Prevalence, Genetic Diversity and Risk Factors Associated with Hepatitis B Infection among Women Attending Antenatal Clinic at St. Orsola Hospital, Tharaka Nithi County, Kenya
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Date
2025-07
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Kenyatta University
Abstract
There is a dearth of information on the impacts of hepatitis B virus (HBV) because it is rarely screened for in prenatal profiles in many facilities especially in Tharaka Nithi County. The transmission of Hepatitis B virus (HBV) occurs in the uterus through trans-placental, childbirth, and during newborn care. The likelihood of transmission is influenced by the presence of HBV markers in the mother where the risk is decreased if she is positive for HBsAg test result but rose if she has a positive HBsAg and HBeAg test result. Therefore, this study was carried out to determine the prevalence, genetic diversity and the associated risk factors for hepatitis B virus infection among expectant mothers seeking ANC at St. Orsola Hospital. A total of 385 pregnant mothers who were enrolled from September to December 2021 participated in a cross-sectional study. Blood samples were collected and examined for the presence of HBsAg and to determine the HBV risk of perinatal transmission, the positive sample for HBsAg were tested for HBsAg, HBsAb, HBeAg, HBeAb, HBcAb using five panel kit. The viral DNA was extracted from HBsAg positive samples, partial HBV-pol gene was amplified in nested PCR, directly sequenced using the Big Dye chain terminator method using ABI 3730xl DNA Analyzer. The obtained sequences were then scrutinized and assembled using BioEdit software v7.1.1 and subjected to multiple sequence alignment by MUltiple Sequence Comparison by Log- Expectation (MUSCLE). Phylogenetic relationships were estimated using Maximum likelihood-based inference of phylogenetic trees with Smart Model Selection (PhyML+SMS). From the analysis, the prevalence of HBV among pregnant womem was 25 (6.5%). Among these (25 pregnant women); 19 (76%) were inactive carrier, 4 (16%) chronically infected, 1 (4%) at recovery HBV and 1 (4%) at occult HBV. From the SPSS analysis, age (χ2= 13.55, p = 0.019), education (χ2= 44.53, p = 0.000), liver problems (χ2= 5.724, p = 0.017) and HIV (χ2= 6.267, p = 0.012) were associated with risk to HBV infection. From the phylogenetic analysis, the HBV genotype that was in circulation was genotype A, 11(100%). The detected prevalence of HBV in Tharaka Nithi region indicated possible increasing trends in HBV infection with age, education, liver problem and HIV being the associated risk factors, and HBV genotype A being the most predominate genotype in circulation. In order to control the spread of the virus there is need to identify cases both during antenatal as well as postnatal care, raise the risk awareness, track HBV genotypes and offer treatment for positive cases and HBV immunization for negative as well as all women of childbearing age
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science (Medical Microbiology) in the School of Pure and Applied Sciences of Kenyatta University, July, 2025
Supervisor:
1.Anthony Kebira
2.James Nonoh