SEROPREVALENCE AND RISK FACTORS OF HEPATITIS E VIRUS AMONG PREGNANT WOMEN IN URBAN SETTINGS

Abstract

Hepatitis E virus (HEV) poses a significant threat to maternal and fetal health in low-resource urban settings, yet data on its prevalence and determinants among pregnant women remain scarce. We conducted a cross-sectional survey of 500 second-trimester antenatal attendees in three metropolitan hospitals from July to September 2023 to estimate HEV seroprevalence and identify modifiable risk factors. Participants provided demographic and behavioral data via structured interviews and 5 mL blood samples for anti-HEV IgG and IgM ELISA testing. Overall, 55 of 500 women (11.0%) were IgG-positive and 20 (4.0%) were IgM-positive, indicating both prior exposure and recent infection. Multivariable logistic regression revealed that reliance on unimproved water sources more than doubled the odds of seropositivity (adjusted OR = 2.10; 95% CI 1.50–2.90; p < 0.001), and consumption of undercooked meat increased risk by 80% (adjusted OR = 1.80; 95% CI 1.20–2.70; p = 0.010), while age and educational level were not independently significant after adjustment. These findings highlight water sanitation and dietary practices as critical intervention targets. Incorporation of HEV screening into routine antenatal care, paired with community-based WASH (water, sanitation, and hygiene) initiatives and food-safety education, could substantially reduce HEV burden in pregnant populations. Future longitudinal studies should monitor incident infections, genotype distributions, and vaccine efficacy to guide public health strategies. Addressing these modifiable risk factors through integrated water-safety improvements, hygiene promotion, and culturally tailored nutrition guidance will be pivotal for safeguarding maternal and child health in rapidly urbanizing environments.