Factors associated with hepatitis B and C among adults in Buea, Cameroon: A community‐based cross‐sectional study

Abstract

Introduction: Viral hepatitis is a major cause of death in Africa. A paucity of community-based studies on the determinants of viral hepatitis in Africa impedes efforts to appropriately target prevention, screening, and treatment interventions. We assessed factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) in a semi-urban health district in Cameroon. Methods: We conducted a community-based, cross-sectional study from 28 February to 15 May 2021 in the Buea Health District in Buea, Cameroon. We recruited a sample of consenting individuals aged over 15 years old. Participants were surveyed for factors associated with HBV/HCV and were screened for HBV surface antigen (HBsAg) and HCV antibody using rapid point-of-care tests. We performed univariable and multivariable logistic regression analyses to identify factors associated with HBsAg and HCV seropositivity. Results:We screened 1144 participants (66% female) with a median age of 30 years (IQR: 23-44). HBsAg prevalence was 5.7% (95%CI: 4.5-7.2%) and HCV seropositivity was 1.9% (95%CI: 1.3-2.9%). Three people (0.3%) were seropositive for both HBsAg and HCV antibody. Male sex (adjusted OR [aOR] = 2.31; 95%CI: 1.28-4.18) and a history of traditional operation or scarification (aOR = 2.87; 95%CI: 1.67-4.92) were associated with HBsAg. None of the assessed factors was significantly associated with HCV antibody. Conclusion:Men and participants with a history of traditional operation and scarification had higher odds of HBsAg. We did not observe any associations with HCV seropositivity. Prevention and screening efforts among adults in this setting should prioritize men and those with a history of traditional operation and scarification.

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

“…We also observed evidence that traditional scarring could be associated with HBsAg positivity among other household members. These potential sources of HBV infection corroborate findings from past studies in other African settings [ 25 , 32 ] and suggest priority behaviors or subgroups for intervention in urban Kinshasa that may be relevant to other megacities in Africa.…”

Hepatitis B virus prevalence and transmission in the households of pregnant women in Kinshasa, Democratic Republic of Congo

“…We also observed evidence that traditional scarring could be associated with HBsAg positivity among other household members. These potential sources of HBV infection corroborate findings from past studies in other African settings, 25,31 and suggest priority behaviors or subgroups for intervention in urban Kinshasa that may be relevant to other megacities in Africa.…”

“…We also observed evidence that traditional scarring could be associated with HBsAg positivity among other household members. These potential sources of HBV infection corroborate findings from past studies in other African settings, 25,31 and suggest priority behaviors or subgroups for intervention in urban Kinshasa that may be relevant to other megacities in Africa. Roll-out of infant HBV vaccination within the pentavalent series starting at six weeks of age is one possible explanation for the HBV prevalence among exposed children, which was more than 13 times as high for those who were >13 years compared to those who were ≤13 years in 2022.…”

Costs of Community-Based Viral Hepatitis Screening in Cameroon Using Point-of-Care Technologies

“…Screening program yield depends on the capacity of personnel to enroll and test additional participants for each day of testing; expanding this program could entail additional training and implementation costs. We did not include reference testing for HBV and HCV but used a point-of-care assay with a high reported sensitivity and specificity in community testing [ 11 ].…”

“…We implemented a 9-day community-based viral hepatitis screening program from 28 February 2021 to 15 May 2021 in 4 health areas (ie, subdistricts) in the South West Region of Cameroon [ 11 ]. This previously described hepatitis screening program detected 65 new HBV diagnoses, 22 new HCV diagnoses, and 3 HBV/HCV coinfections among 1144 people screened [ 11 ]. We undertook a costing analysis of this screening program by collecting and analyzing all costs associated with its design and implementation.…”