Public Health of Indonesia
E-ISSN: 2477-1570 | P-ISSN: 2528-1542
Original Research Determinants and Prevalence of Hepatitis B Among Multigravidae Pregnant Women in Bengkulu Province.
Indonesia Fiya Diniarti1,2.
Mohamed Saifulaman Mohamed Said1.
Sandeep Poddar1.
Jonathan Andrew Ware3.
Norhashima Abd Rashid1* 1School of Nursing and Applied Science.
Lincoln University College, 47301 Petaling Jaya.
Selangor.
Malaysia 2Kesehatan Masyarakat.
Fakultas Ilmu Kesehatan.
Universitas Dehasen Bengkulu.
Indonesia Faculty of Computing.
Engineering and Science.
University of South Wales.
*Corresponding author Norhashima Abd Rashid School of Nursing and Applied Science.
Lincoln University College, 47301 Petaling Jaya.
Selangor.
Malaysia.
Email: norhashima@lincoln.
DOI: https://doi.
org/10.
36685/phi.
Copyright: A 2025 the Author.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
Article History:
Received 12 December 2024 Revised 31 January 2025 Accepted 13 April 2025 Abstract Background: Morbidity and mortality caused by Hepatitis B Virus (HBV) infection continue to pose a serious global public health concern.
Globally, an estimated three million new cases of chronic HBV infection are reported annually, contributing to approximately 51,000 deaths.
Indonesia.
HBV is recognized as the fourth leading cause of mortality.
Objectives: This study aimed to investigate the factors associated with HBV infection among multigravida pregnant women in Kota Bengkulu.
Indonesia, based on an evidence-based approach.
Methods: A quantitative case-control study was conducted involving 148 pregnant women, comprising 74 women who tested positive for hepatitis B and 74 who tested negative.
The study employed total sampling as the sampling technique.
Data were analyzed using chi-square tests and multiple logistic regression to identify significant associations.
Results: The analysis revealed significant associations between HBV infection and several variables: age .
= 0.
OR = 2.
, educational level .
= 0.
OR = 2.
, type of previous delivery .
= 0.
OR = 3,753.
, history of blood transfusion .
= 0.
OR = 2.
, and low level of knowledge .
= 0.
OR = 2.
Among these, the most dominant factor associated with HBV infection was a history of blood transfusion .
= 0.
OR = 3.
The overall prevalence of hepatitis B in the study population was 0.
Conclusion: This study concludes that a history of blood transfusion is the most significant factor associated with HBV infection among multigravida pregnant women in Bengkulu Province.
Indonesia.
These findings highlight the need for enhanced screening and preventive measures, particularly in maternal healthcare settings.
Keywords: Hepatitis B.
multigravida pregnant women.
education level.
delivery history.
transfusion history Background In this modern era, there are variuos types communicable and non-communicable diseases which has taken over urban and rural communities.
Therefore, the dependence of communities to drugs whether it is a pharmaceutical compound, lifestyle or healthy food to overcome those deseases is increasing tremendously (Abd Rashid et al.
, 2023.
Abdullah et al.
, 2024.
Hasibuan et al.
, 2023.
Kasmara et al.
, 2.
Approximately 240 million people worldwide are Volume 11.
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July Ae September 2025 chronically infected with hepatitis B virus (HBV) and it is defined as positive for hepatitis B surface antigen (HBsA.
for at least six months (Nelson et al.
, 2.
Data from 2019 shows that HBV incidence is suspected to be more than 90%, with 3 million new infections, with 354 million chronic infections, and over 1 million deaths worldwide (Moonen et al.
WHO data indicates that about 296 million people were infected with chronic HBV infection in 2019, with 1.
million of new case per year.
The impact of HBV incidence is about 820000 death of people annually around the world, atrributed to the development of liver cirrhosis and heart cancer (WHO, 2.
The highest HBV infection rates occurred in the WHO Western Pacific and Africa Regions, where 116 million and 81 million people respectively were chronically Sixty million people were infected in the WHO Eastern Mediterranean region, 18 million in the WHO Southeast Asia region, 14 million in the WHO Europe region, and 5 million in the WHO Americas region (Zampino et al.
, 2.
East and Southeast Asia, particularly Indonesia.
HBV infection is still very common .
