INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
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Evaluating The Effectiveness of Hepatitis B Pmtct Interventions: A
Comparative Analysis of Models of Care in Sardauna and Kurmi Lgas,
Taraba State, Nigeria
Danjuma Adda
1
, Daniel Lawrence
1
, Obed Tiwah John
1
, Rijimra Ande
1,
Helmina Bantar
1
Edward Yibon
Stephen
1
Tomen E Agu
2
Mohammed Umaru
1
Emmanuel Nicodemus
1
1
Center for Initiative and Development (CFID) Taraba
2
Department of Public Health, Taraba State University, Jalingo
DOI: https://dx.doi.org/10.51244/IJRSI.2025.1215PH000205
Received: 10 November 2024; Accepted: 20 November 2024; Published: 05 December 2025
ABSTRACT
Background:
Hepatitis B virus (HBV) remains a major public health concern in Nigeria, where mother-to-child transmission
(MTCT) contributes significantly to chronic infections. This study evaluated the effectiveness of HBV
PMTCT interventions implemented in Sardauna LGA (2023) and Kurmi LGA (2024) in Taraba State,
comparing screening coverage, prophylaxis uptake, and childhood immunization outcomes across the two
models of care.
Methods:
A descriptive analysis was conducted using programme data from both LGAs, encompassing HBV/HCV
screening among pregnant women, women of childbearing age (CBA), and male partners; initiation of
Tenofovir prophylaxis for HBV-positive pregnant women; and uptake of HBV birth-dose and subsequent
childhood vaccinations. Health worker capacity-building outputs and step-down training outcomes were also
assessed.
Results:
In Sardauna LGA, 2,426 individuals were screened, identifying 99 HBsAg-positive and 34 Anti-HCV-positive
cases; all 56 HBV-positive pregnant women received Tenofovir prophylaxis. Similarly, Kurmi LGA screened
1,435 individuals, identifying 101 HBsAg-positive and 65 Anti-HCV-positive cases, with full prophylaxis
initiation for all 58 HBV-positive pregnant women. Birth-dose vaccination within 24 hours was high in both
LGAs—1,357 infants in Sardauna and 850 in Kurmi—although attrition across the vaccine series persisted,
with only 1,005 and 484 infants completing the pentavalent schedule, respectively. Screening indicators fell
short of five-year EMTCT targets, whereas infant vaccination and health workforce training exceeded
expectations. Step-down training improved health worker knowledge, service readiness, antenatal care uptake,
HBV screening rates, and birth-dose vaccination performance.
Conclusion: The HBV PMTCT interventions demonstrated strong maternal prophylaxis coverage, improved
service availability, and high birth-dose uptake across both LGAs. However, screening coverage for pregnant
women, women of CBA, and male partners remained below targets, and vaccine completion rates showed
notable drop-offs. Strengthening community outreach, improving facility-based deliveries, and enhancing
follow-up systems are critical to achieving HBV EMTCT goals in Taraba State.
Keywords: Hepatitis B, PMTCT, Tenofovir prophylaxis, birth-dose vaccination, immunization dropout,
maternal screening, Taraba State, Nigeria.
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
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Page 2705
INTRODUCTION
Hepatitis B virus (HBV) infection presents a significant global health burden, as highlighted by the World
Health Organization (WHO) in 2023. Chronic HBV infection, particularly in women, poses an increased risk
of mother-to-child transmission (MTCT), a critical pathway for the perpetuation of the disease (Sintusek et al.,
2023). Recognizing this threat, the World Health Assembly in 2016 set forth an ambitious goal to eliminate
viral hepatitis as a public health threat by 2030 with eradicating MTCT of HBV as one of the key pillars.
(WHO, 2020; Kabore et al., 2023). The WHO estimates that as of 2019, approximately 296 million individuals
globally were living with chronic hepatitis B, with an annual incidence of 1.5 million new infections. Out of
this, Africa alone constitutes 63% of the burden, and Nigeria, as the largest country in Africa with a population
of over 220 million people having the largest burden out of the 63% in Africa. This condition is a leading
cause of acute and chronic liver diseases, contributing significantly to the global health burden.
In Nigeria, the prevalence of hepatitis B is notably high, with approximately 8% of the general population and
5.9% of pregnant women affected, as reported by the Nigerian AIDS Indicator and Impact Survey (NAIIS) in
2018. Furthermore, the prevalence of Hepatitis B surface antigen (HBsAg) among children under five years
ranges between 4.1% and 13.5% (FMoH, 2018). Specifically, in Taraba State, a prevalence of 12.8% for
hepatitis B and 4.7% for hepatitis C has been documented (CFID, 2021).
