Abstract
BACKGROUND AND AIMS: Hepatitis B virus (HBV) infection during pregnancy is associated with adverse maternal and neonatal outcomes. Although Ghana's national HBV prevalence is 8.36%, regional disparities are often underexplored. The Bono East Region, characterized by its trade-driven labor force, population mobility, and limited maternal health access, may experience different HBV transmission patterns. In response, our study quantified HBV prevalence and identified its correlates among pregnant women in the Bono East Region. METHODS: This study employed a cross-sectional design with a mixed-methods approach among 1430 pregnant women. Data were collected using serological tests, closed-ended questionnaires, in-depth interviews, and focus group discussions. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression (bivariate at p ≤ 0.25, and multivariate at p < 0.05 with 95% confidence intervals). Thematic analysis of the qualitative data was conducted following a four-stage interpretive framework. RESULTS: The study found an HBV prevalence of 1.82% (95% CI: 1.24-2.65). Several factors were independently associated with increased odds of infection. These included sharing sharp items (AOR = 3.24; 95% CI: 2.98-5.71), unprotected sex (AOR = 5.04; 95% CI: 1.98-6.81), unsafe abortion (AOR = 3.51; 95% CI: 1.16-5.53), blood transfusion (AOR = 6.82; 95% CI: 2.53-8.34), body piercing (AOR = 2.50; 95% CI: 1.85-4.31), street nail trimming (AOR = 3.63; 95% CI: 1.37-5.62), being unmarried (AOR = 17.51; 95% CI: 5.47-25.98), low income (AOR = 6.28; 95% CI: 1.58-11.94), living in compound houses (AOR = 7.25; 95% CI: 1.23-12.43), secundigravidae (AOR = 5.37; 95% CI: 2.45-11.80), and blood group O (AOR = 4.36; 95% CI: 1.40-6.54). CONCLUSION: The HBV prevalence was lower than the national average of 8.36%. However, the associated determinants highlight the need for expanded vaccination coverage and improved health education.