510%) (Lusida et al.
, 2.
For instance, in Central Java Province, the prevalence of HBV infection is moderate for example, 6-7% of the population.
Fortunately.
Indonesia has a fairly low prevalence rate of anti hepatitis C virus antibodies such as around 0.
Thus, it can be estimated that the prevalence of hepatitis C infection is much lower than that of HBV (Adji et al.
, 2.
Previous study by Dwiartama et al.
stated that Indonesia is facing problem during screening of HBV infection due to lack of awareness among public.
This is because majority of the people in Indonesia is feeling healthy even without HBV Furthermore, health services on HBV infection in urban and rural areas of Indonesia are quite limited (Dwiartama et al.
, 2.
Transmission of HBV can occur through perinatal transmission from an infected mother to child during birth, or through horizontal transmission .
xposure to infected bloo.
Chronic infection often develops in babies infected by their mothers (Zhang et al.
, 2.
The transmission of HBV from mother to infant during the perinatal period is one of the most effective ways the virus spreads, often resulting in severe long-term complications.
Infants born to mothers who are positive for hepatitis B surface antigen (HBsA.
and hepatitis B "e" antigen (HBeA.
face a 70%-90% risk of acquiring perinatal HBV infection, with 85%-90% of these infants going on to become chronic HBV carriers (Singh Thakur et al.
It is estimated that over 25% of these carriers will eventually die from primary hepatocellular carcinoma or cirrhosis of the liver.
These deaths typically occur in adulthood, when they are especially devastating due to the added familial and financial responsibilities (Nguyen et al.
, 2.
HBV can be transmitted through shared needle injections, tattoos, piercings, exposure to infected blood, and bodily fluids such as saliva, menstrual fluids, blood transfusions, vaginal fluids, and semen (Rajamoorthy et al.
, 2.
Additionally, transmission through sexual contact is more common among individuals who are not vaccinated and have multiple partners (Al-Busafi et al.
, 2021.
Chen et al.
, 2018.
Rajamoorthy et , 2.
HBV can survive outside human body for about 7 days and able to cause infection if it successfully enters the unvaccinated body (Schillie et al.
, 2.
The incubation period for HBV ranges between 30 to 60 days after infection and may lead to the development of chronic hepatitis B, especially when the transmission occur during infancy or childhood (Fasano et al.
, 2.
In 2017, there were about 100 cases of HBV infections among pregnant mothers.
This number increased to 125 cases in 2018, 150 cases in 2019, 155 cases in 2020, 160 cases in 2021, and decreased to 76 cases in 2023 (Diniarti et al.
Therefore, the purpose of this study is to investigate the associated factors and prevalence of HBV infection among multigravida pregnant women in Bengkulu.
Indonesia through evidence-based study.
The prevalence of HBV infection based on doctor's diagnosis in Bengkulu province was 0.
1% in 2013 and increased to 0.
4% in 2018 (Lusida et al.
Previous study in Bengkulu showed that individual aged 16-40 years old were at high risk of hepatitis B infection.
Among sufferers, 54.
3% had low education, 52.
9% had a positive family history of HBV infection, 73.
5% were not immunized, and 57.
1% were multigravida HBV sufferers (Diniarti et al.
, 2.
A study by Gobel and Kurnesih identified blood transfusion history is one of the associated factor for the incidence of HBV in pregnant mothers (Gobel & Kurnesih, 2.
while Pither et al.
Denando and Cahyanti .
suggest level of education, parity and age as another associated factors of HBV incidence in pregnant mothers (Denando & Cahyati, 2022.
Pither et al.
, 2.
Methods Study Design The research design used in this study is a quatitative study with descriptive analytic case-control .
This study aimed to determine the frequency and the risk factors associated with HBV infection among multigravida pregnant women.
The risk factors considered include age of first marriage, childbirth history, blood transfusion history, education, and knowledge, treated as independent variables, while the incidence of HBV infection among multigravida pregnant women is considered as the dependent variable.
Sample The population in this study were multigravida pregnant women who underwent Hepatitis B screening every month from January to December 2022 and received a positive diagnosis of HBV infection at 201 Public Health Center Volume 11.
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July Ae September 2025 Bengkulu Province .
Public Health Center with hospitalization.