In regions with high endemicity such as Nigeria and particularly Taraba State, HBV transmission
predominantly occurs perinatally or during early childhood. Over the past decade, organizations like CFID and
Chagro-Care Trust have implemented numerous interventions targeting HIV/AIDS, hepatitis B, and C testing
among Pregnant Women, women of child bearing age and their male partners, health care workers, children
between the ages of 0 – 14 years, adolescent and young persons, general and special populations, along with
sexual and reproductive health services across Taraba State, with a focused effort on HBV/PMTCT in
Sardauna and Kurmi Local Government Area (LGAs). The interventions were conducted across secondary and
primary health care facilities and communities. These interventions have revealed program, structural, cultural,
behavioural and health care systems gaps and challenges which affect the goals of achieving the HBV PMTCT
services. This intervention sought to demonstrate HBV and HCV testing of pregnant women at community and
facility-based to achieve PMTCT goals in Taraba State, Nigeria, by comparing the outcomes of interventions
implemented in Sardauna and Kurmi Local Government Areas with the sole goal of identifying the
effectiveness of these interventions and highlight areas that need improvement to better prevent and manage
HBV transmission.
METHODOLOGY
Study Design
A mixed-methods approach was used, combining quantitative data analysis with qualitative interviews.
Study Population:
Quantitative Component: Individuals tested for HBsAg and Anti-HCV in 2023 and 2024, including pregnant
women, women of childbearing age, and male partners.
Qualitative Component: Healthcare workers and traditional birth attendants trained during the project years
(2023-2024).
Data Collection:
Quantitative Data:
Data Source: Maternal and Child Health registers (MCHRs), Hepatitis registers, Client Intake Forms and
project reports from participating facilities in Sardauna and Kurmi LGAs
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
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Page 2706
Variables:
Number of individuals tested for HBsAg and Anti-HCV.
Number of individuals positive for HBsAg, HBeAg, and Anti-HCV.
Number of pregnant women on Tenofovir prophylaxis.
Vaccination data: Number of babies receiving hepatitis B Birth dose Vaccine within 24 hours, vaccinated
after 24 hours, babies who completed their hepatitis B second and third doses, and those who have not
completed their hepatitis B vaccination.
Qualitative Data:
Data Source: Interviews and focus group discussions with healthcare workers, Pregnant Women, Male
partners, communities and the TBAs trained during 2023-2024.
Data Analysis
Quantitative Analysis:
Descriptive statistics were used to summarize the data.
Comparative analysis was performed to assess differences in uptake of care, training of health care workers,
prevalence rates, vaccination coverage, and TDF (prophylaxis) among pregnant women outcomes between
2023 - 2024.
Qualitative Analysis:
Thematic analysis of interview and focus group data to identify key themes and insights regarding training
effectiveness and challenges in HBV management.
Ethical clearance
Ethical clearance was obtained from the National Health Research Ethics Committee of Nigeria,
Federal Ministry of Health with NHREC Protocol Number NHREC/01/01/2007-16/01/2024 and NHREC
Approval Number NHREC/01/01/2007- 22/01/2024. Support letters were acquired from the Taraba state
Ministry of Health. Pregnant women were informed about the study's purpose, and their anonymity and right to
decline. Permission and written informed consent were sought before and during data collection, with consent
provided by CFID’s legally authorized representatives for women aged 15–18 years. Privacy and
confidentiality were ensured through the use of a unique identification number and a separate interview room,
adhering to relevant guidelines and regulations.
RESULTS
Table 1. Summary Data on HBV PMTCT Program 2023 in Sardauna LGA of Taraba State
Descriptio
n
HBsA
g &
Anti-
HCV
Tested
HBsA
g +ve
Ani-
HC
V
+ve
Monovalen
t
Pentavalent
Children
Born in the
facility
monovalent
dose within
24hrs
Children
born
outside
the
facility &
vaccinate
d within
24 weeks
No. of
childre
n who
receive
d their
second
HBV
dose
Numbe
r of
childre
n who
receive
d 3
rd
dose
No. of
children
who
completed
their
pentavalen
t
Pregnant
Women
1789
56
21
1357
572
1231
1029
1005
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
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Page 2707
Women of
CBA
392
15
8
Total number of children born within the project year=1929
Male
Partners
245
28
5
Total
2426
99
34
Table 2. Summary Data on HBV PMTCT Program 2024 in Kurmi LGA of Taraba State
Description
HBsA
g &
Anti-
HCV
Teste
d
HBsA
g +ve
Ani-
HC
V
+ve
On
Tenofovir
Prophylax
is.
