Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study

George Uchenna Eleje; Godwin Otuodichinma Akaba; Ikechukwu Innocent Mbachu; Ayyuba Rabiu; Olabisi Morebise Loto; Hadiza Abdullahi Usman; Preye Owen Fiebai; Rebecca Chinyelu Chukwuanukwu; Ngozi Nneka Joe-Ikechebelu; Chike Henry Nwankwo; Stephen Okoroafor Kalu; Chinyere Ukamaka Onubogu; Chukwuanugo Nkemakonam Ogbuagu; Shirley Nneka Chukwurah; Chinwe Elizabeth Uzochukwu; Samuel Oluwagbenga Inuyomi; Bukola Abimbola Adesoji; Uchenna Chukwunonso Ogwaluonye; Sussan Ifeyinwa Nweje; Richard Obinwanne Egeonu; Odion Emmanuel Igue; Chiamaka Henrietta Jibuaku; Prince Ogbonnia Aja; Chiamaka Perpetua Chidozie; Hadiza Sani Ibrahim; Fatima Ele Aliyu; Aisha Ismaila Numan; Ogbonna Dennis Okoro; Solace Amechi Omoruyi; Ijeoma Chioma Oppah; Ubong Inyang Anyang; Aishat Ahmed; Osita Samuel Umeononihu; Eric Okechukwu Umeh; Ekene Agatha Emeka; Arinze Anthony Onwuegbuna; Emeka Philip Igbodike; Ifeoma Clara Ajuba; Ibrahim Adamu Yakasai; Oliver Chukwujekwu Ezechi; Joseph Ifeanyichukwu Ikechebelu; Triplex Infection in Pregnancy Collaboration Group

doi:10.1177/25151355211032595

Pregnant women's hepatitis B vaccination coverage in Nigeria: a national pilot cross-sectional study

Ther Adv Vaccines Immunother. 2021 Jul 29:9:25151355211032595. doi: 10.1177/25151355211032595. eCollection 2021.

Authors

George Uchenna Eleje¹, Godwin Otuodichinma Akaba², Ikechukwu Innocent Mbachu³, Ayyuba Rabiu⁴, Olabisi Morebise Loto⁵, Hadiza Abdullahi Usman⁶, Preye Owen Fiebai⁷, Rebecca Chinyelu Chukwuanukwu⁸, Ngozi Nneka Joe-Ikechebelu⁹, Chike Henry Nwankwo¹⁰, Stephen Okoroafor Kalu¹¹, Chinyere Ukamaka Onubogu¹², Chukwuanugo Nkemakonam Ogbuagu¹³, Shirley Nneka Chukwurah¹⁴, Chinwe Elizabeth Uzochukwu¹⁵, Samuel Oluwagbenga Inuyomi¹⁶, Bukola Abimbola Adesoji¹⁷, Uchenna Chukwunonso Ogwaluonye¹⁸, Sussan Ifeyinwa Nweje¹⁹, Richard Obinwanne Egeonu²⁰, Odion Emmanuel Igue²¹, Chiamaka Henrietta Jibuaku¹⁸, Prince Ogbonnia Aja⁸, Chiamaka Perpetua Chidozie⁸, Hadiza Sani Ibrahim²², Fatima Ele Aliyu²², Aisha Ismaila Numan²³, Ogbonna Dennis Okoro²⁴, Solace Amechi Omoruyi²⁵, Ijeoma Chioma Oppah²⁵, Ubong Inyang Anyang²⁶, Aishat Ahmed²⁶, Osita Samuel Umeononihu³, Eric Okechukwu Umeh²⁷, Ekene Agatha Emeka²⁸, Arinze Anthony Onwuegbuna²⁹, Emeka Philip Igbodike³⁰, Ifeoma Clara Ajuba³¹, Ibrahim Adamu Yakasai⁴, Oliver Chukwujekwu Ezechi³², Joseph Ifeanyichukwu Ikechebelu³; Triplex Infection in Pregnancy Collaboration Group