135 Public Health Center without hospitalizatio.
The case group comprises of 74 diagnosed respondents, while the control group consists of 74 individuals who tested negative for HBV infection.
A sample of 74 individuals was obtained using consecutive sampling technique from secondary data provided by the Bengkulu City Health Service.
Indonesia.
Data were collected using primary and secondary data using univariate, biavariate and multivariate data analysis.
Consecutive sampling technique was used in this study to minimize sampling bias and every diagnosed respondents is treated as eligible participants who went for Hepatitis B screening every month from January up to December 2022.
The collected data for this study include age at first marriage .
ore than 19 years old.
less than 19 years ol.
(Denando & Cahyati, 2.
, childbirth history .
ormal birth.
cesarean sectio.
(Yang et al.
, 2.
, blood transfusion history (Sukmawati et al.
, 2.
, education level .
niversity / college leve.
(Gobel & Kurnesih, 2.
, knowledge (Denando & Cahyati, 2.
, and the incidence of HBV infection in multigravida pregnant Data analysis The statistical data analysis method starts from data entry, tabulating, performing statistics, using the SPSS 28 program, univariate, bivariate and multivariate analysis.
Univariate analysis was conducted to describe the frequency distribution and matching of age.
Bivariate analysis used the chi-square test (X.
to determine the magnitude of the risk (OR) of the risk associated factor at a Confidence Interval (CI) value of 95% ( = 0.
Multivariate analysis used the Multiple Logistic Regression test using the Enter method to determine the Adjusted Odds Ratio and measure the probability of HBV occurrence.
Ethical considerations This research has obtained ethical permission from the Ethics Division of Dehasen University.
Indonesia, with the following number: 0034/D/KEPK/FD/IV/2023 Results Table 1.
Characteristics Respondent Variable Age of first marriage .
ore than 19 years ol.
ess than 19 years ol.
Childbirth History Normal Birth Caesarean section Blood Transfusion History Yes Education High (University / College Leve.
Low (Elementary / Middle Schoo.
Knowledge Good Low Incidence of Hepatitis B in mothers multigravida pregnancy Case Control Table 1 shows that the majority of respondents were in the at-risk age group, specifically those younger than 19 years .
%).
In addition, more than half of the respondents reported having a history of childbirth .
8%), while nearly twothirds had a history of blood transfusion .
5%).
Educational attainment among the respondents was notably low, with 5% categorized as poorly educated.
Similarly, a significant proportion of respondents demonstrated limited knowledge regarding the related health issues, also at 82.
These findings highlight a combination of demographic and educational vulnerabilities that may increase the risk of adverse health outcomes, emphasizing the need for targeted interventions and health education programs to improve awareness and reduce risk factors within this population.
Volume 11.
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July Ae September 2025 Table 2.
Presents the Prevalence of Hepatitis B Based on Doctor's Diagnosis According to Districts/Cities in Bengkulu Province in 2022, as Documented in the Basic Health Research.
Regency City Hepatitis B Based Diagnosis Doctor
95% CI
South Bengkulu
Rejang Lebong
North Bengkulu
Kaur
Seluma
1,704
Muko-muko Lebong Kepahiang Central Bengkulu Bengkulu City Bengkulu Province Table 3.
Factors Risk of Hepatitis B in Multigravida Pregnant Women with Chi Square Test, n=154 Hepatitis B in Multigravida
Variable Total
Pregnant Women
Case
Control
N (%)
N (%)
Age at first marriage .
ore than 19 years ol.
ess than19 years ol.
Childbirth History Normal Birth 43 .
652Caesarean section 60 .
Blood Transfusion History Yes Education High (University / College 6 .
Leve.
Low (Elementary/Middle 68 .
Schoo.
Knowledge Good 16 .
Low 58 .
Table 2 illustrates the prevalence of HBV disease diagnosed by doctors in Bengkulu Province.
Among the 11 districts in Bengkulu Province.
Central Bengkulu Regency has the highest prevalence of hepatitis B at 0.
94%, while Lebong Regency has the lowest prevalence at 0.
19%, and Bengkulu City at 0.
Hepatitis B is a contagious disease that must be reduced to prevent liver cancer, cirrhosis, and even death.
The national target in Indonesia is to decrease the incidence of hepatitis B in the population from 1.
