High hepatitis B seroprevalence and risk factors for infection in pregnant women on the Thailand-Myanmar Border

  • Tristan Banks Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Joy Kang Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Isabella Watts Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Mary Ellen G Tyrosvoutis Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Aung Myat Min Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Nay Win Tun Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Lily Keereecharoen Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Wiriya Simmawong Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Sunaree Wanyatip Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Borimas Hanboonkunupakarn Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
  • François Nosten Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
  • Rose McGready Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
Keywords: hepatitis B, marginalized populations, perinatal transmission, prevention, limited resource setting

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.

Author Biographies

Aung Myat Min, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand

obstetrics and Gynaecologist

Shoklo Malaria Research Unit

Thailand

François Nosten, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand

Professor Franc,ois Nosten

Director

Shoklo Malaria Research Unit

Rose McGready, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand

Professor Rose McGready

Deputy Director

Shoklo Malaria Research Unit

Published
2016-04-28
How to Cite
1.
Banks T, Kang J, Watts I, Tyrosvoutis ME, Min AM, Tun NW, Keereecharoen L, Simmawong W, Wanyatip S, Hanboonkunupakarn B, Nosten F, McGready R (2016) High hepatitis B seroprevalence and risk factors for infection in pregnant women on the Thailand-Myanmar Border. J Infect Dev Ctries 10:384-388. doi: https://doi.org/10.3855/jidc.7422
Section
Original Articles