Exploring Sociocultural and Behavioral Drivers of High Hepatitis B Prevalence in Pregnant Women in Central Ethiopia

Hepatitis B virus (HBV) infection remains a major public health concern globally, particularly in sub-Saharan Africa, where vertical transmission significantly contributes to the burden of chronic infection. Pregnant women represent a critical population due to the risk of mother-to-child transmission during pregnancy, delivery, or early infancy. This study aimed to assess the prevalence of HBV infection and identify associated sociocultural and behavioral risk factors among pregnant women in Hossana Town, Central Ethiopia. A cross-sectional study was conducted among pregnant women attending antenatal care services. Serological testing for hepatitis B surface antigen (HBsAg) was performed to determine HBV infection status. Data on sociodemographic characteristics, behavioral practices, and potential exposure risks were collected using structured questionnaires. Statistical analyses were conducted to identify factors associated with HBV infection, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. The overall prevalence of HBV infection among the study participants was 8% (95% CI: 6–11%), indicating an intermediate to high endemicity level. Pregnant women who reported intimate contact with an HBV-infected person had significantly higher odds of infection (AOR: 5.77; 95% CI: 1.47–22.5). Several sociocultural and behavioral factors were identified as potential contributors to HBV transmission, including traditional practices such as tattooing, ear and nose piercing, scarification, and other forms of skin penetration performed under non-sterile conditions. These findings are consistent with previous studies conducted in Ethiopia and other sub-Saharan African countries, where similar practices have been linked to increased HBV risk. HBV infection during pregnancy poses serious health risks for both the mother and the child. Maternal complications may include hepatitis flare, gestational diabetes, antenatal hemorrhage, and progression to chronic liver disease or cirrhosis. For infants, vertical transmission can result in chronic HBV infection, which is associated with long-term liver complications, including hepatocellular carcinoma. Additionally, adverse birth outcomes such as miscarriage, preterm delivery, and neonatal morbidity may occur. In conclusion, the prevalence of HBV infection among pregnant women in Hossana Town is relatively high, with significant associations observed with sociocultural and behavioral factors. Strengthening antenatal screening, promoting public health education on safe cultural practices, and improving access to vaccination and preventive interventions are essential to reduce HBV transmission and its associated health burden