臨床感染症と実践

抽象的な

Potential Missed Opportunities Related to the Systematic Screening for Hepatitis B Surface Antigen in Thailand

Prapan Sabsanong ,Nicolas Salvadori *,Nicole Ngo-Giang-Huong ,Arun Yaisiri ,Achara Puangsombat ,Pra-ornsuda Sukrakanchana ,Kanchana Than-in-at ,Wasna Sirirungsi ,Woottichai Khamduang ,Gonzague Jourdain

Background: In Thailand, hepatitis B surface antigen (HBsAg) testing is part of routine antenatal screening. We assessed the association between characteristics of pregnant women attending Samut Prakan Provincial Hospital antenatal care clinic (ANC) and their Hepatitis B virus (HBV) infection status.

Methods: This is a cross-sectional study of pregnant women ≥ 18 yrs presenting at the ANC between August 1st, 2013 and June 30th, 2015. Data on socio-demographics, general physical examination, obstetrical and medical history and knowledge of HBV status were collected. Comparisons were performed using the Wilcoxon-Mann- Whitney test or Fisher’s exact test.

Results: A total of 115 pregnant women, 18 HBsAg positive and 97 negative, participated. The women had a median age of 27.1 yrs (interquartile range (IQR): 22.4 to 31.5) at a median 28.0 weeks gestational age (IQR: 26.1 to 29.7). Forty-five (39%) reported being born abroad. Sixteen (14%) did not receive primary education. The women’s household contained a median of 3 persons (IQR: 2 to 4). None of these characteristics differed between HBsAg positive and negative women. HBsAg positive women were more likely to know their HBV status than HBsAg negative women [6 (33%)] vs. 12 [(12%), p=0.04] and their previous live offsprings’ HBV status [9 (60%)] vs. 21 [(26%), p=0.01]. In contrast, they were less likely to know their partner’s HBV status [3 (17%)] vs. 50 [(52%), p=0.009].

Conclusion: HBV chronic infection was not associated with any characteristics, which justifies systematic screening for HBsAg during antenatal care. The vast majority of women were not able to report their and their partner’s HBsAg status, underlining potential missed opportunities to be followed for their hepatitis B infection.