequences were also analysed for drug resistance mutations using Insilico HBV drug resistance database. The demographic data was analyzed using SPSS version 19 and frequency tables generated. The sero-prevalence markers for HBV was presented in percentage and tabulated. Two tailed chi-square tests with significance set at p value of < 0.05 was used to compare the association between socio-demographic factors, serological markers and HBV infection stages across the study participants. Overall 8.6% prevalence was detected. Marital Status, level of education, history of undergoing FGM, having Ear piercing were risk factors associated with HBV infection (p < 0.05) while Age, history of; blood transfusion, caesarean section, dental procedures, tattoo, having liver disease or having family history of liver diseases (p > 0.05), were not risk factors associated with HBV infection. From the analysis, 19(10.2%) were immune to HBV infection, 6(3.2%) acute infection, 11(5.9%) on HBV recovery, 8(4.3%) were on chronic stage and 5(2.7%) had occult HBV. After the confirmation of HBV DNA by Gel electrophoresis, 9 samples were successful amplified, purified and sequenced. The phylogenetic analysis of HBV sequences revealed that seven (7) isolates were classified as HBV genotype A while two (2) isolates belonged to genotype D. The study found high overall drug resistance prevalence of 77.8%. Five participants harbored cross-resistance mutations to Lamivudine, Entacavir, and Telbivudine. Two had additional resistance to Adefovir and Entacavir, while no drug resistance mutations associated with tenofovir. Two participants had no detectable resistance mutations.This study suggests need for utilisation of HBV -5 panel seromarkers in HBV testing for early detection, infection staging and effective treatment. HBV genotype A predominates among pregnant women in Dadaab, with a high prevalence of drug resistance mutations. Continuous genotype surveillance is essential to monitor viral evolution and resistance dynamics. Based on observed cross-resistance, combined therapy with Tenofovir and Lamivudine is recommended for effective HBV management