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RÉSUMÉ
Objectif. L’objectif était d’évaluer les facteurs associés au portage de l’aghbs en grossesse afin d’identifier des cibles de prévention. Matériels et méthodes. Il s’agit d’une étude cas témoin réalisée dans trois hôpitaux universitaires de Douala et Yaoundé. Les cas étaient constitués de femmes enceintes avec une sérologie AgHBs positive. Nous avons recruté 121 femmes enceintes Ag HBs positifs et les avons appariées à 242 mères Ag HBs négatifs après régression logistique. Résultats. Les facteurs associés au portage de l’AgHBs en grossesses étaient l’union libre [OR : 5,01 IC 95% (2,51-10,02) p=0,001 ]; la religion pentecôtiste [OR 4,3 IC 95% (1,41-13,47) p=0,01]; les antécédents d’ictère [OR : 5,3 IC 95% (1,20-23,37) p=0,02 ]; de soins dentaires [OR : 2,4 IC 95% (2,26-4,96) p=0,01 ]; et de scarifications [OR 7,4 IC 95% (3,77-14,58) p=0,00], l’hépatite B dans l’entourage [OR : 4,86 IC 95% (1,20-19,65) p=0,02] et l’antécédent familial d’infection à l’hépatite B au premier degré [OR : 7,08 IC 95% (1,44-34,78) p=0,01]. Conclusion. Plusieurs facteurs associés à l’hépatite B en grossesse précédemment identifiés dans la littérature récente ont été retrouvés. Le rôle des congrégations pentecôtistes, donnée spécifique de notre travail reste à confirmer.
ABSTRACT
Objective. The objective of the study was to evaluate sociodemographic and clinical factors associated to hepatitis B surface antigen in pregnancy so as to identify potential preventive targets. Materials and methods. It was a case-control study conducted in three university teaching hospital of Douala and Yaoundé. Cases were AgHBs positive pregnant women and the control were AgHBs negative. We included 121 AgHBs positive pregnant women and 242 controls. Results. After logistic regression, factors associated to hepatitis B in pregnancy were co-habitation [OR : 5.01 CI 95% (2.51-10.02) p=0.001 ]; pentecostalism, [OR 4.3 CI 95% (1.41-13.47) p=0.01]; past histories of jaundice [OR : 5.3 CI 95% (1.20-23.37) p=0.02 ]; dental care [OR : 2.4 CI 95% (2.26-4.96) p=0.01 ]; scarifications [OR 7.4 CI 95% (3.77-14.58) p=0.001]. history of hepatitis B among entourage [OR: 4.86 CI 95% (1.20-19.65) p=0.02] and past history of hepatitis B among first degree siblings [OR: 7.08 CI 95% (1.44-34.78) p=0,01]. Conclusion. Several factors associated to HBsAg positive profile identified in recent literature were confirmed. The relationship with pentecostalism, a specific finding of this study has to be confirmed by more studies.
Article Details
References
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- - Schweitzer A, Horn J, Mikolajczyk RT, Krause G and Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013.LANCET 2015; Oct 17 ;386(10003) :1546-55.
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- Disponible sur : https://www.researchgate.net/publication/275717071_Prevalence_infectivity_and_correlates_of_hepatitis_B_virus_infection_among_pregnant_women_in_a_rural_district_of_the_Far_North_Region_of_Cameroon_Disease_epidemiology_-_Infectious visité le 15 avril 2019.
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- - Abongwa LE, Anye Mambo C, Nantia Akono E and Ntonifor HN. Sero-Prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) Co-Infection among Pregnant Women Residing in Bamenda Health District, Cameroon. Int.J.Curr.Microbiol.App.Sci (2015) 4(12): 473-483.
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- - Mbopi-Keou FX,Monthe Nkala IV,Kalla GC,Nguefack Tsague G,Gonsu Kamga H,Noubom et al. Séroprévalence et facteurs associés au VIH et aux hépatites virales B et C dans la ville de Bafoussam au Cameroun. Pan Afr Med J.2015 ;20 :156. Disponible sur :
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- - Eke CB, Ogbodo SO, Ukoha OM, Ibekwe RC, Asinobi IN, Ikefuna AN, et al. Seroprevalence and Risk Factors of Hepatitis B Virus Infection among Adolescents in Enugu, Nigeria. J Trop Pediatr. 1 déc 2015 ;61(6) :407‑13.
