Factors associated with hepatitis B virus infection among pregnant women attending antenatal clinic in Western Area Urban District, Sierra Leone.

Background: Hepatitis B virus infection remains a global health concern, particularly in resource-constrained countries such as Sierra Leone. Understanding the risk factors for hepatitis B virus among pregnant women can guide public health initiatives, prenatal care, and maternal-child health policies.

Objectives: We assessed the prevalence and risk factors for hepatitis B virus infection among pregnant women in Sierra Leone's Western Area Urban District.

Design: We conducted a facility-based cross-sectional study in five randomly selected hospitals in the Western Area Urban District.

Methods: A cross-sectional study was conducted in five randomly selected hospitals in May 2021. Data were collected from 320 pregnant women using structured questionnaires. Hepatitis B virus infection, identified by hepatitis B surface antigen positivity, was analyzed using descriptive statistics, Pearson's chi-square test, and logistic regression. Variables that were significant in bivariate analysis were included in the multivariable model. All tests were computed with 95% confidence intervals.

Results: The mean age of participants was 26.0 ± 5.7 years, and the prevalence of hepatitis B virus infection was 13.8% (95% confidence interval: 10.4-18.0). Women with no formal education (adjusted odds ratio: 3.69, 95% confidence interval: 1.33-10.22) or primary education (adjusted odds ratio: 8.30, 95% confidence interval: 2.69-25.63) had significantly higher odds of infection. Single women (adjusted odds ratio: 3.05, 95% confidence interval: 1.29-7.22) and those engaging in risky practices, such as toothbrush sharing (adjusted odds ratio: 1.37) or tattooing (adjusted odds ratio: 2.09), were more likely to be infected. Conversely, a history of stillbirth (adjusted odds ratio: 0.20, 95% confidence interval: 0.04-0.99) was associated with reduced odds of infection.

Conclusion: Hepatitis B virus infection was common among pregnant women in Sierra Leone's Western Area Urban District. Education level, marital status, and unsafe practices such as tattooing and toothbrush sharing were significantly associated with hepatitis B virus infection risk. The findings emphasize the urgent need for targeted public health interventions to reduce hepatitis B virus transmission in this population.