Potential Missed Opportunities Related to the Systematic Screening for
Hepatitis B Surface Antigen in Thailand
Prapan Sabsanong
1
, Nicolas Salvadori
2,3*,
Nicole Ngo-Giang-Huong
2,3,4
, Arun Yaisiri
1
, Achara Puangsombat
1
, Pra-ornsuda Sukrakanchana
2,3
, Kanchana
Than-in-at
2,3
, Wasna Sirirungsi
3
, Woottichai Khamduang
3
and Gonzague Jourdain
2,3,4
1
Obstetrics and Gynecology Department, Samut Prakan Provincial Hospital, Samut Prakan, Thailand
2
PHPT-UMI 174, Institut de recherche pour le développement (IRD), Marseille, France
3
Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
4
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States
*
Corresponding author : Nicolas Salvadori, Institut de recherche pour le développement (IRD), France and Faculty of Associated Medical Sciences, Chiang Mai
University, Changklan Rd, Changklan, Muang, Chiang Mai 50100, Thailand, Tel: +66 53819125-9; Fax: +66 53819130; E-mail: Nicolas.Salvadori@phpt.org
Received date: September 07, 2017, Accepted date: September 21, 2017, Published date: September 28, 2017
Copyright: ©2017 Sabsanong P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
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 1
st
,
2013 and June 30
th
, 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.
Keywords:
HBsAg; hepatitis B; HBV; pregnancy; pregnant; screening; Thailand; Southeast Asia
Introduction
An estimated 257 million people are chronically infected with
Hepatitis B virus (HBV) worldwide [1], of whom 100 million live in
the World Health Organization Southeast Asia region [2]. Universal
hepatitis B immunization, including a birth dose, was integrated into
Tailand’s National Expanded Program on Immunization (EPI) in
1992, but an estimated 7% of the adults born before 1992 are chronic
carriers of hepatitis B surface antigen (HBsAg) [3].
Universal HB immunization has been shown very efective to
prevent HBV infection in infants [4-7]. In addition, specifc
interventions are needed to prevent transmission in infants born to
HBV infected mothers [8]. Tus, screening all pregnant women may be
important. However, little is known as whether pregnant women are
usually already aware of their HBV status, and whether they are
informed of the HBV status of their relatives, which may have
important implications for prevention in the family and eventually for
treatment.
We investigated the knowledge of HBsAg status and compared
characteristics according to HBsAg status in pregnant women
attending the antenatal care clinic (ANC) of Samut Prakan Provincial
Hospital, a typical provincial hospital in Tailand.
Methods
Study population and design
Tis is a cross-sectional study of HBsAg positive and negative
pregnant women aged 18 yrs or more who presented at the ANC of
Samut Prakan Provincial Hospital during the course of their
pregnancy. All HBsAg positive pregnant women screened for HBsAg
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ISSN: 2476-213X
Journal of Clinical Infectious Disease
and Practice
Sabsanong et al., J Clin Infect Dis Pract 2017, 2:1
DOI: 10.4172/2476-213X.1000120
Research Article OMICS International
J Clin Infect Dis Pract, an open access journal
ISSN:2476-213X
Volume 2 • Issue 1 • 1000120