98% per 100.
000 population in 2018 to 1.
09 per 100,000 population in 2024, representing a decrease of 54.
Table 3 shows the evidence that the variables are related to the incidence of HBV infection in multigravida pregnant women, as determined by the Chi-square test, include age of first marriage .
-value = 0.
OR = 2.
childbirth history .
-value = 0.
OR = 3.
, blood transfusion history .
-value = 0.
OR = 3.
, education .
value = 0.
OR = 2.
, and knowledge .
-value = 0.
OR = 2.
Volume 11.
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July Ae September 2025 Table 4.
Factors Dominant Incidence of Hepatitis B in Multigravida Pregnant Women Variable Age at first marriage Childbirth History Blood Transfusion History Education Knowledge Table 4 shows dominant factor that relates with incidence of HBV infection in multigravida pregnant women is blood transfusion history with a p-value of 0.
002 (OR =3.
Discussion The present study investigated the associated factors of HBV infection and prevalence among multigravidae pregnant women in Bengkulu.
Indonesia.
Associated factors that had been studied were age of multigravidae pregnant women (>19 years.
<19 year.
, childbirth history, blood transfusion history, educational level, knowledge, and the incidence of HBV infection.
Based on the results of the Chi-Square test in this study, a p value of 0.
004 was obtained from relationship of age at first marriage to HBV infection.
The bivariate results showed an OR of 2.
867 with 95% CI = 1.
693, meaning that mothers who marry under the age of 19 have a 2.
9 times greater risk of being infected with HBV compared to mothers who marry over the age of 19.
Marrying under the age of 19 means that they are having an early Early marriage has various impacts including psychological, health, and socio-economic impacts.
The reproductive organs of mothers at this age are yet mature enough to face pregnancy even though they are physically healthy (Denando & Cahyati, 2.
This study is in line with Surapathi et.
where mothers who married under the age of 19 years were 2.
5 times more at risk of being infected with hepatitis B compared to mothers who married over the age of 19 years with a p value of 0.
024 (Surapathi et al.
, 2.
The results of the statistical test for childbirth history variable showed 3.
753 with a confidence level (CI), a lower limit value of 1.
652 and an upper limit of 8.
592 with p value of 0.
003, childbirth history has a significant relationship with HBV infection among multigravida pregnant women.
Therefore, multigravida pregnant women who have had giving birth may have 3.
753 times risk of being infected with HBV.
This finding is in line with Yang et al.
, who demonstrated 31% of normal birth mothers and 4.
37% or cesarean section mothers were infected with HBV (Yang et al.
, 2.
However, it was found that only 41.
6% cesarean section mothers were infected with HBV compared to normal birth mothers .
1%).
This finding is parallel to Yang et al.
who showed a significant decrease in vertical transmission of HBV through cesarean section compared to normal birth (Yang et al.
, 2.
Most mother-to-child transmission cases likely occur perinatally, as a result of maternal blood flowing into the fetal circulation during uterine contractions and the tearing of the placenta at birth.
Other potential modes of HBV infection include the ingestion of amniotic fluid, vaginal secretions, or exposure to maternal blood during normal birth (Pan et al.
, 2.
Elective cesarean sections involve minimal placental contraction, which is thought to reduce maternal-fetal transfusion (Guo et al.
, 2.
Additionally, it decreases the fetus's direct contact with infected secretions or blood in the maternal genital tract.
The results of the statistical test for the variable blood transfusion history obtained of 3.
767 with a confidence level (CI), a lower limit value of 1.
652 and an upper limit of 8.
592 with p value of 0.
002, which means that a history of blood transfusion is significant for the incidence of HBV in multigravida pregnant women.
Thus, multigravida pregnant women who have had blood transfusion may have 3.
767 times greater risk of being infected with HBV compared to multigravida pregnant women who never had a blood transfusion.
This finding is in line with Sukmawati et al.
which demonstrated a connection between a history of blood transfusion and the incidence of hepatitis B in pregnant mothers, with a value of OR = 2.
95% CI = 0.
p = 0.
They suggested that pregnant women with history of blood transfusion may have double the risk compared to those without a history of blood transfusion (Sukmawati et al.
Furthermore, previous study by Alemu et al.
support these findings.
