In Sub-Saharan Africa, the hepatitis C virus (HCV) is a major public health concern and is extremely prevalent. The purpose of this study was to ascertain the hepatitis C virus prevalence in expectant mothers. Pregnant women who visited antenatal clinics in the Idaeto Local Government Area in 2023 participated in this cross-sectional survey. Using the 4th ELISA method, samples were screened for HCV infection, and SPSS version 23 statistical software was used for data analysis. There were 123 pregnant women in all, and 7 of them (5.6%) tested positive for HCV. Age groups between 30 and 39 (n = 4), educated (n = 4), employed (n = 6), and married (n = 6) were reported to have the highest proportion of HCV. With the exception of employment status (p > 0.05), there was no statistically significant correlation found between demographic factors and HCV positive. This study established that HCV infection is a public health concern in pregnant women and shown a significant incidence of the virus.

Infection with the hepatitis C virus (HCV)is a serious global public health hazard. It is an infectious disease that hasa sneaky onset and obvious pathways of transmission [1]. The World Health Organization (WHO) estimatesthat 58 millionpeople worldwide, or 0.75% of the total population, are infected with HCV [2]. Infection with the hepatitis C virus (HCV) is a global health concern that is particularly common in Sub Saharan Africa [3]. In Nigeria, hepatitis C virus (HCV) infection may be among the most frequent illnesses among expectant mothers;globally, HCV infectionaffects 8% of pregnant women, with a frequency as high as 4% in the US [4]. About 6of babies born to mothers with HCV viremia will have mother-tochild transmission of HCV duringpregnancy, and the risk doubles in the presence of poorly managedHIV coinfection [5]. Mothertochild transmission of HCV has been disregarded becauseperinatal hepatitis C infection is a treatablechronic infectious illnesswith a spontaneous clearancerate of 2530% [6]. In actuality,though, after an HCV infection is identified, over 80% of infants willexhibit chronic symptoms; of these, 30% will experience clinicalsymptoms in adolescence or adulthood, and they will also be at a heightened risk of developing liver cirrhosis and hepatocellular carcinoma (HCC) [7].

Furthermore, there is a clear correlation between hepatitis C infection and unfavorable pregnancy outcomes, such as low birth weight, congenital defects, preterm birth, and restricted fetal growth[8]. Therefore, there is a chance that the fetus will be at risk for preterm birth and neonatal death if the mother has HCV infection.Thus, it is criticalto comprehend the incidence of HCV in expectant mothers and investigate risk factors. The World Health Organization (WHO) set 2030 as the deadline for eradicating viral hepatitis as a threat to public health,which included a 90?crease in new infections and a 65?crease in mortality [9]. As a result, a number of public health and medical associations have lately suggested that all expectant mothers undergo universal HCV screening [10].

There hasn't been much information on HCV infection during pregnancy until recently, and findings on the virus's impact on pregnancy and postnatal outcomes have been inconsistent. A number of more recent works have attempted to fill up this vacuum in the literature. All of these studies pointed to a rising incidence of HCV infections duringpregnancy over the previous 20 years, even though the majority of them only covered a portion of that time.Adverse perinatal eventslinked to HCV have also been documented in a few studies, although it's possible that these studies did not adequately account for the potential confounding effects of substance use, which is another known risk factor for unfavorable pregnancy outcomes [11].

While there is debate surrounding the efficacy of universal prenatal HCV screening, prenatal HCV diagnosis offers benefits to both mother and child.Prenatal HCV screening aids in the diagnosis of an infection that the mother is unaware she has. Additionally, screening during pregnancy revealsthe newborn's exposurestatus to HCV and offers the chance to manage mother-to-child transmission (MTCT) and other unfavorable fetal outcomes that may be linked to maternal HCV infection [12].

Given that Nigeria lacks guidelines for the regular screening of HCV and health promotion tactics during prenatal care. Since their healthcare practitioners might not have brought up the subject,some pregnant women might not be aware that they are infected with HCV. Furthermore, the majority of infected women might not be aware of their statusuntil an accidental diagnosis of chronicHCV is obtained becauseHCV infection is typically silent. Considering the likelihood of vertical HCV transmission, the rise in HCV infections in women of reproductive age (Ryerson et al., 2020), and possible adverseeffects connected to pregnancy [13]. A deeperknowledge of HCV infection during pregnancy and its effects on outcomes is necessary for physicians and policy makers.

