PDF(Pubmed)
Abstract：
BACKGROUND: Co-infections involving human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis pose significant public health problems during pregnancy. It can increase the risk of adverse outcomes for both the woman and the infant more than each infection alone does. However, the magnitude of these co-infections remains insufficiently documented. Hence, this study aimed to determine the seroprevalence of HIV, HBV, and syphilis co-infections and associated risk factors among pregnant women attending antenatal care in Amhara region referral hospitals in northern Ethiopia.
METHODS: A hospital-based cross-sectional study was conducted in Amhara regional state referral hospitals from January 1 to February 30, 2024, among 606 pregnant women. Pregnant women were selected using a systematic random sampling technique. An interviewer-administered questionnaire and chart review were used to collect data. Data were analyzed in SPSSV26.0. Descriptive statistics were used to determine the magnitude of co-infections, and binary logistic regression was used to determine associated factors. Variables with a P-value < 0.05 were used to declare statistical significance.
RESULTS: Overall, 4.1% (95% CI: 2.7, 6.1) of pregnant women were co-infected. The prevalence of specific co-infections was 2% (95% CI: 1, 3.5) for HIV/HBV, 1.3% (95% CI: 0.6, 2.6) for HIV/syphilis, and 0.8% (95% CI: 0.3, 1.9) for HBV/syphilis. No cases of triple co-infection were observed. Women with a history of unsafe sex (AOR = 8.2, 95% CI: 1.5, 16.7) and incarceration (AOR = 9.3, 95% CI: 1.6, 20.8) were associated with HIV/syphilis co-infection. For HIV/HBV co-infection, contact with jaundice patients (AOR = 5.5, 95% CI: 1.3, 22.5) and women with a history of STIs (AOR = 4.6, 95% CI: 1.4, 14.9) was significantly associated. Women with STI history (AOR = 6.3, 95% CI: 1.2, 15.9) were also significantly associated with HBV/syphilis co-infection.
CONCLUSIONS: Despite the government\'s elimination efforts, a relatively high prevalence of coinfections with the infections studied was found among pregnant women. Therefore, HIV, HBV, and syphilis testing and treatment packages should be strengthened by targeting pregnant women with a history of STIs, contact with patients with jaundice, a history of incarceration, and unsafe sex.
METHODS: A hospital-based cross-sectional study was conducted in Amhara regional state referral hospitals from January 1 to February 30, 2024, among 606 pregnant women. Pregnant women were selected using a systematic random sampling technique. An interviewer-administered questionnaire and chart review were used to collect data. Data were analyzed in SPSSV26.0. Descriptive statistics were used to determine the magnitude of co-infections, and binary logistic regression was used to determine associated factors. Variables with a P-value < 0.05 were used to declare statistical significance.
RESULTS: Overall, 4.1% (95% CI: 2.7, 6.1) of pregnant women were co-infected. The prevalence of specific co-infections was 2% (95% CI: 1, 3.5) for HIV/HBV, 1.3% (95% CI: 0.6, 2.6) for HIV/syphilis, and 0.8% (95% CI: 0.3, 1.9) for HBV/syphilis. No cases of triple co-infection were observed. Women with a history of unsafe sex (AOR = 8.2, 95% CI: 1.5, 16.7) and incarceration (AOR = 9.3, 95% CI: 1.6, 20.8) were associated with HIV/syphilis co-infection. For HIV/HBV co-infection, contact with jaundice patients (AOR = 5.5, 95% CI: 1.3, 22.5) and women with a history of STIs (AOR = 4.6, 95% CI: 1.4, 14.9) was significantly associated. Women with STI history (AOR = 6.3, 95% CI: 1.2, 15.9) were also significantly associated with HBV/syphilis co-infection.
