Missed opportunities for Hepatitis B virus testing among third-trimester women at Lira Regional Referral Hospital, Uganda: A cross-sectional study

Abstract

Abstract Introduction: Hepatitis B virus (HBV) infection remains a significant public health concern, particularly among pregnant women in sub-Saharan Africa. Despite the availability of effective screening methods, missed opportunities for HBV testing during pregnancy persist, leading to adverse maternal and neonatal outcomes. This study aimed to assess the prevalence of missed opportunities for HBV testing among third-trimester women at Lira Regional Referral Hospital (LRRH) in Uganda. Methods A cross-sectional study involving third-trimester women receiving antenatal care (ANC) was conducted at LRRH between August and October 2023. The data were collected using structured questionnaires, and statistical analysis was performed to determine the prevalence of missed opportunities for HBV testing. Ethical approval was obtained from the Bishop Stuart University Research Ethics Committee, and informed consent was obtained from all participants. Results Among the participants, 90% experienced missed opportunities for HBV testing during their ANC visits. Rural residence (adjusted odds ratio [AOR] 2.9, 95% confidence interval [CI] 1.961–9.101, p = 0.049), nonattendance of ANC (AOR 4.2, 95% CI 1.887–5.542, p = 0.018), and age above 30 years (AOR 0.3, 95% CI 0.104–0.675, p = 0.005) were significantly associated with missed testing. The seropositivity rate among pregnant women who missed testing was 12.4%. These findings underscore the influence of sociodemographic factors and healthcare-seeking behaviors on HBV testing uptake during pregnancy. Conclusion This study revealed a concerning prevalence of missed opportunities for HBV testing (90%) among third-trimester women receiving ANC at LRRH in Uganda, indicating a significant deficiency in HBV screening program implementation within this setting. The key contributing factors included rural residence, nonattendance of ANC, and younger age, emphasizing the urgent need for targeted interventions to overcome barriers to accessing and utilizing HBV testing, particularly among rural and younger pregnant women. Additionally, the increase in the seropositivity rate among pregnant women who missed testing (12.4%) underscores the potential risk of undiagnosed HBV infections, highlighting the importance of addressing missed opportunities for screening to mitigate vertical transmission and adverse maternal and neonatal outcomes.