Affiliations

¹ Effective Care Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
² Department of Obstetrics and Gynecology, University of Abuja, Abuja, Nigeria.
³ Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria.
⁴ Department of Obstetrics and Gynecology, Bayero University, Kano, Nigeria.
⁵ Department of Obstetrics and Gynecology, Obafemi Awolowo University, Ile-Ife, Nigeria.
⁶ Department of Obstetrics and Gynecology, University of Maiduguri, Maiduguri, Nigeria.
⁷ Department of Obstetrics and Gynecology, University of Port Harcourt, Port Harcourt, Nigeria.
⁸ Immunology Unit, Department of Medical Laboratory Science, Nnamdi Azikiwe University, Awka, Nigeria.
⁹ Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria.
¹⁰ Department of Statistics, Nnamdi Azikiwe University, Awka, Nigeria.
¹¹ HIV Care Laboratory/HIV Care Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
¹² Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nigeria.
¹³ Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
¹⁴ Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
¹⁵ Department of Mass Communication, Nnamdi Azikiwe University, Awka, Nigeria.
¹⁶ Department of Physics and Engineering Physics, Obafemi Awolowo University, Ile-Ife, Nigeria.
¹⁷ Department of Nursing, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.
¹⁸ Department of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.
¹⁹ Department of Nursing, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
²⁰ Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
²¹ Department of Physiological Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
²² Department of Obstetrics and Gynecology, Aminu Kano Teaching Hospital, Kano, Nigeria.
²³ Department of Obstetrics and Gynecology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
²⁴ Department of Parasitology & Entomology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria.
²⁵ Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
²⁶ Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria.
²⁷ Department of Radiology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
²⁸ Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
²⁹ Department of Ophthalmology, Nnamdi Azikiwe University, Awka, Nigeria.
³⁰ Department of Obstetrics and Gynecology, St Georges Hospital Memorial Centre, Lagos, Nigeria.
³¹ Department of Hematology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
³² Nigerian Institute of Medical Research, Lagos, Nigeria.

Abstract

Objective: To determine the hepatitis B vaccination coverage, full-dose (⩾3) coverage and the associated factors affecting uptake among pregnant women.

Methods: This was a cross-sectional study among pregnant women attending antenatal care in six tertiary hospitals across all the geopolitical zones of Nigeria. Pregnant women who consented to the study completed screening questions about their hepatitis B vaccination status and coverage. The main outcome measures were hepatitis B vaccination coverage rate, dose, and factors affecting uptake. Bivariate analysis was performed by the chi-square test and conditional logistic regression analysis was used to determine variables associated with uptake of the vaccination. Odds ratios (ORs) and adjusted odds ratios (aORs) were calculated and statistical significance was accepted when p-value was < 0.05.

Results: Of 159 pregnant women who completed the interview questions, 21 [13.2%, 95% confidence interval (CI) 7.9-18.5%] were vaccinated for hepatitis B for one to three doses. The numbers of doses received were: three doses (8/159, 5.0%), two doses (5/159, 3.1%), and one dose (8/159, 5.0%). The reasons for non-uptake of vaccination included: lack of awareness of the vaccine 83/138 (60.1%), inadequate access to vaccine 11/138 (8.0%), and positivity to hepatitis B virus 10/138 (7.2%). The uptake of hepatitis B vaccination was significantly affected by the level of education (OR 0.284, 95% CI 0.08-1.01, p = 0.041), but in multivariable logistic regression, adjusted for confounders, the association between hepatitis B vaccination and participants' level of education (aOR 3.09; 95% CI 0.95-10.16; p = 0.061) did not remain significant.

Conclusions: In Nigeria, the national hepatitis B vaccination coverage among pregnant women appears poor, with the full-dose coverage even poorer. The level of education was not positively associated with uptake of hepatitis B vaccination, while lack of awareness of the vaccine was the commonest reason for non-uptake.

Funding: TETFund National Research Fund 2019 (grant number TETFund/DR&D/CE/NRF/STI/33).

Keywords: antenatal care; coverage; hepatitis B; pregnancy; vaccination; virus.