Seroprevalence of Hepatitis B, Hepatitis C, and Syphilis Antibodies in Premarital Screening Program

• Amna M. Meshari

  Family Medicine Specialist/ Basrah Health Directorate, Abi-Alkhasib Sector for Primary Health Care, Basrah

• Lamis A. Hameed

  Family Medicine, Department of Family and Community Medicine, College of Medicine, University of Basrah.

• Hayat Y. Almousawi

  Family Medicine Specialist and clinical dietician, Al-Mawanni Teaching Hospital

Background: Premarital screening is essential for identifying reproductive, genetic, and infectious diseases to prevent long-term health complications in couples and their future offspring. Specific Background: Infections such as hepatitis B (HBV), hepatitis C (HCV), and syphilis pose serious public health risks, particularly in regions with high endemicity, yet data on their prevalence in premarital populations remain limited. Knowledge Gap: Despite mandatory screening policies, seroprevalence data and associated sociodemographic factors among premarital individuals are underreported. Aim: This study aimed to determine the seroprevalence of HBV, HCV, and syphilis antibodies among individuals undergoing premarital screening and to explore related sociodemographic characteristics. Results: Among 1066 randomly selected participants from Basrah in 2017, the highest prevalence was observed for HBV (0.66/1000), followed by HCV (0.59/1000) and syphilis (0.52/1000). Significant associations were found between all infections and gender and occupation, while HBV was significantly related to residence and syphilis to age. Novelty: This study provides updated, large-scale evidence of low but present infection rates and sociodemographic correlations in a premarital cohort. Implications: Findings support the continuation and refinement of premarital screening programs to guide early interventions, inform public health strategies, and reduce transmission risks to spouses and offspring.

Highlights:

1. Identifies hidden infections in asymptomatic individuals before marriage.

2. Links sociodemographic factors to infection prevalence.

3. Supports targeted public health interventions through early detection.

Keywords: Premarital Screening, Hepatitis B, Hepatitis C, Syphilis, Seroprevalence

[1] N. H. T. Sidabutar and E. N. Hadi, “Premarital Screening: A Catalyst for Achieving Good Health and Well-Being,” Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, vol. 12, 2024.

[2] H. Suresh, S. Jamil, B. K. Padhi, and M. J. Hossain, “Thalassemia Prevention: Religious and Cultural Barriers to Premarital Screening in Bangladesh,” Health Science Reports, vol. 6, p. e1176, 2023.

[3] A. Alhosain, “Premarital Screening Programs in the Middle East, From a Human Right’s Perspective,” Diversity Equality Health Care, vol. 15, pp. 41–45, 2018.

[4] A. A. Al-Balushi and B. Al-Hinai, “Should Premarital Screening for Blood Disorders Be an Obligatory Measure in Oman?,” Sultan Qaboos University Medical Journal, vol. 18, p. e24, 2018.

[5] J. Natarajan and M. A. Joseph, “Premarital Screening for Genetic Blood Disorders—An Integrated Review on the Knowledge and Attitudes of Middle Eastern University Students,” Middle East Fertility Society Journal, vol. 26, p. 19, 2021.

[6] S. AlOtaiby, A. Alqahtani, R. Saleh, A. Mazyad, A. Albohigan, and E. Kutbi, “Comprehension of Premarital Screening and Genetic Disorders Among the Population of Riyadh,” Journal of Taibah University Medical Sciences, vol. 18, p. 822, 2023.

[7] F. M. Alswaidi and S. J. O'Brien, “Premarital Screening Programmes for Haemoglobinopathies, HIV and Hepatitis Viruses: Review and Factors Affecting Their Success,” Journal of Medical Screening, vol. 16, pp. 22–28, 2009.

[8] W. A. Al-Shroby, S. M. Sulimani, S. A. Alhurishi, M. E. Bin Dayel, N. A. Alsanie, and N. J. Alhraiwil, “Awareness of Premarital Screening and Genetic Counseling Among Saudis and Its Association With Sociodemographic Factors: A National Study,” Journal of Multidisciplinary Healthcare, pp. 389–399, 2021.

[9] N. Alhusseini, H. Farhan, L. Yaseen, S. Abid, S. S. Imad, and M. Ramadan, “Premarital Mental Health Screening Among the Saudi Population,” Journal of Taibah University Medical Sciences, vol. 18, pp. 154–161, 2023.

[10] L. F. Y. Alvarado and M. R. A. Pranoto, “Premarital Screening: A Catalyst for Achieving Good Health and Well-Being,” Unpublished Manuscript, 2024.

[11] M. Saffi and N. Howard, “Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review,” Public Health Genomics, vol. 18, pp. 193–203, 2015.

[12] E. H. Rahi, Z. M. H. Al-Hejaj, and A. M. Tiryag, “Nurses' Knowledge of Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study,” Academia Open, vol. 9, pp. 10306–10306, 2024.

[13] I. A. Naqid et al., “Hepatitis B and C Virus Infection Among Couples Undergoing Premarital Screening in Iraqi Kurdistan,” IJID Regions, vol. 14, p. 100492, 2025.

[14] S. A. Mir and B. Alshehri, “Seroprevalence of Hepatitis B and C Viral Infections in the Premarital Adult Population of Al Majmaah, Saudi Arabia,” Malawi Medical Journal, vol. 33, pp. 221–225, 2021.