They found history of blood transfusion poses a risk for HBV infection, with a value of OR = 5.
71, 95% CI = 3.
This indicates that individuals who have undergone blood transfusion are five times more likely to contract HBV infection (Alemu et al.
, 2.
Candotti and Allain .
documented that low detection of HBV among blood donors may increase the HBV infection among population.
This is due to the high cost and specific equipment needed for hepatitis B surface antigen (HBsA.
assays which may not be affordable for small-scale blood services particularly in resource-limited developing countries (Candotti & Allain.
Besides that, mutations associated with conformational and hydrophobic changes in and outside the immunogenic major hydrophilic region (MHR) of the S antigen .
he main target for capture antibodies used in diagnostic test.
and with reduced synthesis or secretion of HBsAg may be the cause of failure or a significant decrease in detecting HBsAg among blood donors (Candotti & Allain, 2.
Additionally, mutations may occur naturally from escaping active or passive Volume 11.
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July Ae September 2025 immunity or antiviral therapy.
Occurrence of such mutant strains may reach 30% in areas of high endemicity following vaccination programs (Hsu et al.
, 2.
The findings of this study demonstrate a significant relationship between education and the incidence of hepatitis B in multigravida pregnant mothers with 2.
889 of confidence level (CI), a lower limit value of 1.
464 and an upper limit of 775 with p value of 0.
The mean variable of education becomes a possible factor in the transmission of HBV to multigravida pregnant mothers, as respondents with low education have a 2.
889 times higher risk of infected with HBV.
Additionally, research findings by Kabede et al.
suggested that the level of education has a strong relationship with an individual's awareness of the possibility of contracting diseases, including HBV infection (Kebede et al.
, 2.
Individuals with higher education levels typically possess better knowledge, leading to a reduced disease transmission, as demonstrated by Metaferia et al.
(Metaferia et al.
, 2.
This indicates that education is one of the associated factors for the transmission of HBV to multigravida pregnant women.
Multigravida pregnant women who lack formal education were three times more likely to be infected with HBV compared to those with at least intermediate school education (Denando & Cahyati, 2.
The findings of this study showed a significant relationship between knowledge and incidence of HBV infection among multigravida pregnant women with 2.
935 of confidence level (CI), a lower limit value of 1.
480 and an upper limit 885 with p value of 0.
This shows multigravida pregnant women with low knowledge about HBV transmission 935 times higher risk of being infected with the virus.
This finding is in line with Apriadi .
who stated there is a connection between low knowledge and the high incidence of HBV infection among pregnant women .
=0.
(Apriadi, 2.
Similarly.
Suryantoro et al.
found a connection between knowledge and the incidence of HBV infection in pregnant women .
=0.
(Suryantoro et al.
, 2.
Faizaturrahmi .
reveals that low knowledge with high incidence of HBV infection among pregnant women is due to lack of information from media as a problem.
Providing information to pregnant mothers about disease elimination is crucial.
It is hoped that in the future, there will be medium for sharing quality information to increase mothers' knowledge and motivate them to adopt positive behaviors in implementing efforts to prevent the HBV elimination program (Faizaturrahmi et al.
, 2.
Additionally, the research results are further supported by the theory from Notoatmodjo .
, which states that knowledge is the result of knowing and occurs after individuals perceive certain objects.
Perception occurs through the senses of sight and hearing, as well as smell, taste, and touch.
Most of the knowledge individuals acquire is through their eyes and ears.
The level of knowledge is influenced by several factors, including age, experience, education, environment, and access to information Knowledge is also related to a women's decisions in determining actions related to her health.
The research results by Malungu Ngaira et al.
show that the prevalence of HBV infection in pregnant women attending the Antenatal Clinic (ANC) at Mmbathi District Hospital.
Nairobi, is lower .
8%) compared to the national prevalence of pregnant women .
4%).
These women also exhibit a low level of HBV awareness .
2%) (Malungu Ngaira et al.
, 2.
According to Alberts et al.
, the prevalence of HBV infections is lower in cirrhosis patients in Europe.
America, and Oceania (UN subregional prevalence ranges between 3-14%) compared to Africa and Asia .
-61%).
In some large areas of Asia and Africa, the combined prevalence of HBV and HCV infections exceeds 50%.
