Impact of hepatitis B virus infection in patients with plasmodium parasites in selected health facilities in Accra, Ghana

Abstract

Background The severity of malaria is often exacerbated by concurrent health issues, including coinfections with hepatitis B virus (HBV). Recent research suggests that the shared pathophysiological characteristics of HBV and malaria influence patient outcomes. This study aimed to determine the prevalence of HBV among patients infected with Plasmodium species and to evaluate the associated risk factors and clinical outcomes in individuals attending various health facilities. Method A cross-sectional study was conducted at Korle-Bu, Mamprobi, and Ashaiman Polyclinics in the Greater Accra Region. Patients presenting with malaria-like symptoms at the outpatient department (OPD) were recruited. Participants who tested positive for malaria via a rapid diagnostic test (RDT) and provided written consent were included. Demographic and clinical data were obtained through questionnaires. Blood samples (4 mL) were collected into a serum separator and EDTA tubes. The HBV surface antigen (HBsAg) and malaria parasites were detected via an HBV rapid diagnostic test and microscopy, respectively. Polymerase chain reaction (PCR) was also used to confirm the presence of the Plasmodium parasite. Liver function and hematological parameters were evaluated via a chemistry analyser and hematology analyser, respectively. Results In total, 174 participants were recruited, comprising 99 (56.90%) from Korle-Bu Polyclinic, 50 (28.74%) from Mamprobi Polyclinic, and 25 (14.37%) from Ashaiman Polyclinic. Malaria diagnostics revealed that 52.87% (92/174) of the samples tested positive for malaria parasite via microscopy, and 73.56% (128/174) of the samples tested positive via PCR. The majority of participants were females (56.89%) and were predominantly aged 18–30 years. Common symptoms included headache, loss of appetite, and fever. HBV and malaria coinfection was observed in 9.19% of the patients. Increased alanine transaminase (ALT) levels and basophil counts were significantly associated with HBV and malaria coinfection (p=0.029). Conclusion This study revealed a slightly greater prevalence of HBV and malaria coinfection than previously reported. These findings highlight the importance of incorporating routine coinfection diagnostics and improving HBV vaccination efforts to improve patient outcomes.