Screening for HBsAg in women at delivery and prevention of mother-to-child transmission of hepatitis B virus: experience at the University Hospital Complex “Le Bon Samaritain”, N’Djamena, Chad

Hepatitis B virus (HBV) infection in pregnant women is a major contributor to persistent transmission and chronic disease, particularly in highly endemic countries. Mother-to-child transmission occurs mainly during delivery, exposing newborns to a high risk (>90%) of developing chronic infection. Prevention is most effective when the first dose of the HBV vaccine is administered within 24 hours of birth. The aim of this study was to screen women for hepatitis B surface antigen (HBsAg) at the time of delivery and to ensure that all newborns receive vaccination within 24 hours of birth. This descriptive cross-sectional study was conducted from October 30 to December 30, 2025, in the maternity, pediatric, and health center units of the University Hospital Complex “Le Bon Samaritain” (CHU-BS) in N’Djamena, Chad. The screening of women in labor for HBsAg was performed using a rapid diagnostic test, an ABON™ HBsAg immunochromatographic test (Abbott, Chicago, IL, USA), with a sensitivity of over 99% and a specificity of approximately 97%, according to the manufacturer. All live newborns during the study period whose parents had given informed consent were included. Data collection and analysis were performed using Excel and SPSS version 23.0 software. A total of 203 women and 214 newborns were involved in the study, the difference being due to 11 twin deliveries (5.42%). The mean age of the women was 26.37 years, ranging from 15 to 40 years. The most represented age groups were 20-25 years and 26-30 years, each accounting for 28.57% of the participants. The overall HBsAg prevalence was 12.32%. Homemakers were the most represented occupational group (35.96%), followed by students (30.55%). The highest prevalence was observed among students (5.42%), followed by homemakers (4.43%), while healthcare personnel had the lowest prevalence (0.00%). The prevalence of HBV remains very high among women at delivery, placing newborns at a significant risk of mother-to-child transmission. It is therefore essential to strengthen preventive measures, particularly by introducing the first dose of the hepatitis B vaccine at birth for all newborns, in order to reduce perinatal transmission and effectively protect infant health.