Seroprevalence of Hepatitis B Virus and Associated Factors among Health Professionals in University of Gondar Hospital, Northwest Ethiopia

Prevalence of hepatitis B virus surface antigen, associated risk factors, and liver enzyme abnormalities among individuals with diabetes in Aksum town public hospitals, Tigray, northern Ethiopia

Introduction

hepatitis is an inflammatory disease of the liver; it is a major threat to public health and is more prevalent worldwide. Hepatitis B virus (HBV) is the leading cause of cirrhosis and hepatocellular carcinoma (HCC) with increasing mortality and burden of disease particularly in Asia and sub-Saharan Africa. Therefore, this study intended to assess the prevalence of HBsAg, associated risk factors, and liver enzyme abnormalities among individuals with diabetes mellitus (DM) in Aksum town public hospitals, Tigray, northern Ethiopia.

Methods

a hospital-based cross-sectional study was conducted among 359 randomly selected individuals with diabetes mellitus in public hospitals of Aksum town from February 10 to May 10, 2021. A pre-tested structured questionnaire was used to collect the data. Data was entered into Epi-Data version 3.1 and analysis was made using the statistical software SPSS version 21 for Windows. Bivariate and multivariate Logistic regression model was applied to show association between the dependent and independent variables; P <0.05 and 95% confidence interval was considered for statistical significance.

Results

in this study, 359 individuals with DM were included with a mean age (mean ± SD) of 46.44 ±16.58 years. The percentage of female participants was 44.3% (159/359). The prevalence of HBsAg among individuals with diabetes mellitus in Aksum town public hospitals was 12.8% (95% CI:8.9-17.0%). The associated risk factors were being employed [AOR:13.38, 95% CI 2.79-64.11; p<0.05], having history of multiple sexual partner [AOR:3.49, 95% CI 1.33-9.12; p<0.05], having history of body incision or piercing [AOR:3.80, 95% CI 1.12-12.90; p<0.05], liver enzyme abnormalities [AOR:6.90, 95% CI 2.17-21.94; p<0.005], and being single and widowed in marital status [AOR:4.42, 95% CI1.62-12.07; p<0.05].

Conclusion

based on the HBsAg positivity, the prevalence of HBV among individuals with diabetes mellitus in this study area was high, as compared to the national findings. Therefore, integrated efforts should be made at the community and health facility level to raise awareness of the associated risk factors, and reduce the spread of HBV; targeted screening of HBV among people with diabetes is also important to minimize liver abnormalities.

Seroprevalence of hepatitis B, C, and its associated risk factors among clinically suspected patients attending poly and Maraki Health Centers, Gondar City, North West Ethiopia

Background

Hepatitis B and C viruses are major global health problems with a high mortality rate, mostly due to serious liver diseases such as liver cirrhosis, liver failure, and hepatocellular carcinoma. The objective of this study was to determine the prevalence of the hepatitis B and C viruses and associated risk factors among clinically suspected patients attending Poly and Maraki Health Centers in Gondar City.

Methods

An institution-based cross-sectional study was conducted to recruit 422 clinically suspected patients attending Poly and Maraki Health Centers between June and August 2020. The blood sample was tested for hepatitis B surface antigen and anti-Hepatitis C virus antibodies using commercially available rapid test kits. We used logistic regression and chi-square analysis to assess factors associated with Hepatitis B virus and Hepatitis C virus infections.

Results

The overall prevalence of hepatitis B surface antigen and anti-Hepatitis C virus antibodies was 29 (6.9%) and 5 (1.2%), respectively. The prevalence of Hepatitis B virus and Hepatitis C virus was found to be significantly higher at Maraki Health Center. Multiple sexual partners (adjusted odd ratio (AOR = 12.299; 95% CI = 2.515-60.142), history of delivery by traditional birth attendants (AOR = 6.284; 95% CI = 2.373-16.637), surgical history (AOR = 3.679; 95% CI = 1.009-13.417), previous hepatitis infections (AOR = 10.374; 95% CI = 1.128-95.444), and upper abdominal pain (AOR = 3.382; 95% CI = 1.215-9.414) were significantly associated with an increased risk of Hepatitis B virus infections. On the other hand, a history of blood transfusion (AOR = 43.132; 95% CI = 1.385-1343.176) and a history of kidney dialysis (AOR = 71.199; 95% CI = 2.074-2444.646) were significantly associated with Hepatitis C virus infection.

