Evaluating Hepatitis B Screening During Pregnancy: A Study on Diagnostic Accuracy and Infection Control in Nigeria

Abstract

Hepatitis B virus (HBV) remains a critical public health issue in low- and middle-income countries (LMICs), particularly among pregnant women in Nigeria. Routine screening using rapid diagnostic kits is common in antenatal care, yet the accuracy of these tests can vary. This study aimed to determine the seroprevalencwe of HBV among pregnant women who had previously undergone screening using rapid diagnostic kits at Obafemi Awolowo Teaching Hospital, Ilesa, Osun State, Nigeria, to assess the effectiveness of initial screening and identify any missed cases. A cross-sectional study was conducted, involving 263 pregnant women. Blood samples were tested for HBV markers (HBsAg, HBsAb, and HBcAb) using ELISA. Sociodemographic data and potential risk factors were also analysed. The study found that 7.6% of women were HBsAg positive, indicating active HBV infection, and 49.6% were susceptible to HBV. There was a significant association between higher education levels and HBV seropositivity. Employment status also correlated with HBV prevalence, with self-employed women showing higher seroprevalence. Additionally, a history of blood transfusions was linked to higher HBV seropositivity. The findings highlight the limitations of rapid diagnostic kits in detecting HBV and underscore the need for enhanced infection prevention and control measures, including confirmatory testing, robust vaccination programmes and safe delivery practices to reduce HBV transmission in high-burden regions like Nigeria.