Monovale
nt
Pentavalent
Children
Born in
the
facility
monovale
nt dose
within
24hrs
Children
born
outside
the
facility
&
vaccinat
ed
within
24 weeks
No. of
childre
n who
receive
d their
second
HBV
dose
Numb
er of
childre
n who
receive
d 3
rd
dose
No. of
children
who
complete
d their
pentavale
nt
Pregnant
Women
850
58
35
58
850
245
780
680
484
Women of
CBA
317
27
15
0
Total number of children born within the project
year=1095
Male Partners
268
16
13
0
Total
1435
101
65
58
Fig. 1. Hbv Emtct Target Vs Target Achieved In 2023-2024 (Sardauna And Kurmi Lga)
0
1000
2000
3000
4000
5000
6000
7000
Pregnant
women
Women of
child bearing
age
Male partners Training of
HWCs
TBAs&WHDC NO children
who received
HBV Vaccine
HBsAg +ve
Pregnant
women place
on Tenofovir
prophylaxis
6500
5500
4600
470
100
300
1789
392
245
109
17
1929
56
850
317
268
76
11
484
58
2639
709
513
185
28
2413
114
5 years Target Yea1 SDA Year 2 Kurmi Total
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Page 2708
Fig. 2. Step-Down Training For Hcws In Sardauna And Kurmi Lgas 2023-2024
Figure 3.0 Pre And Post Results Of Step Down Training In SDA And Kurmi Lgas 2023-2024
Description of Results
Table 1 shows that a total of 2,426 individuals were screened in Sardauna LGA in 2023, identifying 99 HBV-
positive cases and 34 Anti-HCV-positive individuals, with all 56 HBsAg-positive pregnant women placed on
Tenofovir prophylaxis, while 1,929 births were recorded with 1,357 facility-born infants vaccinated within 24
hours and 572 non-facility births vaccinated within 24 weeks, and 1,231 infants received dose two, 1,029
received dose three, and 1,005 completed the pentavalent schedule, alongside the training of 79 healthcare
workers.
In Kurmi LGA in 2024, 1,435 individuals were screened (Table 2), yielding 101 HBV-positive and 65 Anti-
HCV-positive cases, with all 58 HBsAg-positive pregnant women initiated on Tenofovir, and among the 1,095
births recorded, 850 facility-born infants received the birth dose within 24 hours and 245 non-facility births
were vaccinated within 24 weeks, while 780 infants received dose two, 680 received dose three, and 484
completed the pentavalent series, with 57 healthcare workers trained in the LGA.
Across both LGAs, Figure 1 shows that screenings reached 2,639 pregnant women, 709 women of
childbearing age, and 513 male partners against five-year targets of 6,500, 5,500, and 4,600 respectively, while
0
10
20
30
40
50
60
70
80
20
8
17
19
0
7
8
79
14
4
21
4
2
4
8
57
Step-Down Training for Healthcare workers SDA year 1(2023)
Step-Down Training for Healthcare workers Kurmi Year 2(2024)
0
10
20
30
40
50
60
70
80
90
100
24
16
6
4
8
18
20
79
60
100 100 100
70
80
Before(%) After (%)
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
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Page 2709
2,413 infants received the HBV birth dose compared to a target of 1,000, 114 HBsAg-positive pregnant
women were identified, and workforce strengthening reached 685 healthcare workers and 128 TBAs/WDC
members (Figure 2).
Figure 3 indicates that following step-down training, healthcare workers’ HBV knowledge increased from 24%
to 79%, pregnant women’s knowledge rose from 16% to 60%, availability of HBsAg test kits and prophylaxis
increased from single-digit figures to 100%, pregnant women’s screening rose to 100%, ANC attendance
increased from 18% to 70%, and birth-dose vaccination within 24 hours improved from 20% to 80%.