Conclusions

According to the WHO endemicity classification, the prevalence of the hepatitis B virus was intermediate, while that of the hepatitis C virus was low. Therefore, it is necessary to strengthen the efforts to control and prevent Hepatitis B virus and Hepatitis C virus infections.

Prevalence of Hepatitis B Virus, Human Immune Deficiency Virus and Associated Risk Factors Among Individuals with Presumptive Pulmonary Tuberculosis Attending at Saint Peter's Specialized Hospital, Addis Ababa, Ethiopia

Background

Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and tuberculosis are the causes of widely spread infectious disease, especially in resource-limited countries. The extent of HBV infection and its contributing factors among people with suspected pulmonary tuberculosis (PTB) were not adequately addressed.

Objective

To assess the prevalence of HBV, HIV & their associated risk factors and the magnitude of TB among individuals with presumptive pulmonary tuberculosis attending at St. Peter's Specialized Hospital, Addis Ababa, Ethiopia.

Methods

A cross-sectional study was conducted among 387 individuals with presumptive PTB from October to December 2020. A standard questionnaire was used to collect socio-demographic data and associated risk factors. Sputum samples were analyzed by GeneXpert, Florescent Microscopy and Ziehl-Nelson staining technique. HBsAg test was carried out using Murex Version 3 ELISA test kit from serum/Plasma samples, HIV testing was performed by rapid HIV test kits and data were analyzed using SPSS version 23.

Results

The mean age of study participants was 44.2 years. Overall, 14 (3.6%), 28 (7.2%) and 37 (9.6%) of them were positive for HBV, HIV & TB, respectively. Only single patient was HBV-HIV co-infected (0.3%). The TB-HIV co-infection was identified in 6 (1.6%). In multivariate analysis, being partner separated, alcohol consumption, body piercing and having multiple sexual partners were significantly associated with HBV infection. Having a spouse, who is divorced, widowed, sharing scissors, alcohol consumption and contact with multiple sexual partners also significantly associated with HIV infection.

Conclusion

This study showed that HBV, HIV and TB are still public health issues that need awareness and health education on the risky behaviors and transmission of HBV, HIV & TB among individuals with presumptive TB suspects. Further large-scale study is necessary.

Cost-effectiveness analysis of current non-mandatory hepatitis B vaccination coverage vs expanding coverage among healthcare workers in Ethiopia

BACKGROUND

Ethiopia is a country with high endemicity in Hepatitis B (HepB) virus infection. However, only 14% of healthcare workers (HCWs) are currently immunized via a non-mandatory strategy in the country. Hence, this study aimed to estimate the cost-effectiveness of the current vaccination coverage and increasing coverage among HCWs in Ethiopia.

METHODS

Based on current practice, the study considered a monovalent HepB vaccine, which has a 90% protection rate with a complete three-dose series for lifelong protection. Markov model for current coverage (14%) and expanding vaccination coverage to 80% (as per World Health Organization (WHO) recommendation) was simulated based on the data got from both primary and secondary data. Secondary data, particularly cost and effectiveness data, were gained from published articles, WHO guidelines, and Ethiopian Federal Ministry of Health documents. Cost-related data for vaccination and chronic HepB treatment were also gathered by interviewing expertise from Tikur Anbesa specialized hospital. We conducted the study from a healthcare payer perspective, with a 3% discount rate of cost and health outcome as recommended by the WHO. The primary health outcome was measured by the Incremental Cost-Effectiveness Ratio (ICER). We employed deterministic analysis and tornado diagrams to manage parameter uncertainty and show a plausible range of cost and effectiveness of variables.

