Viral Hepatitis B and C Detection among Ebola Survivors and Health Care Workers in Makeni, Sierra Leone

Nadege Goumkwa Mafopa,Béatrice Dambaya,Carla Montesano,Judith Torimiro,Alexis Ndjolo,Georges Teto,Antonella Minutolo,Raoul Emeric Guetiya Wadoum,Vittorio Colizzi,Claude Kwe Yinda,Marta Giovanetti,Gianluca Russo,Patrick Turay,Georgia Ambada

doi:10.4236/jbm.2020.810003

Abstract

Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.

Highlights

World Health Organization reports that mortality due to viral hepatitis has increased by 63% since the years 1990 and is ranked the seventh leading cause of mortality worldwide
The Loreto clinic and Holy Spirit hospital were our partners within the framework of implementing routine health care service for Ebola survivors and health care workers (HCWs) living in areas with poor medical coverage during the outbreak
Age and educational level of Ebola survivors were taken from the questionnaire used in our previous study on “Seroprevalence of Ebola virus infection in Bombali District, Sierra Leone” [26]

Summary

Introduction

World Health Organization reports that mortality due to viral hepatitis has increased by 63% since the years 1990 and is ranked the seventh leading cause of mortality worldwide. Viral hepatitis is responsible for approximately 1.34 million deaths yearly in the world. It is reported worldwide that hepatitis B virus (HBV) and hepatitis C virus (HCV) account for the most viral hepatitis morbidity and mortality infections, with Sub-Saharan Africa bearing a substantial portion of the global burden of these infections. Reports state that the global HCV seroprevalence is between 2% and 3%, with an estimated of 71.1 million patients with active viraemia. A recent meta-analysis suggested an overall HCV seroprevalence of 2.98% in Sub-Saharan Africa [2] [3]. In 2002, Valsa and collaborators [4] reported that central African region has the highest estimated prevalence of 6%; West Africa has an estimated prevalence of 2.4%, and southern and east Africa with the lowest estimated prevalence of 1.6%

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