Objective
We assessed the epidemiological impact and cost-effectiveness of antenatal hepatitis B virus (HBV) screening and tenofovir prophylaxis in primary healthcare centres (PHCs) in Burkina Faso, evaluating two laboratory-based strategies for identifying pregnant women eligible for tenofovir prophylaxis: HBV DNA ≥200,000 IU/mL, or hepatitis B e antigen (HBeAg)-positive, and two simplified strategies: positive for an alternative rapid diagnostic test (RDT) to detect HB core antigen (HBcrAg), and Prophylaxis for All HBV-positive women.
Methods
We assessed costs from the Burkina Faso government’s perspective, including costs of interventions, HBV vaccination, and care for advanced HBV disease. We used a deterministic compartmental dynamic model to assess, first, the epidemiological impact of the strategies implemented from 2024 to 2124, and, second, the health impact over a 100-year horizon of the strategies implemented only in 2024, to determine their cost-effectiveness. The baseline strategy was the current HepB-BD administration alongside HepB3. The cost-effectiveness threshold was half of 2022 GDP per capita (US$416.5) and the discount rate was 3%. We conducted deterministic and probabilistic sensitivity analyses.

hepatitis B, mother-to-child transmission, Africa, screening, treatment, modelling, cost-effectiveness