- - Araya Mezgebo T, Niguse S, Gebrekidan Kahsay A, Hailekiros H, Berhe N, Asmelash Dejene T. Hepatitis B virus infection and associated risk factors among pregnant women attending antenatal care in health facilities of Tigray, Northern Ethiopia. J Med Virol. mars 2018;90(3):503‑9.
- - Bayo P, Ochola E, Oleo C and Mwaka AD. High prevalence of hepatitis B virus infection among pregnant women attending antenatal care: a cross-sectional study in two hospitals in northern Uganda. BMJ Open. 11 nov 2014;4(11): e005889.
- - Luksamijarulkul P, Mooktaragosa A, Luksamijarulkul S. Risk factors for hepatitis B surface antigen positivity among pregnant women. J Med Assoc Thail Chotmaihet Thangphaet. mars 2002;85(3):283‑8.
- - Eke AC, Eke UA, Okafor CI, Ezebialu IU and Ogbuagu C. Prevalence, correlates and pattern of hepatitis B surface antigen in a low resource setting. Virol J. 12 janv 2011; 8:12.
- - Rashid S, Kilewo C, Aboud S. Seroprevalence of hepatitis B virus infection among antenatal clinic attendees at a tertiary hospital in Dar es Salaam, Tanzania. Tanzan J Health Res. janv 2014;16(1):9‑15.
- - WHO Guidelines Approved by the Guidelines Review Committee (2015). Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. World Health Organization Copyright (c) World Health Organization 2015., Geneva.
- Disponible sur http://apps.who.int/iris/bitstream/handle/10665/154590/9789241549059_eng.pdf;jsessionid=C46BCE681C34E79E8E293276A61A13B2?sequence=1
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- - Jacquelyn Monroe. Women in Street Prostitution: The Result of Poverty and the Brunt of Inequity, Journal of Poverty;2005. 9:3, 69-88, DOI: 10.1300/J134v09n03_04
- - Abuelgasim MH and Koko Baraka MB. Prevalence of Hepatitis B Infection among Pregnant Women at Khartoum Teaching Hospital, Sudan. J US-China Med Sci. 2015;12(2).
- - Bani I, Mahfouz MS, Maki E, Gaffar A, Elhassan I, Yassin AO, et al. Prevalence and Risk Factors of Hepatitis B Virus among Pregnant Women in Jazan Region- Kingdom of Saudi Arabia. J Biol. 2012; 2:459-65.
- - Obi SN, Onah HE and Ezugwu FO. Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population. J Obstet Gynaecol J Inst Obstet Gynaecol. nov 2006;26(8):770‑2.
- - Nguyen G, Garcia RT, Nguyen N, Trinh H, Keeffe EB, Nguyen MH. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther.2009；29(7):755‑64.
- - Tiruye G, Shiferaw K and Tadesse F. Seroprevalence of hepatitis B virus infection and associated factors among pregnant women attended antenatal care services in Harar City, Eastern Ethiopia. J Women's Health Care. 2018; 7:436.
- - Mahboobi N, Porter SR, Karayiannis P and Alavian S-M. Dental treatment as a risk factor for hepatitis B and C viral infection. A review of the recent literature. J Gastrointest Liver Dis JGLD. mars 2013;22(1):79‑86.
- - Sofian M, Banifazl M, Ziai M, Aghakhani A, Farazi A-A, Ramezani A. Intra-familial Transmission of Hepatitis B Virus Infection in Arak, Central Iran. Iran J Pathol. 2016;11(4):328‑33.
- - Otkun M, Erdogan MS, Tatman-Otkun M and Akata F. Exposure time to hepatitis B virus and associated risk factors among children in Edirne, Turkey. Epidemiol Infect. juin 2005;133(3):509‑16.
- - Alswaidi FM, O’Brien SJ. Is there a need to include HIV, HBV and HCV viruses in the Saudi premarital screening program on the basis of their prevalence and transmission risk factors? J Epidemiol Community Health. nov 2010;64(11):989‑97.
- - Euler GL, Wooten KG, Baughman AL, Williams WW. Hepatitis B Surface Antigen Prevalence Among Pregnant Women in Urban Areas: Implications for Testing, Reporting, and Preventing Perinatal Transmission. Pediatrics. 1 mai 2003;111(Supplement 1):1192‑7.
- - Jan Y, Bilques S, Najmi AM, Qureshi MA, Shahzada, Khan SS, et al. Viral Hepatitis during Pregnancy: A Study of Its Socio- Clinical Profile in A Tertiary Care Hospital. IOSR J Dent Med Sci. 2012;3(2):18‑22.
