Magnitude of hepatitis b, liver status of the cases, and Associated factors among cleaners and cases of Hepatitis b, in jimma town hospitals, southwest Ethiopia

Abstract

Background: Hepatitis B (HBV) poses a higher risk to healthcare cleaners due to frequent exposure to contaminated blood and fluids. Regular screening and vaccination for at-risk professionals are recommended. However, the prevalence of HBV among cleaners is not well studied. Evaluating liver enzymes and the aspartate aminotransferase to platelet ratio index is essential for managing HBV-infected patients effectively. Objective: The main aims of this study was to determine the magnitude of hepatitis B, the liver status of the cases, and associated factors among cleaners and cases of hepatitis B in government and private hospitals in Jimma town, south-west Ethiopia, from April 20 to May 20, 2024. Methods: A mixed-type, institutional-based, multi-centered, cross-sectional and retrospective study was conducted. Data were collected from 501 eligible cleaners and 114 hepatitis B surface antigens (HBsAg) positive cases using KoboCollect, an Android app linked to KoboToolbox for mobile data collection. Structured questionnaires were administered through interviews. Each participant provided about 5 milliliters of venous blood for HBsAg cassette tests, while liver function tests and complete blood counts were conducted for those who tested HBsAg-positive. Descriptive statistics, ROC analysis, and bivariable and multivariable Firth penalized logistic regression were performed using STATA version 14. Results: From the total of 501 cleaners, the magnitude of HBV was 0.6% (95%CI; 0.1% 1.7%), none of them were vaccinated against HBV infection; 34.73% experienced needle stick injuries in the workplace and 26.75% had a history of exposure to blood or fluids. The study participants who had not married were associated with an increased risk of having HBV infection [AOR=1.86; 95% CI, 1.12-2.67; p=0.001]. However, we found no evidence that any other factors were associated with HBV infections. Among 114HBsAg positive cases; 34.2% (95% CI; 25.6% - 43.7%) exhibited abnormal liver status and 29.82% (95% CI; 21.6%-39.1%) were eligible for antiviral treatment. Conclusion and recommendation: The magnitude of HBV was low per WHO classification, but abnormal liver enzymes were noted in HBV-positive cases, with over a quarter eligible for antiviral therapy. Screening and vaccination for HBV are essential for medical waste cleaners. Unmarried individuals should limit sexual partners to reduce HBV risk, and early evaluation of liver function tests, CBC, and APRI is crucial for slowing cirrhosis progression