Hepatitis B testing coverage and positivity rates among pregnant women attending antenatal clinics, Efate Island, Vanuatu, 2018–2020
DOI:
https://doi.org/10.5365/wpsar.2026.17.3.1259Keywords:
hepatitis B, HBsAg, ANC-1, antenatal screening, VanuatuAbstract
Objective: The World Health Organization has set a target for 95% of pregnant women to be tested for hepatitis B virus at their first antenatal care visit. This study assessed testing coverage and test positivity at the first antenatal care visit among pregnant women between 2018 and 2020 on Efate Island, Shefa province, Vanuatu.
Methods: This cross-sectional study used unlinked first antenatal care consultation and hepatitis B surface antigen testing data, where consultation data were extracted from the Vanuatu Ministry of Health’s Health Information Management System and District Health Information System 2, and hepatitis B virus test data were extracted from the Vila Central Hospital Serology Unit registry. Data were restricted to the period of 1 January 2018 to 31 December 2020. Testing coverage and positivity rates were calculated for each year, and Poisson regression models were used to assess changes over time.
Results: First antenatal care visits were reported for each year, with the hospital providing 79.3% (7943/10 020) of consultations. Average hepatitis B virus testing coverage was 89.2% (8942/10 020) over the study period. Of 8942 first antenatal care hepatitis B virus tests performed, 621 (6.9%) were positive. Poisson regression indicated that test coverage and positivity did not change significantly over time.
Discussion: Although hepatitis B virus testing coverage at first antenatal care visits was high, it did not reach the World Health Organization target of 95%, and more recent data suggest a decline since 2020, highlighting the need for ongoing monitoring. A hepatitis B virus positivity rate of 6.9% reflects intermediate endemicity, indicating a substantial risk of mother-to-child transmission. Strengthening such testing and birth-dose vaccination delivery is critical to reducing perinatal transmission in Vanuatu.
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Copyright (c) 2026 Rubby Leiwia Dick, Leila Bell, George Junior Pakoa, Sereana Natuman Damutalau, Kaylene Kalmos, Caroline van Gemert
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