Viral Hepatitis B and Malaria Co-Infection among Pregnant Women in the Bono East Region of Ghana.

Abstract

Viral hepatitis B and malaria during pregnancy pose a significant risk. HBV and Plasmodium undergo certain developmental stages within the liver, and this has been linked with liver damage. Although some studies in the Bono East Region on HBV and malaria mono-infections provided valuable insights into these two infections, their co-infection during pregnancy has not been extensively explored. This study, therefore assessed the seroprevalence of HBV and malaria co-infection among pregnant women in the Bono East Region of Ghana. This multicentre health facility-based cross-sectional study employed the mixed method design to collect relevant data from 1430 pregnant women from seven health facilities. Serological screening, a closed-ended questionnaire, in-depth interviews (IDIs), and focus group discussions (FGDs) were used to collect relevant data. Quantitative data were analyzed using STATA 14. Descriptive statistics, Pearson’s Chi-square tests, and logistic regression were performed as part of data analyses. The findings from the regression model were presented in crude and adjusted odds ratios at a 95% confidence interval. Qualitative data were analyzed using a four-step thematic analysis. The mean age of participants was 28.8 ± 3.73 years. The prevalence of HBV infection was 1.8%, while malaria infection stood at 10.8%. Co-infection with HBV and malaria was observed in 0.7% of the participants [95% CI: 0.37 – 1.29]. Among the co-infected, 6, 1, and 3 had high, moderate, and low malaria parasitemia, respectively. Blood transfusion, street nail trimming, residing closer to refuse dumping sites and closer to water bodies, being unmarried, having no formal education, primigravidae, and secundigravida were significantly associated with increased odds of co-infection. Barriers to adherence were linked to personal, psychological, and socio-cultural. Despite the relatively low prevalence, the identified determinants highlight the need for integrated antenatal screening protocols, targeted public health education, and policy-level interventions to reduce the dual burden of HBV and malaria among pregnant women and contribute to achieving maternal health targets under Sustainable Development Goal 3.