[15] S. A. Jamal et al., “The Prevalence of Hepatitis B and C Virus in Healthy Women in Zakho City, Kurdistan Region of Iraq: A Brief Report,” J Kermanshah Univ Med Sci, vol. 23, p. e99337, 2019.

[16] N. R. Hussein et al., “Prevalence of HBV, HCV and HIV Infections Among Syrian Refugees in Kurdistan Region, Iraq,” International Journal of Infectious Diseases, vol. 4, p. e39420, 2017.

[17] C. Trépo, H. L. Chan, and A. Lok, “Hepatitis B Virus Infection,” The Lancet, vol. 384, pp. 2053–2063, 2014.

[18] D. Hu, M. Kane, and D. L. Heymann, “Transmission of HIV, Hepatitis B Virus, and Other Bloodborne Pathogens in Health Care Settings: A Review of Risk Factors and Guidelines for Prevention,” Bulletin of the World Health Organization, vol. 69, p. 623, 1991.

[19] H. M. Sabty, S. B. Dawood, and A. M. Tiryag, “Nurses’ Knowledge and Practices on Influenza Vaccination for Pregnant Women,” Jurnal Kebidanan Midwiferia, vol. 10, pp. 50–59, 2024.

[20] R. A. d. A. Pondé, “The Serological Markers of Acute Infection With Hepatitis A, B, C, D, E and G Viruses Revisited,” Archives of Virology, vol. 162, pp. 3587–3602, 2017.

[21] F. A. Jassim, A. M. Tiryag, and S. S. Issa, “Effect of Bad Habits on the Growth of School Students: A Cross-Sectional Study,” Indonesian Journal on Health Science and Medicine, vol. 1, pp. 10–21070, 2024.

[22] H. H. Abdul-Ra’aoof et al., “Moderate Knowledge and Attitudes Toward Tonsillitis Among Nursing Students,” Academia Open, vol. 10, pp. 11323–11323, 2025.

[23] W. Xiong et al., “Preconception Syphilis Seroprevalence and Association With Duration of Marriage and Age Among Married Individuals in Guangdong Province, China: A Population-Based Cross-Sectional Study,” PLOS Neglected Tropical Diseases, vol. 16, p. e0010884, 2022.

[24] S. S. Hamid et al., “A Study Regarding the Basic Anatomy and Physiology of the Eye Among Nursing Students: A Cross-Sectional Study,” Indonesian Journal on Health Science and Medicine, vol. 2, pp. 127–127, 2025.

[25] A. M. Tiryag, “Nurses’ Knowledge and Attitudes Toward Pacemaker: A Cross-Sectional Study,” Academia Open, vol. 9, pp. 8845–8845, 2024.

[26] L. Newman et al., “Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting,” PLOS ONE, vol. 10, p. e0143304, 2015.

[27] A. M. Tiryag and H. H. Atiyah, “Nurses’ Knowledge Toward Bariatric Surgery at Surgical Wards at Teaching Hospitals in Al-Basra City,” Indian Journal of Forensic Medicine & Toxicology, vol. 15, pp. 5152–5159, 2021.

[28] A. Tiryag, “Revitalizing Hearts: The Transformative Impact of Pacemaker Therapy on Cardiac Conduction Disorders,” Academia Open, vol. 9, pp. 10–21070, 2024.

[29] P. Angeleri et al., “Viral Hepatitis and Treponema Pallidum Prevalence in Persons Who Underwent Premarital Blood Tests in Argentina,” Scientific Reports, vol. 9, p. 9611, 2019.

[30] H. Bashour and G. Muhjazi, “Hepatitis B and C in the Syrian Arab Republic,” Eastern Mediterranean Health Journal, p. 267, 2016.

[31] M. M. Hayatbakhsh et al., “Seroprevalence of Hepatitis B Before Marriage: A Study on Marriage Candidates in the Southeast of Iran; Is It Worthy of Consideration?,” Archives of Iranian Medicine, vol. 18, pp. 0–0, 2015.

[32] S. M. Abdullah, “Prevalence of Hepatitis B and C Virus Infection and Their Co-relation With Hematological and Hepatic Parameters in Subjects Undergoing Premarital Screening in the Jazan Region, Kingdom of Saudi Arabia,” Pakistan Journal of Medical Sciences, vol. 34, p. 316, 2018.

[33] H. C. Bilek, A. Deveci, and E. A. Tanyel, “Seroprevalence of Hepatitis A Virus, Hepatitis B Virus, Hepatitis C Virus, and Syphilis Among Human Immunodeficiency Virus-Infected People at a University Hospital, Turkey,” Archives of Medical Science, 2020.

[34] D. S. Alfadhli et al., “Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Infection Among Premarital Screening Individuals in Saudi Arabia,” International Journal of Public Health, vol. 69, p. 1607809, 2024.

[35] F. Esmaeilzadeh et al., “Prevalence of Syphilis Infections Among the Iranian Population: A Systematic Review and Meta-Analysis,” Iranian Journal of Public Health, vol. 51, p. 1513, 2022.

[36] X.-E. Gui et al., “A Comprehensive Prevention Program on AIDS, HBV and Syphilis Among Pregnant Women and Couples Experienced Premarital Medical Examination,” Zhonghua Liu Xing Bing Xue Za Zhi (Chinese Journal of Epidemiology), vol. 31, pp. 873–875, 2010.