Integrating Family-centered Screening into HBV Elimination: Outcomes from an EMTCT Program in Ten Nigerian States

Abstract

Aims: To evaluate the outcomes of integrating a family-centered hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and linkage-to-care model into antenatal care (ANC) services as part of an elimination of mother-to-child transmission (EMTCT) program across ten Nigerian states. Study Design: Descriptive programmatic evaluation. Place and Duration of Study: Forty-three health facilities providing ANC services across ten Nigerian states. Methodology: HBV and HCV testing were integrated into routine ANC services for pregnant women and extended to partners and household members. Pregnant women were screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using rapid diagnostic tests. HBV-positive pregnant women were assessed and initiated on tenofovir disoproxil fumarate (TDF) prophylaxis when eligible. HBV-negative household contacts received hepatitis B vaccination. Health workers, peer navigators, and journalists received structured capacity-building training. Descriptive statistics were used to summarize screening coverage, linkage to prophylaxis, vaccination uptake, workforce strengthening, peer navigation outcomes, and community awareness. Results: A total of 116,000 pregnant women and 38,115 partners and household members were screened. All eligible HBV-positive pregnant women were initiated on TDF prophylaxis, achieving 100% uptake. HBV-negative household contacts showed high acceptance of vaccination. Capacity-building activities trained 478 healthcare workers and 600 peer navigators, 70% of whom had lived hepatitis experience. Peer navigators successfully relinked 226 previously diagnosed but untreated individuals to care. Media engagement activities reached an estimated 15–20 million Nigerians with hepatitis prevention messages. Conclusion: Integrating family-centered viral hepatitis screening into ANC platforms is feasible, scalable, and effective in improving testing coverage, linkage to care, prophylaxis initiation, vaccination uptake, and community awareness. This model provides actionable evidence for accelerating EMTCT and HBV elimination efforts in Nigeria.