- - Kerzman H, Green MS, Shinar E. Risk factors for hepatitis C virus infection among blood donors in Israel: a case-control study between native Israelis and immigrants from the former Soviet Union. Transfusion (Paris). juill 2007;47(7):1189‑96.
- - Thakur V, Guptan RC, Malhotra V, Basir SF and Sarin SK. Prevalence of hepatitis B infection within family contacts of chronic liver disease patients--does HBeAg positivity really matter? J Assoc Physicians India. Nov 2002; 50:1386‑94.
- - Li-Zhang C, Zhou W, Zhao S, Liu Z, and Wen S. A nested case-control study of maternal-neonatal transmission of hepatitis B virus in a Chinese population. World J Gastroenterol. 2011; 17(31): 3640–3644.
- - Ajana F. Les variants du virus de l’hépatite B virale. Journal de pédiatrie et de puériculture. 2006;19(2):52-55.
- - Mutagoma M, Balisanga H, Malamba SS, Sebuhoro D, Remera E, Riedel DJ et al. Hepatitis B virus and HIV co-infection among pregnant women in Rwanda. BMC Infect Dis. 2017;17: 6-18.
- - Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011; Aug 11; 365(6): 493–505.
References
- Stanaway J, Flaxman AD2, Naghavi , Fitzmaurice C3, Vos , Abubakar I4 et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet.2016 ; 388 : 1081–88.
- WHO. Global hepatitis report, 2017. Geneva: World Health Organization, April, 2017. Disponible sur : www.who.int/hepatitis/publications/globalhepatitis-report2017/en/ (cité le 10 octobre 2018).
- OMS, Organisation Mondial de la Santé. Journée mondiale contre l’hépatite 2017 : éliminer l’hépatite. Disponible sur : http://www.who.int/campaigns/hepatitis-day/2017/event/fr/. (Cité le 10 octobre 2018).
- WHO. Global health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. Geneva: World Health Organization,2016 disponible sur:
http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdf (visité le 10 octobre 2018)
- Bigna JJ, Amougou MA, Asangbeh SL,Malaha Kenne A,Noumegni SRN, Ngo-Malabo ET et al.
Seroprevalence of hepatitis B virus infection in Cameroon: a systematic review and meta-analysis. BMJ Open 2017;7: e015298. doi:10.1136/bmjopen-2016-015298.
- Schweitzer A, Horn J, Mikolajczyk RT, Krause G and Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013.LANCET 2015; Oct 17 ;386(10003) :1546-55.
- Spearman CW, Afhene M, Reidwaan A, Apica B, Awuku Y, Cunha L et al. Viral hepatitis in sub-Saharan Africa. Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets. Lancet Gastroenterol Hepatol.2017; 2: 900–09.
- OMS, Organisation Mondiale de la Santé. Hépatite B.
Disponible sur : http://www.who.int/mediacentre/factsheets/fs204/fr/. (Cité 10 octobre 2018).
- Bajema LK, Stankiewicz HCK, Tenforde MW, SHawes SE and Heffron R. Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study. Open Forum infectious diseases (OFID).2018:1-6.
Disponible sur : https://academic.oup.com/ofid/article-abstract/5/6/ofy134/5035234 (visité le 1er octobre 2018)
- Musa BM, Bussell S, Borodo MM, Samaila AA, Femi OL. Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: a systematic review and meta-analysis. Niger J Clin Pract. avr 2015;18(2):163‑72.
- Ngaira JA, Kimotho J, Mirigi I, Osman S, Ng'ang'a Z, Lwembe R et al. Prevalence, awareness and risk factors associated with Hepatitis B infection among pregnant women attending the antenatal clinic at Mbagathi District Hospital in Nairobi, Kenya. Pan Afr Med J. 2016 ; 17(24) :315.
- Sbiti M, Khalki H, Benbella I et Louzi L. Seroprevalence of HBsAg in pregnant women in central Morocco. Pan Afr Med J. 2016; 24:187.
- Wan Z, Zhou A, Zhu H, Lin X, Hu D, Peng S, et al. Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-based Case-control Study in Wuhan, China. J Clin Gastroenterol. janv 2018;52(1):73‑8.
