article · PLoS ONE
This study evaluated the prevalence and risk factors of coinfections involving HIV, hepatitis B virus, and syphilis among pregnant women attending antenatal care in Tanzania. Using data from a national feasibility study of triple testing that enrolled 7,828 women, researchers identified an overall coinfection prevalence of 0.4 percent. Specific pairs showed low individual prevalence rates, with HIV and syphilis at 0.2 percent, HIV and hepatitis B at 0.1 percent, hepatitis B and syphilis at 0.1 percent, and triple coinfection near 0.0 percent. Statistical analysis revealed that having multiple sexual partners increased the odds of both HIV-hepatitis B and hepatitis B-syphilis coinfections. Furthermore, older maternal age and marital status were associated with specific dual infections, highlighting a defined demographic burden.
Coinfections of HIV, hepatitis B, and syphilis in pregnancy elevate the danger of vertical transmission to infants and harm maternal health. Understanding the exact burden and associated factors enables public health authorities to tailor screening strategies. This evidence supports expanding antenatal services to identify these infections simultaneously, helping safeguard maternal and infant outcomes.
The findings inform public health policy and clinical screening programmes by justifying the operational adoption of integrated triple-testing diagnostics in antenatal clinics. The direct beneficiaries would be healthcare providers and diagnostic services participating in national prevention programmes. Because the data originates from a national feasibility study, the diagnostic approach is applied and tested, supporting near-market operational integration rather than early-stage discovery.
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BACKGROUND: Coinfection with HIV, hepatitis B virus (HBV) and syphilis increases the risk of vertical transmission. Hence, affecting overall maternal health and child health outcomes. The Tanzanian government is planning to add HBV screening to the existing Prevention of Mother to Child Transmission (PMTCT) of HIV and syphilis program; however, the burden of coinfections in the country is unknown. Therefore, this study aimed to determine the prevalence of HIV, HBV and syphilis coinfections and their associated factors among pregnant women receiving antenatal care in Tanzania. METHODS: A facility-based cross-sectional study design was conducted, utilizing data from the national feasibility study of triple testing for HIV, syphilis and HBV among pregnant women. The data were analysed via STATA version 16.1, and bivariate and multivariate logistic regressions were used to check for associations. Variables with a P value of < 0.05 were considered statistically significant. RESULTS: A total of 7,828 pregnant women were enrolled, 0.4% (95% CI 0.3-0.6) of whom were coinfected. The prevalence rates for HIV/HBV, HIV/syphilis, HBV/syphilis and HIV/HBV/syphilis coinfections were 0.1% (95% CI 0.1-0.2), 0.2% (95% CI 0.1-0.4), 0.1% (95% CI 0.0-0.2) and 0.0% (95% CI 0.0-0.1), respectively. History of multiple sexual partners (AOR 6.1; 95% CI: 1.3-29.7, P = 0.025) was associated with HIV/HBV coinfection. Age 25-49 years (AOR 13.5; 95% CI 1.8-103.8, P = 0.012) and marital status (AOR 0.2; 95% CI 0.1-0.8, P = 0.018) were associated with HIV/syphilis coinfection. For HBV/syphilis coinfection, marital status (AOR 0.1; 95% CI 0.0-0.9, P = 0.036) and history of multiple sexual partners (AOR 16.8; 95% CI 2.5-114.9, P = 0.004) were independently associated. CONCLUSION: Coinfections are present among pregnant women in Tanzania; therefore, it is important to include hepatitis B screening in the existing PMTCT of HIV and syphilis program. Interventions should focus on single, child-bearing women with multiple sexual partners.
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DOI: 10.1371/journal.pone.0329068
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