Epidemiology of hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital (QECH), Blantyre Malawi

Background
Viral Hepatitis is a serious public health concern globally with an estimated 1.3 million deaths annually due to hepatitis B and C viruses. Prevention of mother to child transmission is a critical step toward elimination of hepatitis B and C. The main aim of this study was to assess the prevalence of HBV and HCV among pregnant women at Queen Elizabeth Central Hospital in Blantyre.

Method

A descriptive cross-sectional study was conducted among consecutive pregnant women attending routine antenatal care, and/or admitted at QECH in last quarter of 2021. Of the 114 pregnant women, 84 women consented to participate. Serum was tested for HBsAg and Anti-HCV markers using rapid diagnostic tests (RDT) and compared to Enzyme Linked Immunosorbent Assay (ELISA).

Results

Of the 84 consenting pregnant women, the median age was 25.0 years (IQR: 21.0, 33.0). Hepatitis B surface antigen (HBsAg) was detected in 6.0% (n=5/84, 95% CI: 0.03–6.4) of participants using ELISA and in 1.2% (0.2-6.4; n=1/84), using RDTs, while none tested positive for anti-HCV antibodies. There were no significant associations between HBV infection and any of the socio-demographic characteristics or assessed risk factors.

Conclusion

The prevalence of HBV (6%) and HCV (0%) in this population was lower than reported in previous studies of the general Malawian population, where HBV seroprevalence was estimated at 8.1% and HCV below 1%. We highlight potential underdiagnosis using RDTs for HBV, an ongoing significant rate of HBV infection, and a very low prevalence of HCV. Accessible screening and treatment for all positive pregnant women remains essential to eliminate vertical transmission.