Malaria and hepatitis B virus co-infection among pregnant women in Samaru-Zaria, Nigeria

Background: Malaria and Hepatitis B virus (HBV) infection are endemic in Nigeria. These infections pose significant public health concerns, putting the well-being of both an expectant mother and the unborn child at risk. This study was aimed at determining the co-infection and risk factors of malaria and HBV among pregnant women on antenatal visits in selected hospitals within Samaru-Zaria, Nigeria. Methods: A total of 150 pregnant women were included in this study. Structured questionnaires were used to gather data on socio-demographic and risk factors associated with the infections among them. Two millilitres (2mL) of venous blood sample was collected from each of the study participants. Thin and thick blood smears were made from each sample and stained with Giemsa. Plasmodium parasites were detected using 100× objective of compound light microscope. Serum was obtained from each blood sample by centrifuging at 1500 rpm for 5 minutes. Hepatitis B surface antigen (HBsAg) was detected from the serum using Swe-Care Rapid One-step Test Strip (Stockholm, Sweden). Results: The overall prevalence of malaria among the pregnant women was 84.7%, while HBV was 5.3%, and co-infection was 5.3%. Those between 26-35 years had the highest occurrence of both malaria (86.4%), HBV (8.6%) and co-infection (8.6%). Pregnant women that were employed had the highest malaria (86.2%), HBV (6.9%) and co-infection of 6.9%. The most educated women had the highest malarial burden (88.0%), but HBV (10.0%) and co-infection (10.0%) were highest among those with primary education. Women in monogamous marriage had higher occurrence of malaria (86.6%), but those in polygamy had significantly higher HBV (8.2%; P=0.032), as well as co-infection (8.2%; P=0.032). Non-application of insecticides and presence of stagnant water predisposed them to malaria (OR>1). Those who lived with HBV-infected relative(s) were significantly more infected with HBV (100%; P=0.000). Conclusion: Pregnant women in this study had very high malarial burden, but low HBV infection. The co-infection was also low. Presence of stagnant water and non-application of insecticides were significant risk factors for malaria. Living with infected relative(s) was a risk factor for HBV; while polygamy was associated with the co-infection. These infections endanger maternal and foetal health. Therefore, it is important that every pregnant woman attends antenatal care from early stage of pregnancy, and gets routine screening for malaria and HBV infection. Early and adequate treatments for these infections will ensure good pregnancy outcome.