Prevalence and factors associated with hepatitis B surface antigen (HBsAg) positivity in Bugoye Sub-County, Western...

Hepatitis B virus (HBV) infection is a major cause of global morbidity and mortality. National serosurveys suggest that Uganda has a prevalence of 4.3%of chronic HBV infection. However, there is limited information regarding the potential determinants for infection.

Secondary data from a population-based household survey in the Kasese District were used to estimate HBsAg positivity. From these results, two villages were purposefully selected (i.e., low and high prevalence) for a population-representative household survey and a descriptive cross-sectional study. Descriptive analyses were conducted to characterise HBsAg positivity according to demographic, social-behavioural, clinical, and health-system factors, and spatial kernel density analysis and scan statistics were used to detect high-risk areas.

A total of 2,067 adults were tested for HBV, of whom 93 were HBsAg-positive, giving an overall seroprevalence of 4.5% (95% CI: 3.6-5.5). In the two selected villages, 286 participants were enrolled, including 125 individuals aged ≥ 15 years and 161 children aged < 15 years. HBsAg positivity was detected in 6 of 125 adults (4.8%) and in no children. Descriptive comparisons suggested that HBsAg-positive participants more frequently reported a history of HBV testing, blood transfusion, and receipt of parenteral medications. A significant spatial cluster of elevated HBV risk was identified in the central region of the study area (RR = 5.22, p = 0.0266).

The prevalence of HBsAg is highly variable between villages in rural western Uganda. Infection was exclusively found in adults, which suggests. This suggests the benefit of hepatitis vaccination among children and could suggest that vertical and early-life transmission may be less of a risk factor. In adults with HBV, we observed a higher frequency of prior healthcare-associated exposures, which merits further investigation into practices intended to prevent transmission of blood-borne pathogens.