Hepatitis B Virus Infection and Risk Factors Among Pregnant Women in Healthcare Facilities in West Africa: A Systematic Review and Meta-Analysis

Abstract

Background: Hepatitis B virus (HBV) infection remains a critical global health issue, affecting over 254 million individuals and causing approximately 1.2 million new infections annually. This systematic review and meta-analysis is aimed at estimating the pooled prevalence of HBV infection and identifying associated risk factors among pregnant women in West African countries. Methods: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched Ovid Medline, Ovid Global Health, Ovid Embase, Web of Science, African Journals Online (AJOL), and African Index Medicus for studies on HBV infection in pregnant women in West African countries. We assessed the methodological quality of the included studies using the Hoy et al. tool. The random-effects model was used to calculate the pooled prevalence of HBV infection, whereas the I2 statistic quantified heterogeneity. Egger′s test and funnel plots evaluated publication bias. Results: This analysis included 138 studies from 11 West African countries. The pooled prevalence of HBV infection, based on HBsAg seropositivity, was 8.0% (95% CI: 7.3–8.6), with significant heterogeneity between studies (I2 = 96.8%, p < 0.001). The prevalence of HBeAg was 15% (95% CI: 10.5–19.9, I2 = 79.3%, p < 0.01). HBV prevalence did not significantly differ between pregnant women with a history of blood transfusion or dental care compared with those without these exposures. Body tattoos were associated with HBV infection, with an odds ratio of 2.28 (95% CI: 1.08–4.79). Conclusion: This systematic review reveals a substantial prevalence of HBV infection among pregnant women in West Africa, underscoring the urgent need to enhance prevention efforts. Improved access to diagnostic testing and vaccination remains essential to achieving HBV elimination in this population.