Antenatal Hepatitis B screening in pregnancy: Prevention of mother-to-child transmission strategy in Kedah, Malaysia.

INTRODUCTION: Hepatitis B virus remains a major global public health concern, with mother-to-child transmission contributing substantially to chronic infection, cirrhosis and hepatocellular carcinoma. In 2019, the Ministry of Health Malaysia initiated pilot universal antenatal hepatitis B screening in four selected states, namely Kedah, Pahang, Terengganu and Sabah, to strengthen prevention of motherto- child transmission (PMTCT). This study reviewed the implementation of the PMTCT hepatitis B pilot project in Kedah by evaluating the transmission rate of HBV to infants, antenatal screening coverage of HBV and the prevalence of hepatitis B among pregnant mothers. MATERIALS AND METHODS: A cross-sectional review of secondary data was conducted using programme registers from 17 participating health clinics in Kedah. Data were extracted and analysed. The key outcomes were antenatal screening coverage, maternal HBsAg prevalence and mother-to-child transmission rate. RESULTS: A total of 54,682 antenatal attendees were screened for HBV during the study period, giving an overall screening coverage of 95.8%. Maternal HBsAg prevalence was 0.16%, with 92 confirmed HBsAg-positive mothers. Of these, 91 were referred for further assessment and 83 received antiviral therapy during pregnancy. Among exposed infants with documented follow-up, no HBsAg-positive cases were detected, resulting in a mother-to-child transmission rate of 0%. CONCLUSION: Overall, the mother-to-child transmission rate of the pilot project in Kedah was satisfactory at 0% among antenatal mothers who were treated and completed the follow-up plan. In addition, the prevalence of HBV among antenatal mothers was relatively low at 0.16%, with high HBV screening coverage of 95.8% among antenatal attendees.