@article{Ndiaye:2026:10.2471/BLT.25.294507,
author = {Ndiaye, A and Motyl, F and Drammeh, S and Dibba, B and Famiglietti, A and Whittaker, M and Jean, K and Lemoine, M and Boyer, S and Kania, D and Guingané, AN and Hashimoto, N and Tanaka, Y and Sugiura, W and Murray, K and Vandi, C and D'Alessandro, U and Guivel-Benhassine, F and Da, Conceicao H and Pakula, G and Ndow, G and Shimakawa, Y},
doi = {10.2471/BLT.25.294507},
journal = {Bull World Health Organ},
pages = {301--314},
title = {Carbon emissions associated with antenatal testing for hepatitis B prophylaxis eligibility, the Gambia.},
url = {http://dx.doi.org/10.2471/BLT.25.294507},
volume = {104},
year = {2026}
}

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TY  - JOUR
AB  - OBJECTIVE: To estimate the carbon footprint of three diagnostic strategies to identify pregnant women eligible for antiviral prophylaxis to prevent hepatitis B vertical transmission in the Gambia. METHODS: In 2024, we conducted a life cycle assessment of a point-of-care polymerase chain reaction (PCR) test using plasma, and a rapid diagnostic test for hepatitis B core-related antigen (HBcrAg) using plasma and capillary blood across three hospitals (rural, suburban and urban) and a suburban health centre. We included all products and processes in each diagnostic strategy. The functional unit was an antenatal testing episode assessing eligibility for antiviral prophylaxis, beginning after positive hepatitis B surface antigen screening. We estimated carbon emissions in grams of carbon dioxide equivalent (g CO2e) ± uncertainty. FINDINGS: Mean carbon emissions per strategy were significantly different between point-of-care PCR and the rapid diagnostic tests (P-value: 0.028): 1619.0 ± 200.6 g CO2e (PCR), 520.4 ± 59.1 g CO2e (plasma-based rapid diagnostic test) and 374.3 ± 50.4 g CO2e (capillary-based test). Higher emissions with the PCR test were mainly driven by its reliance on air conditioning (759.1 g CO2e compared with 125.2 g CO2e for plasma-based rapid diagnostic test and 24.3 g CO2e for capillary-based test); the test itself (290.0 g CO2e versus 129.0 g CO2e for rapid diagnostic tests); and PCR-specific requirements including diagnostic device (47.0 g CO2e) and additional patient travel to collect results (255.8 g CO2e). CONCLUSION: Our findings suggest that HBcrAg rapid diagnostic tests can reduce emissions substantially compared with point-of-care PCR. Our study demonstrates that life cycle assessments are feasible in resource-constrained settings and highlights the importance of integrating sustainability into
AU  - Ndiaye,A
AU  - Motyl,F
AU  - Drammeh,S
AU  - Dibba,B
AU  - Famiglietti,A
AU  - Whittaker,M
AU  - Jean,K
AU  - Lemoine,M
AU  - Boyer,S
AU  - Kania,D
AU  - Guingané,AN
AU  - Hashimoto,N
AU  - Tanaka,Y
AU  - Sugiura,W
AU  - Murray,K
AU  - Vandi,C
AU  - D'Alessandro,U
AU  - Guivel-Benhassine,F
AU  - Da,Conceicao H
AU  - Pakula,G
AU  - Ndow,G
AU  - Shimakawa,Y
DO  - 10.2471/BLT.25.294507
EP  - 314
PY  - 2026///
SP  - 301
TI  - Carbon emissions associated with antenatal testing for hepatitis B prophylaxis eligibility, the Gambia.
T2  - Bull World Health Organ
UR  - http://dx.doi.org/10.2471/BLT.25.294507
UR  - https://www.ncbi.nlm.nih.gov/pubmed/42058608
VL  - 104
ER  - 

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