Background: Hepatitis is a disease defined by the inflammation of the liver and it is
characterized by the existence of inflammatory cells in the tissues of the liver leading to
fibrosis or cirrhosis. Viral hepatitis has become a global public health threat affecting
millions of people yearly, causing disability and mortality. There are an estimated five
hundred million people who are chronically infected with hepatitis B virus (HBV) or
Hepatitis C virus (HCV). Reliable data is required by policy making health officials on
regular basis in planning and improving of relevant interventions. However, a common
challenge health care-planners face often is lack of data and if data is available at all they are
imperfect. A review of the national health facilities viral hepatitis data in Ghana indicated
that 60% of viral hepatitis data are untyped. Currently the extent of the prevalence of
Hepatitis B among sections of the Ghanaian population like pregnant women and the level of
endemicity of Hepatitis B is unknown in Ghana.
Therefore this study aimed to determine the prevalence of Hepatitis B Surface Antigen
(HBsAg), Hepatitis B Core Antibody (HBcAb) and Hepatitis B envlope-Antigen (HbeAg)
among pregnant women in Ghana. And determine the prevalence of Hepatitis B in rural and
urban HSS sites and to estimate the endemicity of hepatitis B in Ghana.
Method: A laboratory base cross sectional study involving the use of archived samples from
the 2010 HSS was conducted in Ghana. Archived samples from the 2010 HSS were screened
for HBV markers. Univeriate analysis was expressed as frequencies and percentages. Results
were presented using appropriate chart and tables.
Results: In this study the overall prevalence HBsAg among pregnant women was estimated
to be 14.33%. Prevalence of HBcAb was 75.3%; prevalence of HBeAg was 1.23%. HBsAg
prevalence rate was highest in the northern sector {14.80% (95% CI 0.13, 0.17)} and
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followed by the southern sector {14.70% (95% CI 0.13, 0.17)}. HBsAg prevalence rate in the
middle sector was 13.20% (95% CI 0.11, 0.15), the lowest HBsAg prevalence rate among the
sectors. However, there was no significant difference in the hepatitis B prevalence in the
sectors (p= 0.518). There was also no significant difference between the prevalence of
hepatitis B virus infection among pregnant women in rural and urban sites (p= 0.374).
Hepatitis B prevalence rate was 15.35% among age group 25-29; this was the highest
prevalence rate among all the age groups. There was no significant difference in hepatitis B
prevalence among the age groups (p=0.279). The overall HBeAg prevalence rate was 1.23%.
Conclusion: The HBsAg and HBcAb prevalence rate among pregnant women in this study.
Because hepatitis B prevalence does not differ between pregnant women and the general
adult population this shows that a higher proportion of population of Ghana has ever been
exposed to hepatitis B virus obtained in this study shows Ghana is a highly endemic country
for hepatitis B.. Further, the northern sector recorded the highest prevalence of all Hepatitis B
markers tested. Additionally, this study determined that there is no significant difference
between hepatitis B viral infection between rural and urban sites. On the other hand, HBeAg
prevalence is low, indicating a lower contribution of vertical transmission of HBV in Ghana.
Recommendations: Immunization of children against HBV infection should be scaled up to
capture children who are not delivered in the hospital and those who do not get postnatal
care. Current hepatitis B testing strategies should be changed to include other Hepatitis B
virus markers in hospital blood bank units.