Factors Associated With Hepatitis B Virus Infection among Soldiers in the Southern Part of the Ghana Armed Forces- A Case-Control Study

Abstract

Background: Military personnel are high-risk people for parenteral and sexually transmitted diseases such as hepatitis B virus (HBV). Hepatitis B is one of the most common infectious diseases globally. The burden of Chronic Hepatitis B infection in the Ghana Armed Forces is not known. As part of the Ghana Armed Forces Hepatitis Programme, the Forces Liver Health Protection (FLiHP) Project is implementing interventions aimed at reducing the estimated burden of viral hepatitis by 50% by the year 2020 within the Ghana Armed Forces. Objectives: To determine the factors associated with Hepatitis B infection in soldiers of the Southern Command of the Ghana Armed forces. Methods: A secondary data was obtained among military personnel from the FLiHP Project of the Ghana Armed Forces (GAF) across military units in the Southern part of Ghana. A random sample of 306 was selected for this study with half tested positive of Hepatitis B (HB) serving as cases; whereas, those tested negative only served as control cases. Bivariate analysis and logistic regression analysis was used to determine the association between Hepatitis B infection and Socio-demographic factors, Medical related factors and Behavioural factors and P value < 0.05 was considered statistically significant using STATA 15. Results: It was revealed that the most significant risk factors that influenced Hepatitis B positive cases among the selected military personnel were sexual intercourse with prostitutes (AOR=12.76, 95% C.I=1.11-14.31), those with history of HB immunization (AOR=11.82, 95% C.I=1.11-14.31), soldiers from the northern ethnic groups (AOR=3.72, 95% C.I=1.22-11.29), possession of scarification marks (AOR=1.95, 95% C.I=0.63-6.07) and ages of soldiers between 28 and 37 years (AOR=1.48, 95% C.I=0.51-4.57). Conclusions: From the foregone, I conclude that a small proportion of the military personnel screened in the southern part of the GAF by the FLiHP project tested positive to HBV infection. This proportion is half that of the nationwide but higher than the proportions of other militaries in the world. Secondly, only age and ethnicity were the significant sociodemographic factors associated with Hepatitis B infection while bisexual orientation, sexual intercourse with irregular sexual companions such as prostitutes and possession of scarification marks were the behavioral risk factors that had significant effect on positive HBV infection status. Finally, having HBV vaccination prior to the screening was the only medical risk factor associated with HBV infection among the selected military personnel.