DISCUSSION OF RESULTS
The findings from the HBV PMTCT programme implemented in Sardauna LGA (2023) and Kurmi LGA
(2024) reveal important progress and persistent gaps in hepatitis B virus (HBV) prevention, maternal health
screening, and childhood immunization coverage. Screening uptake among pregnant women was relatively
high in both LGAs, with 1,789 pregnant women tested in Sardauna and 850 in Kurmi. This aligns with WHO
recommendations for universal HBV screening during antenatal care as a key strategy to prevent mother-to-
child transmission (WHO, 2023). However, the positivity rates observed—56 HBsAg-positive cases in
Sardauna and 58 in Kurmi—underscore the continuing burden of chronic HBV infection among pregnant
women, consistent with national reports indicating medium-to-high HBV endemicity in Nigeria (Oluwole et
al., 2022).
The program also screened women of childbearing age (CBA) and male partners. In Sardauna LGA, 392
women of CBA and 245 male partners were screened, while Kurmi LGA recorded 317 women of CBA and
268 male partners. Although these numbers are lower than the pregnant women screened, they highlight the
need for expanded community-based screening to identify HBV carriers early and interrupt household-level
transmission (Eke et al., 2021).
Positivity for HCV, while lower than HBV, was notable across both LGAs, with 34 positive cases in Sardauna
and 65 in Kurmi. The dual burden of HBV and HCV has implications for maternal and child health outcomes,
given the potential complications associated with co-infections (Adekanle et al., 2020).
A key achievement of the programme was the placement of all HBV-positive pregnant women identified in
both LGAs on Tenofovir prophylaxis—56 in Sardauna and 58 in Kurmi. This demonstrates strong adherence
to national PMTCT guidelines, which recommend Tenofovir for high-risk pregnant women to prevent vertical
transmission (Federal Ministry of Health [FMOH], 2021).
The immunization data further demonstrate variations in childhood vaccine uptake. In Sardauna LGA, 1,357
children received the monovalent HBV vaccine within 24 hours of birth, while 572 children born outside the
facility received the vaccine within 24 weeks. Kurmi LGA showed a similar pattern, with 850 children
vaccinated within 24 hours and 245 vaccinated within 24 weeks. These differences suggest facility delivery
remains an important determinant of early HBV birth-dose administration, consistent with previous findings
that facility-based delivery improves adherence to the birth-dose timeline (Umar et al., 2023).
Completion of the HBV immunization series (second and third doses) revealed attrition across the vaccination
schedule. In Sardauna, 1,231 children received the second dose, 1,029 the third dose, and 1,005 completed the
pentavalent series. In Kurmi, drop-offs were more pronounced, with 780 receiving the second dose, 680 the
third dose, and only 484 completing the pentavalent series. This dropout pattern reflects nationwide challenges
with immunization completion attributed to access constraints, caregiver hesitancy, and inconsistent follow-up
systems (NPHCDA, 2022).
Overall, the programme demonstrated strong implementation of HBV screening and maternal prophylaxis, but
childhood vaccination completion remains suboptimal. These findings highlight the need for intensified
community mobilization, improved tracking mechanisms, and expanded outreach to ensure timely
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
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immunization adherence. Strengthening facility delivery rates and addressing barriers to follow-up vaccination
could significantly reduce vertical and early childhood HBV transmission in these LGAs.
CONCLUSION
In conclusion, the comparative evaluation of Sardauna and Kurmi LGAs shows that targeted investments in
training, commodity availability, and facility-based birth-dose delivery can produce rapid and large gains in
key PMTCT outcomes — notably universal maternal prophylaxis initiation and very high birth-dose coverage
— but that scaling screening, improving male partner engagement, and retaining infants through the full
vaccine series remain pressing priorities. These findings are consistent with national and regional evidence and
point the way to pragmatic, evidence-based adjustments that should accelerate progress toward HBV EMTCT
targets.
RECOMMENDATIONS
1. Strengthen routine HBV screening for pregnant women, women of childbearing age, and male partners
by expanding outreach and integrating testing into all entry points of care.
2. Sustain and scale up Tenofovir prophylaxis for all eligible HBsAg-positive pregnant women, ensuring
uninterrupted drug supply and adherence monitoring.
3. Improve facility-based delivery rates through community sensitization and incentives, as early birth-
dose vaccination was higher among facility deliveries.
4. Enhance early childhood vaccination coverage by ensuring timely administration of the HBV
monovalent birth dose, particularly for children born outside health facilities.
5. Address immunization drop-out rates by implementing reminder systems, defaulter tracking, and
community health worker follow-up to improve completion of the second, third, and pentavalent doses.
