Hepatitis B in Pregnancy: Knowledge, Access to Screening and Vaccination in a Low-Resource Setting, Cameroon

Background: Hepatitis B virus (HBV) infection is a global public health problem with a high burden in Sub-Saharan Africa. This burden is more felt in the paediatric population, mother to child transmission (MTCT) being a major mode of infection. This study sought to assess the knowledge of pregnant women on HBV and their access to screening and vaccination.

Methods: A cross-sectional study was carried out in the South West Region, Cameroon from 15th January to the 15th April, 2018 involving third trimester pregnant women attending antenatal care (ANC) and those in the post-partum period admitted at the maternity wards of some hospitals. Data was collected using a structured questionnaire and analysed using SPSS version 23. Knowledge was evaluated using a series of twelve questions. Vaccination status was determined from vaccination cards and ANC registers.

Results: Of the 349 women studied, 31.8% were knowledgeable with scores of ≥ 6/12. High educational level (P= 0.002) and occupation as a health worker (P < .001) were associated with good knowledge. Ninety (90.0%) had been screened for hepatitis B surface antigen (HBsAg) during pregnancy while 14.6% had been vaccinated. Determinants of vaccination were monthly income >60.000FCFA (OR: 5.7 CI: 1.6-19.9), urban residence (OR: 4.0 CI: 1.1-15.0) and regional level of ANC health facility (OR: 12.4 CI: 2.0-76.4).

Conclusion: Only about three in ten women were knowledgeable on HBV infection. Ninety percent were screened during pregnancy but only ten percent were vaccinated. These results show that despite the high rate of HBV screening in this setting, most women have a poor level of knowledge about this infection and its prevention. We recommend that health education on HBV should be provided to pregnant women especially during antenatal visits and that preventive measures be re-enforced in South West Region.