Cross sectional study of chronic hepatitis B prevalence among healthcare workers in an urban setting, Sierra Leone.

Abstract

INTRODUCTION:

Hepatitis B is a serious public health problem across sub-Saharan Africa. Sierra Leone has no national hepatitis B strategy plan or high quality estimates of prevalence. Healthcare workers are perceived as an at-risk group for hepatitis B. We assessed the prevalence of hepatitis B among healthcare workers at two hospital sites in Freetown, Sierra Leone.

METHODS:

In October 2017, healthcare workers were offered voluntary testing for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc), hepatitis B e antigen (HBeAg) and hepatitis B e antibody (anti-HBe) using rapid lateral flow assay for all samples, followed by Enzyme Immunosorbent Assay to confirm positive results. Participants completed a questionnaire about knowledge, attitudes and practices concerning hepatitis B. HBsAg positive participants were invited to a clinic for further assessment.

RESULTS:

Overall, 447 participants were tested for hepatitis B. Most (90.6%, 405/447) participants were nurses, 72.3% (323/447) were female and 71.6% (320/447) were 30 years or older. The prevalence of chronic hepatitis B (HBsAg positivity) was 8.7% (39 / 447, 95% CI 6.3-11.7%). There was no significant difference in prevalence by sex, age group, site of work or type of job. None of the 66.7% (26 / 39) of participants with chronic hepatitis B who attended the clinic met the 2015 WHO criteria to start treatment for hepatitis B on the basis of cirrhosis. Most participants (96.9% 432 / 446) stated that they were worried about their risk of hepatitis B at work.

CONCLUSIONS:

Hepatitis B is highly prevalent among healthcare workers in Sierra Leone. It is unclear whether this reflects high community prevalence or is due to occupational risk. No participants with chronic hepatitis B needed to start treatment. In order to achieve the WHO target of elimination of viral hepatitis by 2030, introduction of birth dose vaccine for infants and catch-up vaccines for healthcare workers and healthcare students, together with a national hepatitis B screen and treat programme is advisable for Sierra Leone.

• Authors: Thomas A Massaquoi, Rachael M Burke, Guang Yang, Suliaman Lakoh, Stephen Sevalie, Bo Li, Hongjun Jia, Lei Huang, Gibrilla F Deen, Fenella Beynon, Foday Sahr
• Journal: PloS one (PLoS One) Vol. 13 Issue 8 Pg. e0201820 ( 2018) ISSN: 1932-6203 [Electronic] United States
• PMID: 30096162 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral

Topics

• Adult
• Antibodies, Viral (blood)
• Cross-Sectional Studies
• Female
• Health Personnel
• Hepatitis B, Chronic (epidemiology)
• Humans
• Male
• Prevalence
• Sierra Leone (epidemiology)
• Urban Population