A viral infection known as hepatitis C affects about 1% of women who are fertile. Hepatitis C is most frequently contracted through intravenous drug use, although it is also more prevalent in some immigrant populations and may have been contracted by medical intervention. 2016 saw the widespread availability of Hepatitis C medicines that were effective and had cure rates of above 95%. In order to start therapy and cure Hepatitis C before becoming pregnant, women should be screened for the disease prior to becoming pregnant. Even though the majority of women have an extremely minimalchance of passingon Hepatitis C to theirunborn child, taking treatment before becoming pregnant benefits the diseased woman, her unborn child, and health workers by lowering occupational exposure. therapy for women with Hepatitis C after becoming pregnant and finishing breastfeeding should be addressed, but therapy during pregnancy is not advised. Pregnant women with Hepatitis C should receive care from a multidisciplinary team with specific knowledge of infectious diseases. While a newborn with a hepatitis C infectionshould not be denied breast milk, it is advisable to express and discard the milk until any open wounds have healed if there is nipple cracking or bleeding. But for the purpose of stopping and eliminating this virus, empirical data is crucial. Nevertheless, there are few nationally representative data on HCV during pregnancy.

This was a multicenter hospital-based cross-sectional pilot baseline study designed to explore the the prevalence of HCV and factors affecting prevalence rates of HCV among pregnant women.

Study area

Participants were recruited from randomly selected health facilities in Ideato South Local Government of Imo State.

Ethical consideration

Written consent was obtained from all participants before recruitment into the study. Ethical clearance for this study was obtained from the Imo State University in accordance with the Medical code of conduct for biomedical research involving human subjects.

Study population

The study was carried out among consenting pregnant women, who were attendees of the antenatal clinic in randomly selected healthcare facilities Ideato South Local Government of Imo State, Nigeria.

Inclusion criteria: Pregnant women registered for their antenatal care in the study sites were eligible to participate in the study.

Exclusion criteria: Non-pregnant women and women whose pregnancy could not be confirmed by ultrasound or blood test were excluded.

Recruitment of participants

The study employed random sampling by selecting six hospitals across Ideato South Local Government Area. Pregnant women were recruited from the antenatal clinics of each hospital over a 1-month (between 2 August 2023 and September, 2023) period. After detailed explanation of the objectives, procedures, and possible benefits of the study, only those who accepted to participate in the study and gave a written informed consent were enrolled into the study. Their blood sample was collected for HCV determination.

Laboratory procedure and analysis

Five milliliters of the blood sample was aseptically collected by venipuncture from each pregnant woman into a plain specimen bottle after consent was sought and obtained. The participant’s code, age, education level, occupation and marital status were labeled on the bottle for proper identification. Each of the samples was centrifuged at 3000 r/min for 5 min and the serum portion was used on the test strip for antigen or antibody detection. Sera samples were stored at −25°C in line with the kit manufacturer’s instruction until screened for HBsAg, anti-HIV, and anti-HCV antibodies.

Screening for anti-HCV antibodies was conducted using the enzyme-linked immunosorbent assay (ELISA) kit manufactured by LabACON (Hangzhou Biotest Biotech Company, Ltd., China) which has a specificity of 99.0% and a sensitivity of 99.9?cording to the manufacturer’s declared figures. The kit has in-built controls. The manufacturer’s instruction was strictly followed and executed by trained research assistants in each facility. The results were reported as positive or negative.

Statistical analysis

The data were entered into an Excel 2016 spreadsheet (Microsoft Corporation, Redmond, WA, USA) and subsequently was imported into Statistical Package for the Social Sciences (SPSS) Version 23.0 (IBM Corp., Armonk, NY, USA). Statistical analyses were performed with SPSS Version 22.0 (IBM Corp.). The bivariate analysis was performed using a Pearson’s chi-square test or Fisher’s exact test, whenever appropriate, to compare the demographic characteristics as well as risk factors for HCV and prevalence rates.

Prevalence of hepatitis C virus among pregnant women attending antenatal

Table 4.1 displays the prevalence of hepatitis C virus (HCV) among pregnant women attending antenatal care. Out of a total of 125 pregnant women, 118 of them tested negative for HCV, which accounts for 94.4% of the population. On the other hand, 7 pregnant women, or 5.6% of the total, testedpositive for HCV (Table 1). The data reveals that the majority of pregnant women in this group do not have hepatitis C virus, while a small percentage have tested positive for the virus during their antenatal screening (Figure 4.1).

4.2 Association between socio-demographic characteristics and hepatitis C virus among pregnant women attending antenatal 

Table 4.2 explores the relationship betweensocio-demographic characteristics and the presence of hepatitis C virus (HCV) among pregnant women receiving antenatal care.

Among pregnant women aged 18-29, 55 tested negative for HCV, and 3 tested positive. In the 30-39 age group,4 out of 57 pregnantwomen tested positive for HCV. In the 40-49 age group, all 10 pregnant women tested negative for HCV. Importantly, the statistical analysis (p- value of 0.660) indicatesno significant association between age and HCV status of the pregnant women.

