The Uganda HIV serobehavioural survey of 2004/2005 sellckchem estimated the prevalence of hepatitis B in northern Uganda to be

between 18.4% and 24.3%, much higher than the national average of 10%,14 while in a recent community-based study in Gulu municipality the prevalence of HBV in the general population was estimated at 17.6%.15 In this study, we report the prevalence of HBV infection among pregnant women attending antenatal care (ANC) at St. Mary’s Hospital Lacor (Lacor) and Gulu Regional referral Hospital using the HBsAg test. We also report HBeAg positivity, a surrogate measure of infectivity among those women who tested positive for HBsAg, and describe the factors associated with HBV infection among these women, with possible implications for testing of pregnant mothers, as well as vaccination of HBV-exposed neonates. Methods Study design and setting This was a cross-sectional study at the Lacor and Gulu regional referral Hospitals. The two hospitals are both in Gulu district in northern Uganda. Lacor hospital is 6 km west of Gulu town; it is a 482 bed capacity teaching hospital16 and a sentinel site for infectious disease surveillance in northern

Uganda, and has a laboratory with the capacity to separate and store frozen plasma. The Lacor Hospital antenatal clinic (ANC) is visited by 50–80 pregnant women per day, Monday through Friday. The Gulu regional referral hospital, on the other hand, is a 250-bed government owned referral facility located in the centre of Gulu town16; the antenatal clinic in Gulu hospital is visited by about 40–60 pregnant women every working day. Study population We included pregnant women attending ANC at the two study hospitals from September 2012 until January 2013, whose gestation age was 28 weeks or more confirmed by clinical history and examination or an obstetric ultrasound scan. We excluded women who had emergency conditions requiring urgent intervention. The two hospitals receive a majority of pregnant women from Gulu district;

however, AV-951 some women attend ANC in other private facilities in the town and health centres. Sample size and sampling method We used the Kish Leslie formula (1965) and a prevalence of HBsAg of 30% for sample size determination, to cater for the North-central Uganda prevalence of about 20%14 and an additional 10% since pregnant women are engaged in unprotected sex, a known risk factor for STIs compared with the general population.17 To cater for the possible incomplete responses, we added 10% of the calculated sample size; hence, 402 participants were recruited. Sampling procedures Women were sampled on two working days a week in the two study hospitals: Lacor on Wednesdays and Fridays, while in Gulu, sampling was done on Mondays and Thursdays.