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Morgan, Camille E.; Ngimbi, Patrick; Boisson-Walsh, Alix J.; Ntambua, Sarah; Matondo, Jolie; Tabala, Martine; Kashamuka, Melchior M.; Emch, Michael; Edwards, Jessie K.; & Powers, Kimberly A., et al. (Preprint). Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo. medRxiv. PMCID: PMC10705650


BACKGROUND: Despite routine infant vaccination and blood donor screening, the Democratic Republic of Congo (DRC) has high hepatitis B virus (HBV) prevalence compared to the United States and Europe. Through the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we characterized household prevalence in DRC's capital, Kinshasa, to inform additional prevention efforts.
METHODS: We introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care (ANC) in high-volume maternity clinics in Kinshasa. We recruited households of pregnant women who were HBsAg-positive and HBsAg-negative, defining households as "exposed" and "unexposed," respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates.
RESULTS: We enrolled 1,006 participants from 200 households (100 exposed, 100 unexposed) across Kinshasa. HBsAg prevalence was more than twice as high in exposed households (5.0%; 95% CI: 2.8%-7.1%) as in unexposed households (1.9%; 0.6%-3.2%). Exposed direct offspring had 3.3 (0.9, 11.8) times the prevalence of unexposed direct offspring. Factors associated with HBsAg-positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among exposed offspring.
CONCLUSIONS: Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.


Reference Type

Journal Article

Year Published


Journal Title



Morgan, Camille E.
Ngimbi, Patrick
Boisson-Walsh, Alix J.
Ntambua, Sarah
Matondo, Jolie
Tabala, Martine
Kashamuka, Melchior M.
Emch, Michael
Edwards, Jessie K.
Powers, Kimberly A.
James, Linda
Mbonze, Nana
Mampunza, Samuel
Yotebieng, Marcel
Thompson, Peyton
Parr, Jonathan B.

Article Type





Democratic Republic of Congo




Edwards, J -0000-0002-1741-335X
Emch - 0000-0003-2642-965X