Prevalence of hepatitis B virus and immunity status among healthcare workers in Beira City, Mozambique

Seroprevalence and risk factors of hepatitis B virus infection among healthcare workers in Africa: A systematic review and meta-analysis

BACKGROUND

Healthcare workers are at an increased risk of hepatitis B virus infection due to potential exposure to blood and other infectious materials. The infection can lead to acute liver disease and chronic liver complications such as cirrhosis and liver cancer. It can impact workforce health, leading to absenteeism, and increased healthcare costs. Hence, this study aimed to determine the seroprevalence and risk factors of the hepatitis B virus among healthcare workers in Africa.

MATERIALS AND METHODS

The protocol for this systematic review and meta-analysis was registered on PROSPERO with the registration number CRD42024556654. Literatures were searched from PubMed, Science Direct, HINARI, African Online Journal, Google Scholar, Google, Semantic Scholar, and Directory of Open Access Journals using relevant search terms. The process of searching relevant articles was completed on 1 August 2024. Studies with a quality evaluation indicator score of 50% or above were included in this study. The random effect model was used to measure the pooled seroprevalence and associated factors of hepatitis B virus infection among healthcare workers in Africa. The finding of the meta-analysis was presented using forest plots with a 95% confidence interval.

RESULT

Among 26 studies selected for meta-analysis, 6983 participants were included. The inclusion of 26 studies showed that the pooled prevalence of hepatitis B virus infection among healthcare workers was 17.2% (95% CI: 8.36, 26.04). Healthcare workers diagnosed with liver disease were 5.01 times more likely to having hepatitis B virus infection compared to those who were not diagnosed (POR = 5.01: 95% CI; 2.25,7.77). In addition, healthcare workers who did not receive technical training were 2.70 times more likely to having HBV infection than those who received training (POR = 2.70:95% CI; 1.10, 4.30). Furthermore, healthcare workers aged 40 years and above were 2.53 times more likely to having hepatitis B virus infection than young healthcare workers (POR = 2.53: 95% CI; 1.29,3.77).

CONCLUSION

The pooled prevalence of hepatitis B virus infection was high. Previously diagnosed liver diseases, the absence of technical training, and the age of healthcare workers were the factors influencing the pooled prevalence of HBV infection among healthcare workers. Hence, providing appropriate medical follow-up for healthcare workers diagnosed with liver disease, comprehensive training and education, and early detection and diagnosis of healthcare workers aged 40 years and above are the most important interventions to prevent the risk of hepatitis B virus infection.

Immune response to GeneVac-BⓇ (rDNA I.P. hepatitis B vaccine) in vaccinated persons with a standard schedule in Bobo-Dioulasso, Burkina Faso

Objective

This study aimed to evaluate the immune response in people fully vaccinated against hepatitis B with the GeneVac-BⓇ vaccine in Burkina Faso under actual conditions of use.

Methods

This cross-sectional study included individuals fully vaccinated with GeneVac-BⓇ. For each consenting participant, sociodemographic and clinical data were collected using a structured questionnaire. Approximately 4 ml of whole blood was collected for immunological (anti-HBs, hepatitis B surface antigen, anti-hepatitis C virus, and anti-HIV) and biochemical (blood glucose, total cholesterol, and triglycerides) testing. The anti-HBs titer was used to determine the immune response.

Results

A total of 392 participants were included in the study. The mean age was 35.5 ± 15.3 years. Approximately 56% had been previously exposed to hepatitis B virus. Overall, 380 participants had an anti-HBs titer ≥ 12 mIU/ml indicating a seroprotection rate of 96.9%, and 12 had a titer <12 mIU/ml, a nonresponse rate of 3.1%. Among the nonresponders, 11 (11/12; 91.7%) had high total cholesterol levels (>240 mg/dl), and 8 (8/12; 66.7%) were older than 40 years of age.

Conclusions

The results showed an excellent immune response to GeneVac-BⓇ in our study population. However, age > 40 and high total cholesterol appear to be factors associated with nonresponse.

Hepatitis B in Healthcare Personnel: An Update on the Global Landscape

Despite the outstanding progress that has been made in the prevention, detection, and management of hepatitis B during the past decades, hepatitis B remains a problem among healthcare personnel (HCP) in many countries. We reviewed studies on all aspects of hepatitis B in HCP published from 2017 through April 2023. They revealed wide variations on the prevalence of infection among HCP, ranging from 0.6% in Europe to >8.7% in Africa, almost always in association with very low vaccination rates. Many studies found a significant association between HCP's knowledge about hepatitis B and hepatitis B vaccines, their vaccination status, and practices. This research also discloses global inequities regarding vaccination policies against hepatitis B, free-of-charge vaccinations, and access to post-exposure prophylaxis (PEP). Strategies to prevent and manage accidental exposures are needed in order to reduce the burden of hepatitis B on HCP, while written policies for all aspects of infection prevention, protective equipment, and PEP should be available. Lastly, HCP should be accordingly educated. These are all imperative given the decline of routine vaccinations in the COVID-19 era, particularly in countries with fragile vaccination programs, and the disruptions of interventions for hepatitis B that are expected to provide a pool of virus transmission to future generations.

Hepatitis B virus infection status and associated factors among health care workers in selected hospitals in Kisumu County, Kenya: A cross-sectional study

Poorly managed medical waste produced at the health facilities are potential source of infections including occupational exposure to Hepatitis B Virus (HBV). This study evaluated the prevalence of HBV infection among healthcare workers (HCWs) in Kisumu County. We determined prevalence of HBV infections among 192 HCWs from nine purposively selected high-patient volume public hospitals in Kisumu County. A structured questionnaire was administered, and 4.0 ml of venous blood sample collected for Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and total hepatitis B core antibody (anti-HBc) testing using enzyme immunoassay (EIA). Of 192 HCWs sampled, 52.1% were males and the median participants age was 34.4 years with interquartile range (IQR) of 11 (28-39) years. Most participants (44%) had worked for between 1-5 years. There was low HBV vaccine uptake with 35.9% completing the required 3 doses, while 40.6% had never been vaccinated. HBV prevalence was 18.8% (36/192), prevalence of past resolved infection was 25.5% (49/192), while 37.5% (72/192) of HCW had evidence of vaccine-derived immunity and 17.7% (34/192) were susceptible. HBV prevalence among HCW who had worked for less than one year and those who had never been vaccinated was 37.5% and 35.9% respectively. Significant risk of HBV lifetime exposure was noted among HCWs with one vaccine dose, those with no known exposure, while highest in those with knowledge on HBV transmission (aOR, 7.97; 95% CI, 2.10-153.3, p-value = 0.008). HCWs who had received ≥2 doses of HBV vaccine (aOR, 0.03; 95% CI, 0.01-0.10, p-value = <0.0001) had significant HBV protection. Duration of service was not associated with HBV among HCWs. HBV prevalence was high among HCWs from nine high patient volume public hospitals in Kisumu County. Efforts to strengthen HBV vaccination uptake and dose completion are needed to reduce HBV infections among HCWs.