CONCLUSIONS: Despite the government\'s elimination efforts, a relatively high prevalence of coinfections with the infections studied was found among pregnant women. Therefore, HIV, HBV, and syphilis testing and treatment packages should be strengthened by targeting pregnant women with a history of STIs, contact with patients with jaundice, a history of incarceration, and unsafe sex.
摘要：
背景：涉及人类免疫缺陷病毒（HIV）的共感染，乙型肝炎病毒（HBV），和梅毒在怀孕期间会造成重大的公共卫生问题。与单独的感染相比，它可以增加妇女和婴儿的不良后果的风险。然而,这些共感染的严重程度仍未得到充分记录.因此，这项研究旨在确定艾滋病毒的血清阳性率，HBV,在埃塞俄比亚北部阿姆哈拉地区转诊医院接受产前护理的孕妇中，梅毒合并感染和相关危险因素。
方法：于2024年1月1日至2月30日在阿姆哈拉地区州转诊医院对606名孕妇进行了一项基于医院的横断面研究。使用系统随机抽样技术选择孕妇。使用面试官管理的问卷和图表审查来收集数据。数据分析采用SPSSV26.0。描述性统计数据用于确定共感染的程度，并采用二元logistic回归确定相关因素。使用P值<0.05的变量来声明统计学意义。
结果：总体而言，4.1%(95%CI:2.7,6.1)的孕妇合并感染。特定共感染的患病率为2％（95％CI：1，3.5）的HIV/HBV，1.3%（95%CI：0.6，2.6）为HIV/梅毒，和0.8％（95％CI：0.3，1.9）为HBV/梅毒。没有观察到三重共感染的病例。有不安全性行为史（AOR=8.2，95％CI：1.5，16.7）和监禁史（AOR=9.3，95％CI：1.6，20.8）的女性与HIV/梅毒合并感染有关。对于HIV/HBV共感染，与黄疸患者(AOR=5.5,95%CI:1.3,22.5)和有性传播感染史的女性(AOR=4.6,95%CI:1.4,14.9)有显著相关性.有STI病史的女性（AOR=6.3，95％CI：1.2，15.9）也与HBV/梅毒合并感染显着相关。
结论：尽管政府努力消除，在孕妇中发现与所研究感染合并感染的患病率相对较高。因此,艾滋病毒,HBV,和梅毒检测和治疗方案应加强针对有性传播感染史的孕妇,接触黄疸患者，被监禁的历史,不安全的性行为。
方法：于2024年1月1日至2月30日在阿姆哈拉地区州转诊医院对606名孕妇进行了一项基于医院的横断面研究。使用系统随机抽样技术选择孕妇。使用面试官管理的问卷和图表审查来收集数据。数据分析采用SPSSV26.0。描述性统计数据用于确定共感染的程度，并采用二元logistic回归确定相关因素。使用P值<0.05的变量来声明统计学意义。
结果：总体而言，4.1%(95%CI:2.7,6.1)的孕妇合并感染。特定共感染的患病率为2％（95％CI：1，3.5）的HIV/HBV，1.3%（95%CI：0.6，2.6）为HIV/梅毒，和0.8％（95％CI：0.3，1.9）为HBV/梅毒。没有观察到三重共感染的病例。有不安全性行为史（AOR=8.2，95％CI：1.5，16.7）和监禁史（AOR=9.3，95％CI：1.6，20.8）的女性与HIV/梅毒合并感染有关。对于HIV/HBV共感染，与黄疸患者(AOR=5.5,95%CI:1.3,22.5)和有性传播感染史的女性(AOR=4.6,95%CI:1.4,14.9)有显著相关性.有STI病史的女性（AOR=6.3，95％CI：1.2，15.9）也与HBV/梅毒合并感染显着相关。
结论：尽管政府努力消除，在孕妇中发现与所研究感染合并感染的患病率相对较高。因此,艾滋病毒,HBV,和梅毒检测和治疗方案应加强针对有性传播感染史的孕妇,接触黄疸患者，被监禁的历史,不安全的性行为。