RESULTS

Current vaccination program is more expensive (USD 29.99) with a more additional cost of USD 1.32 and with reduced effectiveness of 0.08 Life Years (LYs) compared to the expanded HepB vaccination strategy which costs USD 28.67 and gives a relatively high total LY gain of 28.62. The resulting ICER was USD-16.23 per LYs gained. The negative ICER shows that the expanded HepB vaccination strategy dominated the current vaccination strategy. A one-way sensitivity analysis also revealed that the current vaccine coverage was dominated by an increase in the risk of infection among unvaccinated individuals.

CONCLUSIONS

Expanded vaccination coverage (to 80%) was found the most cost-effective strategy in Ethiopian HCWs compared to the current non-mandatory vaccine coverage (14%). In addition, the results of one-way and two-way sensitivity analysis reveal the robustness of our model conclusion.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Female Sex Workers Using Respondent-Driven Sampling in Hawassa City, Ethiopia

BACKGROUND

Female sex workers (FSWs) are a marginalized group having limited healthcare access and poor-quality care. Inevitably, they are vulnerable to sexually transmitted infections including hepatitis B virus. It is one of the most serious and major public health problems, with an increased risk of transmission and acquisition of the infection. Hence, this study was aimed to assess the prevalence and associated factors of HBV infection among FSWs in southern Ethiopia.

METHODS

A cross-sectional study was conducted from November to February 2019 at Hawassa city among ISHDO confidential clinics among 383 FSWs using respondent-driven consecutive sampling techniques to select study participants using a standardized questionnaire. The blood samples were collected to detect viral surface antigen using ELISA. Data were entered into SPSS version 21. Descriptive and logistic regression analysis was used.

RESULTS

The overall prevalence of HBV was 35 (9.2%) (95% CI=6.3-12.1). Among 381 FSWs, 249 (65.4%) of them had stayed for 2-5 years in sexual work. A total of 240 (63%) of them used condoms consistently during sexual practice. In multivariate analysis, FSWs who did not use a condom during sexual practice were 6-times more at risk than those who used a condom (AOR=6.38, CI=2.04-18.51). Condom breakage (AOR=2.10, CI=1.95-4.65), use of stimulants (AOR=3.25, CI=1.59-18.63), history of STI (AOR=2.15, CI=1.02-6.93), and genital ulcer (AOR=4.64, CI=1.31-11.35), number of sexual partners (AOR=3.25, CI=1.59-7.47), sex during menses (AOR=5.85, CI=1.29-21.44), sexual assault (AOR=2.93, CI=1.23-9.01), sharp material sharing (AOR=4.98, CI=1.34-10.95), and history of abortion (AOR=2.46, CI=1.18-12.19) were statistically associated with HBV infection.

CONCLUSION

The prevalence of HBV infection in this study was relatively high compared to the general population. Factors like sociodemographic, behavioral, and previous information were associated with HBV infection. There is a need for ongoing screening of this high-risk population to inform planning for vaccination and preventive measures.

Hepatitis B Vaccination Status and Associated Factors Among Healthcare Professionals Working in Health Centers at Akaki Kality Subcity of Addis Ababa, Ethiopia: A Cross-Sectional Study

Background

People at high risk for hepatitis B virus include healthcare workers in contact with blood and human secretions. Hepatitis B virus is unique compared to other sexually transmitted infections because a highly efficacious vaccine exists. However, there have been few studies conducted around the vaccination status of hospital healthcare workers in Ethiopia. Little is known about vaccination penetration among healthcare professionals working in health centers in Ethiopia.

Objective

To assess hepatitis B vaccination status and associated factors among healthcare professionals working in health centers of Akaki Kality, Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted. Using simple random sampling, 528 healthcare workers were selected. Data were collected using a pre-tested, structured self-administered questionnaire. Data were entered into Epi-data and analyzed using SPSS version 20. Multivariable binary logistic regression analysis was used to identify the significant associations. Adjusted odds ratios were computed to measure the strength of association, with statistical significance considered at p< 0.05.