Globally, among cirrhosis patients, 42% suffer from HBV infection and 21% suffer from HCV infection (Alberts et al.
, 2.
The multivariate analysis results indicate that the variable of blood transfusion is the dominant factor in the occurrence of HBV disease in pregnant women.
This finding is consistent with research by Alemu et al.
Although it has been proven that society needs to be made aware of the significance preventive measure, into place continuously and over an extended period of time.
These measures include health advocacy, hepatitis B virus screening campaigns, health education, counseling.
HBV vaccination with community-based activities, and secondary prevention in the form of combination therapy treatment for patients who have had liver transplants (Diniarti et al.
, 2.
Conclusion The factors associated with the incidence of HBV infection in multigravida pregnant women in Bengkulu City include age at first marriage, childbirth history, blood transfusion history, education level, and knowledge.
It was found that blood transfusion history is the main factor of HBV infection in multigravida pregnant women in Bengkulu Province.
Indonesia.
Transmission of HBV from infected pregnant women to their child contributes to the high prevalence of HBV in Indonesia.
To address this issue, this study is valuable to educate the public on preventing and reducing the transmission of the HBV from pregnant women during pregnancy.
These efforts support the Indonesian government's programs aimed at controlling the transmission risk of HBV among pregnant women Declaration of conflicting interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Volume 11.
Issue 3.
July Ae September 2025 Funding The author.
declare that no financial support was received for the research, authorship, and/or publication of this article Acknowledgement The authors would like to thank the staff of Public Health Center Bengkulu Province.
Indonesia.
Bengkulu City Health Service.
Indonesia and Universitas Dehasen Bengkulu staf for their technical advice.
Author contributions FD: Conceptualization.
Investigation.
Project administration.
WritingAeoriginal draft.
WritingAereview and editing.
MSMS:
Conceptualization.
WritingAereview and editing.
SD.
WritingAereview and editing.
NAR: Conceptualization.
Investigation.
Project administration.
WritingAeoriginal draft.
WritingAereview and editing.
AuthorAos Biographies Fiya Diniarti is a Lecturer of Kesehatan Masayarakat.
Fakultas Ilmu Kesehatan at Universitas Dehasen Bengkulu.
Indonesia.
She obtained her doctorate (Ph.
D in Health Scienc.
in 2025 at Lincoln University College.
Malaysia.
Her research interest focuses on reproduction As a researcher, she has published more than ten research articles in the peer reviewed journals and proceedings.
Mohamed Saifulaman Mohamed Said is a professor of medicine at Lincoln University College.
Malaysia.
He obtained his doctorate (Ph.
D in Biochemistr.
and has 21 years of teaching and research experience.
As a researcher, he has published more than ten research articles in the peer reviewed journals and proceedings.
Sandeep Poddar is a Deputy Vice Chancellor (Research & Innovatio.
at Lincoln University College.
Malaysia.
He obtained his postgraduate degree in M.
Sc.
Zoology (Biochemical Genetic.
from Dayalbagh Educational Institute and Ph.
in Zoology from University of Calcutta.
As a researcher, he has published more than ten research articles in the peer reviewed journals and proceedings.
He is currently holding a role as Chief Executive Editor of Malaysian Journal of Nursing.
Norhashima Abd Rashid is a Lecturer of Biomedical Science at Lincoln University College (LUC).
She obtained her postgraduate degree in Biotechnology (Molecular Biolog.
(MS.
c Biotechnology (Molecular Biolog.
) in 2010 and doctorate (Ph.
D in Biomedical Scienc.
in 2020 at Universiti Kebangsaan Malaysia.
Her research interest focuses on the development of protective effects of natural product against chemotherapy treatment and mechanism of drug toxicity.
As a researcher, she has published more than ten research articles in the peer reviewed journals and proceedings.
She is currently an invited reviewer of the Life Science Journal (Elsevie.
Jonathan Andrew Ware he is a member at Faculty of Computing.
Engineering and Science.
University of South Wales.
References Abd Rashid.
Mohamad Najib.
Abdul Jalil.
, & Teoh.
Essential Oils in Cervical Cancer: Narrative Review on Current Insights and Future Prospects.
Antioxidants, 12.
, 1Ae21.
https://doi.
org/10.
3390/antiox12122109 Abdullah.
