World Hepatitis day 2021 –screening and vaccination against Hepatitis B virus in Accra, Ghana

Abstract

Background In Ghana, Hepatitis B virus (HBV) infection remains a major public health threat as in many parts of the world. Even with an effective vaccine, there are shortfalls with low vaccine coverage among adults. To create awareness and encourage vaccination, community engagement and public-private partnerships are needed in endemic settings to help fund campaigns and offer screening and vaccinations at no cost to under privileged people. Objectives An awareness and screening exercise was scheduled by University of Ghana-based Hepatitis-Malaria (HEPMAL) project team to coincide with the World Hepatitis Day (WHD) 2021. It was to engage the community in creating awareness of the menace and offer diagnostic services to ascertain prevalence levels and provide needed clinical support. Methods Participants from the University of Ghana community and its immediate environs were registered, taken through pre-counselling sessions where they were educated on hepatitis transmission and prevention before consenting. Eligible participants were screened for HBV markers (HBsAg, HBeAg, HBsAb, HBcAb,HbcAg) with a rapid test kit. All HBsAb-negative participants were recommended for initial vaccination at the event, whilst the subsequent shots were administered at the University Hospital Public Health Department. Hepatitis B surface Antigen-positive participants were counselled and referred for appropriate care. Results / Outcomes: A total of 297 people, comprising of 126 (42%) males and 171 (58%) females aged between 17 and 67 years were screened during the exercise. Amongst these, 246 (82.8%) showed no detectable protective antibodies against HBV and all of them agreed to and were given the first dose HBV vaccine. Additionally, 19 (6.4%) individuals tested positive for HBsAg and were counselled and referred to specialists from the University Hospital for further assessment and management. We found that 59 (19.9%) of our participants had previously initiated HBV vaccination and had taken at least one dose of the vaccine more than 6 months prior to this screening, 3 of whom tested positive for HBsAg. For the three-dose HBV vaccines deployed, a little over 20% (50/246) and a further 17% (33/196) did not return for the second and the third doses respectively, resulting in an overall 66% (163/246) of persons who completed all three vaccinations. Conclusions / Lessons learnt: Our medical campaign exercise established an active case prevalence rate of 6.4% and achieved a full vaccination success rate of 66% which is critical in the induction of long-term immunity in the participants. Aside these achievements, we would like to reiterate the importance of the use of different approaches including educational events and WHD activities to target groups and communities to raise awareness. Additionally, home and school vaccination programmes may be adopted to enhance vaccine uptake and adherence to the vaccination schedule. We plan to extend this screening exercise to deprived and/or rural communities where HBV incidence may be higher than in urban communities.

Knowledge and Awareness of Hepatitis B Infection Among Young Adults in Ekiti, Nigeria: Implications for Education and Vaccination

“…The reason for this low percentage might be connected to how the health screening attended by these respondents were planned and executed, and whether adequate information about hepatitis B was provided. It has been noted that for health screening to achieve the expected goal for the population at risk, it must be appropriately planned, funded and carried out [1,18]. In this regard, until there is a motivating push for young people to attend health screening and get educated about tests done for them, the disparity between awareness and attendance of health screening will persist.…”

“…Hepatitis B virus infection is a vaccine-preventable disease [1]. The transmission occurs from exposure to infected persons through sex, by blood, and from mother to child during childbirth [2].…”

Hepatitis B virus infection, associated factors, knowledge and vaccination status among household contacts of hepatitis B index cases in Mwanza, Tanzania

“…The National Viral Hepatitis Strategic Plan (NVHSP 2018/19-2022/2023) has set a goal to ensure that screening, diagnostic, care, and treatment services are available, trustworthy, and reasonably priced within the framework of a continuum of care and in compliance with universal health coverage. Different studies recommended testing and vaccinating the general population in settings where HBV infection is high [ 14 , 15 ]. However, this has been difficult in most of the LMICs due to financial constraints.…”