Screening and linkage to care for medical students with hepatitis B virus infection in Sierra Leone

Abstract

Purpose Hepatitis B virus (HBV) infection is considered a major public health concern for Sierra Leone. Although medical students are at increased occupational risk for HBV infection, little is known about the burden of HBV infection amongst medical students in Sierra Leone. Methods As part of a screening and vaccination campaign, a cross-sectional study on prevalence of HBV among medical students in Freetown was conducted in December 2019. Antigen point of care test was used for HBV screening and data on students' risk history and demographics were collected. Additionally, for students diagnosed positive with HBV, linkage to care and initial assessment data after diagnosis was collected from the HBV clinic they were linked to. Results One hundred and fifty-seven medical students (77.3%) from year three to six were screened for HBV infection. Almost all students (98.1%) had never been vaccinated against HBV and more than half (56.7%) reported a history of needle stick injuries. The prevalence of HBV infection (Hepatitis B surface antigen (HBsAg) positivity) was 10.2% (n = 16). Among HBsAg positive students, 75% (n = 12) were successfully enrolled at chronic HBV clinic within three months of diagnosis. Only one student had evidence of liver cirrhosis and was started on treatment with Tenofovir diproxil fumarate. Conclusion The prevalence of HBV infection is high among medical students in Sierra Leone. Despite the high prevalence, most of the students linked to care had no evidence of severe liver disease.

Prevalence and Burden of Chronic Hepatitis B Virus Infection in Sierra Leone, 1997-2022: Evidence from a 25-Year Systematic Review and Meta-Analysis

“…Most (68%) of the primary studies included in the analysis were rated as having high methodological quality, suggesting a reliable estimate. Our findings are consistent with recent data from Ghana [23], Nigeria [24], Cameroon [25] and other countries in West Africa [26], which have recorded HBV prevalence rates ≥ 8%, in line with WHO's threshold for hyperendemicity [1].…”

Prevalence of Chronic Hepatitis B Virus Infection in Sierra Leone, 1997–2022: A Systematic Review and Meta-Analysis

“…Table 1 outlines the characteristics of the 22 studies included in the meta-analysis. 18 – 39 The total sample size from the 22 studies was 107,186. The individual study sample sizes ranged from 142 to 43,163.…”

Factors Associated with HBsAg Seropositivity among Pregnant Women Receiving Antenatal Care at 10 Community Health Centers in Freetown, Sierra Leone: A Cross-Sectional Study

“…Despite the introduction of HBV vaccination in Sierra Leone in 2009, vaccination is not strictly enforced, and coverage has remained low among adults [13]. In three recent studies among the healthcare workers in Sierra Leone, the HBV vaccination rate ranged from 1.9% to 4.3% [30][31][32]. The universal screening of pregnant women, immunoglobulin prophylaxis and HBV vaccination for exposed newborns and adults lacking immunity could help reduce MTCT transmission rates in Sierra Leone.…”