Amirullah.
Vijayan.
Rashid.
Abdullah.
, & Abidin.
Chemopreventive role of proteins and polysaccharides from Pleurotus tuber-regium.
Food Bioscience, 60, 104311.
https://doi.
org/https://doi.
org/10.
1016/j.
Adji.
Pramana.
, & Susilawati.
Characteristics of patients with Hepatitis B and C at Dr.
Moewardi General Hospital in Surakarta.
Indonesia.
Journal of the Medical Sciences (Berkala Ilmu Kedoktera.
, 54.
, 264Ae271.
https://doi.
org/10.
19106/jmedsci005403202207 Al-Busafi.
Al-Harthi.
Al-Naamani.
Al-Zuhaibi.
, & Priest.
Risk factors for hepatitis b virus transmission in oman.
Oman Medical Journal, 36.
https://doi.
org/10.
5001/OMJ.
Alberts.
Clifford.
Georges.
Negro.
Lesi.
Hutin.
, & de Martel.
Worldwide prevalence of hepatitis B virus and hepatitis C virus among patients with cirrhosis at country, region, and global levels: a systematic review.
The Lancet Gastroenterology and Hepatology, 7.
, 724Ae735.
https://doi.
org/10.
1016/S2468-1253.
Alemu.
Zeleke.
Aynalem.
, & Kassa.
Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.
Infectious Diseases in Obstetrics and Gynecology, 2020.
https://doi.
org/10.
1155/2020/9418475
Apriadi.
Analisis faktor keikutsertaan screening hepatitis Au B Ay pada ibu hamil Factors analysis of hepatitis AuBAy screening participation in pregnant women.
Jurnal SAGO Gizi Dan Kesehatan, 3.
, 56Ae61.
https://doi.
org/http://dx.
org/10.
30867/gikes.
v 3 i 1 71 7 Candotti.
, & Allain.
-P.
Transfusion-transmitted hepatitis B virus infection.
Journal of Hepatology, 51.
, 798Ae809.
https://doi.
org/10.
1016/j.
Chen.
Zha.
Cai.
, & Qin.
Maternal viral load and hepatitis B virus mother-to-child transmission risk: A systematic review and meta-analysis.
Hepatology Research, 48.
, 788Ae801.
https://doi.
org/10.
1111/hepr.
Denando.
, & Cahyati.
Faktor Risiko Hepatitis B Pada Ibu Hamil Di Kota Semarang Tahun 2020-2021 (Studi Kasus Di Puskesmas Genuk & Puskesmas Bangetay.
Jurnal Kesehatan Masyarakat, 10.
, 656Ae665.
Diniarti.
Mohamed Said.
Abd Rashid.
, & Poddar.
Behavioral prevention of HBV transmission in urban communities toward global elimination of hepatitis in 2030: a systematic review.
Healthcare in Low-Resource Settings, 12, 315Ae320.
https://doi.
org/10.
4081/hls.
Volume 11.
Issue 3.
July Ae September 2025 Dwiartama.
Nirbayati.
Giri-Rachman.
Niloperbowo.
Tan.
, & Anin.
Knowledge.
Attitude, and Practice towards Hepatitis B Infection Prevention and Screening among Indonesians.
International Journal of Environmental Research and Public Health, 19.
https://doi.
org/10.
3390/ijerph19084644 Faizaturrahmi.
Ani.
, & Sari.
Risk factors for hepatitis B virus infections among pregnant women in East Lombok District.
Public Health and Preventive Medicine Archive, 6.
, 108Ae113.
https://doi.
org/10.
15562/phpma.
Fasano.
Poliseno.
Fiore.
Lo Caputo.
DAoArminio Monforte.
, & Santantonio.
Management of Chronic Hepatitis B in HIV-Coinfected Patients.
Viruses, 14.
https://doi.
org/10.
3390/v14092022 Gobel.
, & Kurnesih.
Faktor Risiko Hepatitis B Pada Ibu Hamil Di Kota Makassar Tahun 2019.
, 22Ae45.
https://doi.
org/https://doi.
org/10.
52103/jmch.
Guo.
Shi.
Feng.
Wang.
Feng.
Wang.
, & Zhang.
Risk factors of HBV intrauterine transmission among HBsAg-positive pregnant women.