6. Increase community awareness on HBV and HCV through targeted behaviour change communication to
reduce stigma and promote preventive behaviours.
7. Strengthen data quality and reporting systems to improve accuracy, completeness, and use of HBV
PMTCT data for decision-making.
8. Integrate partner testing and counselling into maternal health services to reduce household transmission
risks.
Conflicts of interest: All authors – none to declare.
Funding
This intervention was supported by the TY Danjuma Foundation through the Centre for Initiative and
Development (CFID), Taraba State, Nigeria. The TY Danjuma Foundation had no role in the study design,
data collection, analysis, interpretation, or the preparation of this manuscript. The authors retained full access
to all study data and assume final responsibility for the content and the decision to submit this work for
publication.
ACKNOWLEDGMENT:
The authors acknowledge all hospitals/clinics and Communities that participated in the implementation of this
important project.
REFERENCES
1. Musa, B. M., Bussell, S., Borodo, M. M., Samaila, A. A., & Femi, O. L. (2015). Prevalence of hepatitis
B virus infection in Nigeria, 2000–2013: a systematic review and meta-analysis. Nigerian Journal of
Clinical Practice, 18(2), 163–172.
2. WHO (2020). Prevention of mother-to-child transmission of hepatitis B virus: Guidelines on antiviral
prophylaxis in pregnancy. World Health Organization.
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
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3. Adjei, C. A., Asamoah, R., Atibilla, D., Owusu-Agyei, S., & Ameme, D. K. (2021). Uptake of birth dose
hepatitis B vaccine in rural Ghana: Challenges and strategies. BMC Public Health, 21(1), 1-10.
4. Nelson, N. P., Easterbrook, P. J., & McMahon, B. J. (2023). Epidemiology of hepatitis B virus infection
and impact of vaccination on disease. Clinical Liver Disease, 19(1), 1-14.
5. Eke, A. C., Eleje, G. U., Eke, U. A., Xia, Y., & Liu, J. (2019). Hepatitis B immunization in pregnancy:
Effect of knowledge and attitude of antenatal women in Nigeria. BMC Public Health, 19(1), 1-9.
6. Olayinka, A. T., Oyemakinde, A., Balogun, M. S., Ajudua, A., Nguku, P., Aderinola, M., ... & Nasidi, A.
(2016). Seroprevalence of hepatitis B infection in Nigeria: A national survey. The American Journal of
Tropical Medicine and Hygiene, 95(4), 902–907.
7. Federal Ministry of Health, Nigeria (2016). National Guidelines for the Prevention of Mother-to-Child
Transmission of Hepatitis B Virus.
8. CFID. (2021). Report on hepatitis B and C prevalence in Taraba State. www.cfidtaraba.org
9. Federal Ministry of Health (FMoH). (2018). National Hepatitis B and C control guidelines.
10. Hyun, M. H., et al. (2020). "Impact of early HBV vaccination on the prevention of vertical transmission."
Vaccine, 38(3), 465-471.
11. Kabore HJ, Li X, Alleman MM, et al. Progress Toward Hepatitis B Control and Elimination of Mother-
to-Child Transmission of Hepatitis B Virus — World Health Organization African Region, 2016–2021.
MMWR Morb Mortal Wkly Rep 2023;72:782–787. DOI: http://dx.doi.org/10.15585/mmwr.mm7229a2
12. Kabore, H. A., et al. (2023). Viral hepatitis elimination goals. The Lancet.
13. NAIIS. (2018). Nigerian AIDS Indicator and Impact Survey: Technical Report.
14. Prevention of Mother-to-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in
Pregnancy. Geneva: World Health Organization 2020 PubMed/NCBI
15. Sintusek P, Wanlapakorn N, Poovorawan Y. Strategies to Prevent Mother-to-child Transmission of
Hepatitis B Virus. J Clin Transl Hepatol. 2023;11(4):967-974. doi: 10.14218/JCTH.2023.00332.
16. WHO. (2020). Elimination of mother-to-child transmission of hepatitis B. World Health Organization.
17. WHO. (2023). Global hepatitis report. World Health Organization.
18. World Health Organization (WHO). (2021). "Global health sector strategy on viral hepatitis 2016–2021:
towards ending viral hepatitis." Geneva: World Health Organization.
19. Xu, Y., et al. (2019). "Tenofovir prophylaxis for preventing perinatal transmission of hepatitis B virus
infection." Journal of Clinical Virology, 112, 15-20.