Regarding the participants education, pregnant women with "No formal Education" showed no cases of HCV positivity (4 tested negative). The "Primary" education group had 2 negative cases and 1 positive,but the sample size is small. The majority of pregnant women with "Secondary" and "Tertiary" education levels tested negative. The p-value of 0.50 suggesting there is no significant association between educational level and HCV among pregnant women.

Result on the occupational status and HCV status showed that among "Health Workers," 31 out of 32 testednegative, and 1 tested positive. The other occupation groups, including "Student," "Trader," "Farmer," "Civil Servant," and "Artisan," had mostly negativecases. With a p-value of 0.004, it showed that there is a significant association between occupational status and HCV among pregnant women.

Findings on marital status and HCV status showed that among the "Single" group, all 9 pregnant women tested negative for HCV. In the "Married" group, 102 out of 108 pregnant women tested negative, and 6 tested positive. For the "Widow" and "Divorced" groups, sample sizes are small, and no p-valuesare provided. With a p-value of 0.306, the result indicated that there is no significant association between marital status and HCV statusamong pregnant women.

In summary, table 4.2 provides insights into the relationship between various sociodemographic characteristics and the presence of HCV among pregnantwomen. The data suggests a significant association between occupational status and HCV positivity. However, for age, education level, and marital status have no statistically significant associations, signifying that these factors do not seem to significantly impact HCV prevalence among pregnant women attending antenatal care.

The hepatitis C virus prevalence in pregnant women was examined in this study. HCV-caused viral hepatitis is a serious global public health concern and a potentially fatal liver disease [14, 15, 16]. According to WHO data, there are three categories and grades for HCV prevalence: high (>3.5%), moderate (1.5% - 3.5%), and low (<1>

In comparison to earlier studies conducted in Pakistan that reported a high HCV prevalence rate of 10.84%, Egypt that reported an 8.6% rate, and Yemen that reported an 8.5% rate, our results were low [20]. This variation in the population investigated, genetic variables, socioeconomic level, cultural customs, the detection technology employed, regional variations in the risk factors for viral hepatitis, and the size of the group analyzed could all be responsible for this disparity.

About the relationship between sociodemographic traits and HCV in expectant mothers. Age and HCV status do not significantly correlate, according to the findings. There is a higher proportion of negative than positive cases across all age groups, and there isn't any compelling evidence that the prevalence of HCV varies considerably by age. The findings are in opposition to a research by[21] which concluded that age is a known risk factor for hepatitis C infection and that seropositivity increases till the age of 40 before declining over time. Nonetheless, this might be clarified by the increased likelihood of these women being exposed to risk factors.The status of HCV and education level do not significantly correlate. All levels of education combined, the majority of expectant mothers tested negative for HCV. These results make sense because a woman's age or level of education might not influence her propensity to look for healthcare-related information that could advise her unborn child about the risk factors for HCV. This result is comparable to a prior study conducted in Nigeria by [22] and a report conducted in Ethiopia by [23]. This finding contradicts the findings of other research that linked higher ages, lower levels of education, and low parity to higher rates of HCV infection [24].

Additionally, there is no discernible correlation between married status and HCV status [25]. The majority of positive cases were found among "Married" pregnant women; however, the p-value of 0.306 indicates that this difference is not statistically significant. There were no HCV positive instances among "single" women, although the sample size was tiny. With a p-value of 0.004, the results show a strong correlation between pregnant women's occupation and HCV. Pregnant women are more likely to have a risk factor in their occupation; nonetheless, in comparison to other study groups, being a health worker or artisan increases the likelihood of testing positive for HCV [26, 27]. Among the sociodemographic traits, employment, and more especially being employed, stand out as being highly connected with HCV positive. This implies that pregnant artists and healthcare professionals may be more vulnerable to HCV infection.

To sum up, the findings provide important information about the incidence of hepatitis C virus (HCV)in expectant mothers receiving prenatal care as well as how it relates to other sociodemographic traits. According to the study's findings on the prevalence of HCV in expectant mothers, 94.4% of them tested negative for the virus, while just 5.6% of them tested positive. In terms of the health of the mother and the fetus, this indicates that HCV is not very common among these pregnant women.

Key conclusions were shown by the sociodemographic characteristics. According to this study, age did not significantly affect the prevalence of HCV among pregnant women. Positive instances were less common than negative cases across all age groups. Given that most pregnant women regardless of education level test negative for HCV, education level also does not appear to be a significant influence in HCV prevalence. Because only pregnant women in this category had positive status, it is possible that pregnant health workers and artisans are more susceptible to HCV infection. The occupational status was shown to be substantially correlated with the prevalence of HCV. There was no discernible correlation between marital status and the prevalence of HCV. Despite having the greatest number of positive cases, "Married" women did not significantly vary from other groups, according to the statistical study.