- Bigna J.J, Noubiap J.J, Nansseu J.R, Fokom Domgue F, Tchokfe S, Ndoula T.S et al. Prevalence, infectivity and correlates of hepatitis B virus infection among pregnant women in a rural district of the Far North Region of Cameroon. BMC Public Health (2015) 15 :454
Disponible sur : https://www.researchgate.net/publication/275717071_Prevalence_infectivity_and_correlates_of_hepatitis_B_virus_infection_among_pregnant_women_in_a_rural_district_of_the_Far_North_Region_of_Cameroon_Disease_epidemiology_-_Infectious visité le 15 avril 2019.
- Abongwa L.E and Pen K. Assessing prevalence and risks factors of hepatitis B surface antigen amongst pregnant women. European Journal of Research in Medical Sciences. 2016;'(1):32-43.
- Abongwa LE, Anye Mambo C, Nantia Akono E and Ntonifor HN. Sero-Prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) Co-Infection among Pregnant Women Residing in Bamenda Health District, Cameroon. Int.J.Curr.Microbiol.App.Sci (2015) 4(12): 473-483.
- Fancelo S. « Guérison, délivrance et sida :les femmes et la « maladie de Dieu » dans les églises pentecôtistes africaines »,Sciences sociales et santé.2007 ;4 vol 25 :5-34.DOI10.3917/sss.254.0005
- Raúl Zibechi. Pentecôtisme et mouvements sociaux en Amérique du Sud. Risal_Info. 2009 ;5p. disponible sur : https://www.isal.collectifs.net/spip.php ?article2474 (cité le 10 juin 2018)
- LÉÑERO, L., 1970, « Población, iglesia y cultura : tres sistemas en conflicto », in Acercamiento en torno a la familia y la población, México, IMES, pp. 83-92. Disponible sur https://estudiosdemograficosyurbanos.colmex.mx/index.php/edu/article/view/135/128 visité le 10 juin 2019.
- Boula J.J. Les infections sexuellement transmissibles en Afrique subsaharienne et la prévention – Projet d’intervention.2017 ;18(6):2 [En ligne] Disponible sur: https://www.gfmer.ch/Presentations_Fr/Prevention_istmst.htm. [Cité le 18 juin 2018].
- Mbopi-Keou FX,Monthe Nkala IV,Kalla GC,Nguefack Tsague G,Gonsu Kamga H,Noubom et al. Séroprévalence et facteurs associés au VIH et aux hépatites virales B et C dans la ville de Bafoussam au Cameroun. Pan Afr Med J.2015 ;20 :156. Disponible sur :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469435/pdf/PAMJ-20-156.pdf (cité le 15 mai 2019.)
- Eke CB, Ogbodo SO, Ukoha OM, Ibekwe RC, Asinobi IN, Ikefuna AN, et al. Seroprevalence and Risk Factors of Hepatitis B Virus Infection among Adolescents in Enugu, Nigeria. J Trop Pediatr. 1 déc 2015 ;61(6) :407‑13.
- Araya Mezgebo T, Niguse S, Gebrekidan Kahsay A, Hailekiros H, Berhe N, Asmelash Dejene T. Hepatitis B virus infection and associated risk factors among pregnant women attending antenatal care in health facilities of Tigray, Northern Ethiopia. J Med Virol. mars 2018;90(3):503‑9.
- Bayo P, Ochola E, Oleo C and Mwaka AD. High prevalence of hepatitis B virus infection among pregnant women attending antenatal care: a cross-sectional study in two hospitals in northern Uganda. BMJ Open. 11 nov 2014;4(11): e005889.
- Luksamijarulkul P, Mooktaragosa A, Luksamijarulkul S. Risk factors for hepatitis B surface antigen positivity among pregnant women. J Med Assoc Thail Chotmaihet Thangphaet. mars 2002;85(3):283‑8.
- Eke AC, Eke UA, Okafor CI, Ezebialu IU and Ogbuagu C. Prevalence, correlates and pattern of hepatitis B surface antigen in a low resource setting. Virol J. 12 janv 2011; 8:12.
- Rashid S, Kilewo C, Aboud S. Seroprevalence of hepatitis B virus infection among antenatal clinic attendees at a tertiary hospital in Dar es Salaam, Tanzania. Tanzan J Health Res. janv 2014;16(1):9‑15.
- WHO Guidelines Approved by the Guidelines Review Committee (2015). Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. World Health Organization Copyright (c) World Health Organization 2015., Geneva.
