Journal of Infection in Developing Countries
Volume 10, Issue 4, 2016, Pages 377-383

High hepatitis B seroprevalence and risk factors for infection in pregnant women on the Thailand-Myanmar border (Article)

Banks T. , Khang J. , Watts I. , Tyrosvoutis M.E.G. , Min A.M. , Tun N.W. , Keereecharoen L. , Simmawong W. , Wanyatip S. , Hanboonkunupakarn B. , Nosten F. , McGready R.*
  • a Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • b Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • c Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • d Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • e Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • f Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • g Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • h Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • i Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • j Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
  • k Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
  • l Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

Abstract

Introduction: Infection from Hepatitis B primarily results from peri-partum vertical transmission and the risk increases in the presence of hepatitis B e antigen. We aimed to evaluate a new screening program for hepatitis B in pregnant women as a component of antenatal services in a marginalized population. Methodology: Counseling and screening for hepatitis B screening was offered to all women at the first visit, at Shoklo Malaria Research Unit (SMRU) antenatal clinics on the Thai-Myanmar border. Point-of-care rapid diagnostic tests (RDT) were used throughout the period of evaluation. A certified Thai Public Health laboratory at Mae Sot Hospital verified RDT positive cases using enzyme-linked immunosorbent assay (ELISA) for HBsAb and HBeAg. Risk factors for hepatitis B were identified by data linkage to antenatal care records. Results: There were 523 (8.5%) RDT positive for HBsAg among 6158 women tested (Aug-2012 to April-2014). Of these 373 (96.9%) of 385 sent for confirmation were positive by ELISA i.e. RDT false positive rate of 3.1% (95% CI 1.7- 5.4). The overall confirmed HbsAg prevalence was 8.3% (511/6158) (95% CI 7.6-9.0). HBeAg prevalence was 32.7% (114/350) (95% CI 27.9-37.7) of cases tested. Risk factors for HBsAg positivity included age > 25 years (OR 1.24, CI 1.03-1.49, p 0.021) and Karen heritage (OR 1.73, CI 1.39-2.15, p < 0.01). Conclusions: High hepatitis B seroprevalence amongst migrants and refugees accessing SMRU antenatal services likely reflects that of Kayin State, Myanmar, and perinatal prevention programs are required. False positive cases with HBsAg RDT complicate what is theoretically a straightforward screening. © 2016 Banks et al.

Author Keywords

marginalized populations Perinatal transmission Limited resource setting Hepatitis B prevention

Index Keywords

refugee prenatal care Pregnancy Complications, Infectious Thailand human Refugees middle aged Immunochromatography Young Adult Humans Adolescent Infant, Newborn female risk factor enzyme linked immunosorbent assay Risk Factors newborn Hepatitis B e Antigens pregnancy Myanmar rapid test immunoaffinity chromatography Article blood adult migration seroepidemiology hepatitis B surface antibody hepatitis B surface antigen pregnant woman Transients and Migrants Hepatitis B Surface Antigens hepatitis B seroprevalence Seroepidemiologic Studies hepatitis B(e) antigen Enzyme-Linked Immunosorbent Assay
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84964757039&doi=10.3855%2fjidc.7742&partnerID=40&md5=7f5cb5e2c3d9d0f81100ecbbad1bd72e
DOI: 10.3855/jidc.7742
ISSN: 20366590
Cited by: 5
Original Language: English