Results

Among 505 respondents, only 244 (48%) had ever received a hepatitis B vaccine. Monthly income, religion, age, working unit and educational level were found to be statistically associated with vaccinated status.

Conclusion

This study showed that the percentage of healthcare professionals who had received a hepatitis B vaccination was very low. This is a serious public health concern and a challenge for a country with high prevalence of hepatitis B infection. There is a need to promote hepatitis B screening and vaccination among healthcare professionals. The government must play its part by increasing healthcare budgets and prioritize hepatitis B prevention by establishing a national awareness campaign, and making screening and vaccination services available at all public health centers.

Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

The hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia.

METHODS

Studies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed.

RESULTS

A total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p < 0.001), educational level of diploma and below (p = 0.003), health care providers who received training on infection prevention (p < 0.001), and those who had a history of exposure to blood and body fluids (p = 0.001), were factors significantly associated with full-dose hepatitis B virus vaccination.

CONCLUSION

The national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine.

Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Occupational exposure to blood and body fluids is a major risk factor for the transmission of blood-borne infections to healthcare workers. There are several primary studies in Ethiopia yet they might not be at the national level to quantify the extent of occupational blood and body fluid exposures (splash of blood or other body fluids into the eyes, nose, or mouth) or blood contact with non-intact skin among the healthcare workers. This systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational blood and body fluid exposure of healthcare workers in Ethiopia.

METHODS

PubMed, Science Direct, Hinari, Google Scholar, and the Cochrane library were systematically searched; withal, the references of appended articles were also checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effects meta-analysis model was used to estimate the lifetime and 12-month prevalence of occupational exposure to blood and body fluids among healthcare workers in Ethiopia.

RESULTS

Of the 641 articles identified through the database search, 36 studies were included in the final analysis. The estimated pooled lifetime and 12-month prevalence on occupational exposure to blood and body fluids among healthcare workers were found to be at 54.95% (95% confidence interval (CI), 48.25-61.65) and 44.24% (95% CI, 36.98-51.51), respectively. The study identified a variation in healthcare workers who were exposed to blood and body fluids across Ethiopian regions.

CONCLUSION

The finding of the present study revealed that there was a high level of annual and lifetime exposures to blood and body fluids among healthcare workers in Ethiopia.

An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia

Background

Hepatitis B virus is one of the major public health concerns globally. It is highly infectious and can be transmitted from person to person through vertically or horizontally via contaminated body fluids. Despite the provision of an effective vaccine, it remains a major problem worldwide, particularly among the developing countries.

Methods

Online electronic databases including PubMed, Google Scholar, Science Direct, African Index Medicus, African Journals Online, and WHO Afro Library were searched and published articles from 2010 to June 8, 2019, were considered. Both authors independently screened articles and extracted the data. Funnel-Plots and Egger’s test statistics were used to determine the presence of small-study effects and publication bias. The pooled prevalence of HBV was analyzed using the random-effects model. The possible sources of heterogeneity was analyzed through subgroup analysis, sensitivity analysis, and meta-regression.

Results

The overall pooled prevalence of HBV was 6% and among subgroups, pregnant women, healthcare workers, and HIV positive patients accounted for 5% for each group. Relatively low prevalence (4%) was obtained among blood donors. The Egger’s test statistics (p = 0.747) indicated the absence of publication bias. In addition, from the sensitivity analysis, there was no influence on the overall effect estimate while removing a single study at a time. The level of heterogeneity was reduced among pregnant women, HIV positive and studies with unknown sampling techniques. After conducting meta-regression, province, study group, screening method, and quality of papers were identified as sources of heterogeneity.

Conclusions

The overall pooled prevalence of HBV in Ethiopia was high. Strengthening and scaling up of the scope of the existing vaccination program and implementing novel approaches including screen-and-treat could be implemented to reduce the burden of the disease. Generally, the study can provide current prevalence estimate of HBV that could vital for intervention to tackle the disease.

Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids.

OBJECTIVE

The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia.

METHODS

This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software.

RESULTS

The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively.

CONCLUSIONS

The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.