Disponible sur http://apps.who.int/iris/bitstream/handle/10665/154590/9789241549059_eng.pdf;jsessionid=C46BCE681C34E79E8E293276A61A13B2?sequence=1
- Umare A, Seyoum B, Gobena T and Haile Mariyam T. Hepatitis B Virus Infections and Associated Factors among Pregnant Women Attending Antenatal Care Clinic at Deder Hospital, Eastern Ethiopia. PloS One. 2016;11(11): e0166936.
- Jacquelyn Monroe. Women in Street Prostitution: The Result of Poverty and the Brunt of Inequity, Journal of Poverty;2005. 9:3, 69-88, DOI: 10.1300/J134v09n03_04
- Abuelgasim MH and Koko Baraka MB. Prevalence of Hepatitis B Infection among Pregnant Women at Khartoum Teaching Hospital, Sudan. J US-China Med Sci. 2015;12(2).
- Bani I, Mahfouz MS, Maki E, Gaffar A, Elhassan I, Yassin AO, et al. Prevalence and Risk Factors of Hepatitis B Virus among Pregnant Women in Jazan Region- Kingdom of Saudi Arabia. J Biol. 2012; 2:459-65.
- Obi SN, Onah HE and Ezugwu FO. Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population. J Obstet Gynaecol J Inst Obstet Gynaecol. nov 2006;26(8):770‑2.
- Nguyen G, Garcia RT, Nguyen N, Trinh H, Keeffe EB, Nguyen MH. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther.2009；29(7):755‑64.
- Tiruye G, Shiferaw K and Tadesse F. Seroprevalence of hepatitis B virus infection and associated factors among pregnant women attended antenatal care services in Harar City, Eastern Ethiopia. J Women's Health Care. 2018; 7:436.
- Mahboobi N, Porter SR, Karayiannis P and Alavian S-M. Dental treatment as a risk factor for hepatitis B and C viral infection. A review of the recent literature. J Gastrointest Liver Dis JGLD. mars 2013;22(1):79‑86.
- Sofian M, Banifazl M, Ziai M, Aghakhani A, Farazi A-A, Ramezani A. Intra-familial Transmission of Hepatitis B Virus Infection in Arak, Central Iran. Iran J Pathol. 2016;11(4):328‑33.
- Otkun M, Erdogan MS, Tatman-Otkun M and Akata F. Exposure time to hepatitis B virus and associated risk factors among children in Edirne, Turkey. Epidemiol Infect. juin 2005;133(3):509‑16.
- Alswaidi FM, O’Brien SJ. Is there a need to include HIV, HBV and HCV viruses in the Saudi premarital screening program on the basis of their prevalence and transmission risk factors? J Epidemiol Community Health. nov 2010;64(11):989‑97.
- Euler GL, Wooten KG, Baughman AL, Williams WW. Hepatitis B Surface Antigen Prevalence Among Pregnant Women in Urban Areas: Implications for Testing, Reporting, and Preventing Perinatal Transmission. Pediatrics. 1 mai 2003;111(Supplement 1):1192‑7.
- Jan Y, Bilques S, Najmi AM, Qureshi MA, Shahzada, Khan SS, et al. Viral Hepatitis during Pregnancy: A Study of Its Socio- Clinical Profile in A Tertiary Care Hospital. IOSR J Dent Med Sci. 2012;3(2):18‑22.
- Kerzman H, Green MS, Shinar E. Risk factors for hepatitis C virus infection among blood donors in Israel: a case-control study between native Israelis and immigrants from the former Soviet Union. Transfusion (Paris). juill 2007;47(7):1189‑96.
- Thakur V, Guptan RC, Malhotra V, Basir SF and Sarin SK. Prevalence of hepatitis B infection within family contacts of chronic liver disease patients--does HBeAg positivity really matter? J Assoc Physicians India. Nov 2002; 50:1386‑94.
- Li-Zhang C, Zhou W, Zhao S, Liu Z, and Wen S. A nested case-control study of maternal-neonatal transmission of hepatitis B virus in a Chinese population. World J Gastroenterol. 2011; 17(31): 3640–3644.
- Ajana F. Les variants du virus de l’hépatite B virale. Journal de pédiatrie et de puériculture. 2006;19(2):52-55.
- Mutagoma M, Balisanga H, Malamba SS, Sebuhoro D, Remera E, Riedel DJ et al. Hepatitis B virus and HIV co-infection among pregnant women in Rwanda. BMC Infect Dis. 2017;17: 6-18.
- Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011; Aug 11; 365(6): 493–505.