Burden of Hepatitis B Viral Infection among Workers in a Tertiary Health Institution in Southwestern Nigeria

Abstract

Background: Health care workers (HCWs) are particularly at risk of hepatitis B virus (HBV) infections due to contact with infectious material like contaminated blood and body fluids or contact with HBV contaminated fomites. HBV vaccine is efficient in preventing infection though 5% - 10% of individuals are non-responders. HBV vaccine was introduced into Nigerian childhood immunization services in year 2004. However, routine vaccination of HCWs is often not implemented due to cost in resource limited settings like ours. Therapeutic options are also not affordable and available options do not guarantee complete cure. This study aimed at determining the burden of HBV infection among HCWs in Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Nigeria, in order to institute prompt treatment as a way of curbing HBV spread and disease progression. Materials and Method: This cross-sectional study was conducted between October and December, 2016. Staff from various cadres in EKSUTH, who accepted to participate, was recruited into the study. Following informed consent, 5 mls of blood collected from each participant was screened for HBV markers using HBV serologic combo test kit. Demography and Information on risk factors were collected with questionnaire. Results: A total of 965 participants, of which 323 (33.5%) were males and 642 (66.5%) were females, were recruited. Majority (72.6%) were married. History of unprotected sexual contact and multiple sexual partners was found in 62.3% and 54% of participants, respectively. In this study, 43 (4.5%) were HBsAg positive, out of which 40 (93%) had HBV infection (HBcAb positive). Prevalence of HBV infection was significantly higher among males than females (p value 0.004). Majority (60.5%) of infected individuals were 30 to 49 years of age. All infected participants had no previous vaccination, but no serologic evidence of previous vaccination was seen among vaccinated individuals. Conclusion and Recommendation: We concluded that Hepatitis B virus infection is still high among HCWs and significantly higher among males than females. Vaccinated individuals were found to be HBsAg negative, but had no detectable protective immunoglobulin against HBV. We recommend pre-employment screening and free vaccination of all staff in our health institutions, post vaccination immunization status assessment and provision of standard and affordable treatment for infected individual in order to achieve vision 2030 of HBV eradication.