Journal of Viral Hepatitis, 20.
, 317Ae321.
https://doi.
org/10.
1111/jvh.
Hasibuan.
Said.
Rashid.
Huda.
Kurnia.
, & Poddar.
Adjuvant Hormonal Therapy and Emotional Freedom Techniques to Improve the Quality of Life of Patients with Breast Cancer: A Review of the Literature.
Al-Rafidain Journal of Medical Sciences, 5.
S76AeS80.
https://doi.
org/10.
54133/ajms.
Hsu.
-Y.
Chang.
-H.
Ni.
-H.
, & Chen.
-L.
Survey of hepatitis B surface variant infection in children 15 years after a nationwide vaccination programme in Taiwan.
Gut, 53.
, 1499Ae1503.
https://doi.
org/10.
1136/gut.
Kasmara.
Abdullah.
Harun.
Sari.
Rashid.
, & Teoh.
Mini review of plant products as food supplement against MSG-induced liver injury : antioxidant , oxidative stress and histological prospects.
January.
https://doi.
org/10.
3389/fphar.
Kebede.
Abateneh.
, & Belay.
Hepatitis B virus infection among pregnant women in Ethiopia: A systematic review and Meta-analysis of prevalence studies.
BMC Infectious Diseases, 18.
, 1Ae9.
https://doi.
org/10.
1186/s12879-0183234-2 Lusida.
Juniastuti, & Yano.
Current hepatitis B virus infection situation in Indonesia and its genetic diversity.
World Journal of Gastroenterology, 22.
, 7264Ae7274.
https://doi.
org/10.
3748/wjg.
Malungu Ngaira.
Kimotho.
Mirigi.
Osman.
NgAoangAoa.
Lwembe.
, & Ochwoto.
Prevalence, awareness and risk factors associated with hepatitis b infection among pregnant women attending the antenatal clinic at mbagathi district hospital in Nairobi.
Kenya.
Pan African Medical Journal, 24, 1Ae7.
https://doi.
org/10.
11604/pamj.
Metaferia.
Dessie.
Ali.
, & Amsalu.
Seroprevalence and associated risk factors of hepatitis B virus among pregnant women in southern Ethiopia: a hospital-based cross-sectional study.
Epidemiology and Health, 38, e2016027.
https://doi.
org/10.
4178/epih.
Moonen.
, den Heijer.
Dukers-Muijrers.
, van Dreumel.
Steins.
, & Hoebe.
A systematic review of barriers and facilitators for hepatitis B and C screening among migrants in the EU/EEA region.
Frontiers in Public Health, 11.
https://doi.
org/10.
3389/fpubh.
Nelson.
Easterbrook.
, & McMahon.
Epidemiology of Hepatitis B Virus Infection and Impact of Vaccination on Disease.
Clinics in Liver Disease, 20.
, 607Ae628.
https://doi.
org/10.
1016/j.
Nguyen.
Wong.
Gane.
Kao.
-H.
, & Dusheiko.
Hepatitis B Virus: Advances in Prevention.
Diagnosis, and Therapy.
Clinical Microbiology Reviews, 33.
https://doi.
org/10.
1128/CMR.
Pan.
Zou.
-B.
Chen.
Zhang.
Zhang.
Li.
, & Duan.
Cesarean section reduces perinatal transmission of hepatitis B virus infection from hepatitis B surface antigen-positive women to their infants.
Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association, 11.
, 1349Ae1355.
https://doi.
org/10.
1016/j.
Pither.
Yusuf.
, & Aziz.
Faktor Risiko Kejadian Hepatitis B Pada Ibu Hamil di Kabupaten Luwu Timur.
Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 4.
, 432Ae438.
https://doi.
org/https://doi.
org/10.
56338/mppki.
Rajamoorthy.
Taib.
Mudatsir.
Harapan.
Wagner.
Munusamy.
Rahim.
, & Radam.
Risk behaviours related to hepatitis B virus infection among adults in Malaysia: A cross-sectional household survey.
Clinical Epidemiology and Global Health, 8.
, 76Ae82.
https://doi.
org/10.
1016/j.
Schillie.
Vellozzi.
Reingold.
Harris.
Haber.
Ward.
, & Nelson.
Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices.
MMWR.
Recommendations and