Weighted prevalence and associated risk factors of hepatitis E virus antibodies among pregnant women in rural Burkina Faso using dried blood spot samples

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AIM: To estimate the weighted prevalence of hepatitis E virus (HEV) antibodies and risk factors among pregnant women in Burkina Faso and to evaluate the efficiency of dried blood spots (DBS) in detecting HEV antibodies. METHODS: We first evaluated the efficiency of DBS detecting HEV antibodies by comparing 62 DBS with matched serum samples using recomWell IgG and IgM kits (Mikrogen Diagnostik). Anti-HEV immunoglobulin G (IgG) and immunoglobulin M (IgM) were identified in 491 DBS samples collected from pregnant women in Burkina Faso using recomWell kits. HEV RNA was tested using HEV nested polymerase chain reaction among HEV-antibodies positive. The survey-weighted method was applied for prevalence calculations and risk factors analysis. RESULTS: The detection of anti-HEV IgG and anti-HEV IgM in DBS samples revealed a sensitivity of 96.7% and 76.7% and a specificity of 100% and 93.8% compared to serum samples, respectively. Among 491 pregnant women tested, the weighted prevalence of anti-HEV IgG was 18.6%, and anti-HEV IgM was 2.5%, with no HEV RNA detected. A significant age-related increase was observed in the prevalence of anti-HEV IgG (p < 0.001), while no significant was found for anti-HEV IgM-positivity (p = 0.1451). Multiparity was significantly associated with anti-HEV IgG-positivity, while women aged 25-34 years were at higher risk of anti-HEV IgM-positivity. CONCLUSION: This study revealed that DBS is a reliable alternative for HEV seroepidemiological studies, especially in resource-limited settings, although further investigation is needed for anti-HEV IgM detection. The weighted prevalence of anti-HEV IgG was 18.6% and anti-HEV IgM was 2.5%, highlighting the ongoing burden of HEV infection, particularly in high-risk groups like pregnant women in rural Burkina Faso.

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