Sero-prevalence of hepatitis B among health facility staff in Salima district, Malawi - a cross-sectional study.

BACKGROUND AND AIMS: Hepatitis B (HBV) poses a significant public health challenge in Malawi with a pooled prevalence of 8% in the general population. This study aimed to determine the prevalence of HBV infection among healthcare workers in Salima District, Malawi, and assess the severity of positive cases. METHODS: In September 2020, a cross-sectional study was conducted in all public health facilities across Salima District and screened 854 healthcare workers for hepatitis B virus (HBV) using antigen point-of-care tests. Data on demographics and risk history were collected. Those who tested positive were linked to care, and further assessments were carried out by medical officers. Family members of positive cases were also screened for HBV. Descriptive statistics were used to summarize the data, with categorical variables presented as frequencies and percentages, and quantitative variables as means with standard deviations. The relationship between demographic factors and HBV prevalence was analyzed using unadjusted prevalence ratios (PR). RESULTS: The prevalence of HBV infection among healthcare workers was 2.93% (25 infections, 95% CI: 1.90-4.29%). Infections were more common among males (95% CI: 0.81-5.98%), married participants (95% CI: 0.13-1.07%), and those unvaccinated against HBV. Environmental health personnel (95% CI: 0.78-69.46%) exhibited the highest chronic HBV prevalence. All positive cases were enrolled in the HBV clinic within two weeks of diagnosis, and none had signs of severe liver disease. DISCUSSION: Despite lower prevalence than the general population, HBV infection rates remain concerning among healthcare workers, particularly those in non-clinical roles. The lack of vaccination history is a notable risk factor for infection. CONCLUSION: The study underscores the elevated prevalence of HBV infection among healthcare workers in the Salima District, emphasizing the importance of vaccination and prompt linkage to care.