Seroepidemiology and Virological Analysis of Hepatitis B Virus Infections in Kayayei

Abstract

Globally, hepatitis B virus is a leading cause of liver cirrhosis and hepatocellular carcinoma, with approximately 240 million persons living with chronic hepatitis B. In Sub-Saharan Africa, the disease is highly prevalent (≥8%), but little is known about the epidemiology and occult hepatitis B virus infection in migrant female head porters (Kayayei) in Ghana. Occult hepatitis B virus infection, defined as the presence of hepatitis B virus DNA in an individual negative for hepatitis B surface antigen with or without serological marker has become a global health threat. This study sought to provide information on the prevalence and nature of hepatitis B virus infection in migrant female head porters (Kayayei). The outcome is meant to promote health and inform policies aimed at curbing the spread of hepatitis B virus. A simple random sampling technique was employed to enrol 390 Kayayei from the slum (Agbogbloshie and Madina). Blood samples were collected into EDTA tubes and subsequently separated into plasma. A rapid diagnostic test kit (Micropoint, Micropoint Diagnostics, China) was used to detect hepatitis B surface antigen and hepatitis B virus combo test kit (Diaspot (Serum/Plasma) Colloidal Gold, Zhejiang Orient Gene Biotech, China) was used to detect the serological profile. DNA was extracted and conventional PCR was used to detect hepatitis B virus core DNA. Participants between the ages of 20-29 years, 44.1% (172/390) formed the highest age group recruited. The median age of study participants was 26 years. Majority of the Kayayei were married, 53.3% (208/390), 83.8% (327/390) had no formal education and 80.5% (314/390) were not aware of HBV infection. A total of 228 (58.5%) Kayayei were recruited from Madina and 162 (41.5%) from Agbogbloshie. There were some significant differences in the socio demographic characteristics of study participants at both research sites. The prevalence of HBsAg and occult hepatitis B virus infection were 6.4% (25/390) and 1.9% (7/365) respectively. There was no significant association between socio-demographics of participants and hepatitis B surface antigen positivity. Majority, 52.8% (66/125) of participants were susceptible to hepatitis B virus disease because they were naïve to the infection. Prevalence of 6.4% indicates moderate endemicity of HBV infection among the Kayayei. No identifiable factor was found to be associated with HBV positivity. Occult hepatitis B virus infection has implications for blood donation and transfusion with vulnerable group as blood donors. Vaccines should be made accessible since majority of the Kayayei had no hepatitis B virus serological marker.