Department of Public Health

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Author: search.filters.author.Zoker, Exton Mohamed

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    Screening and Seroprotection against Hepatitis B among Healthcare Workers in Rural Healthcare Facilities in Bo District, Sierra Leone
    (2026) Zoker, Exton Mohamed
    Hepatitis B virus (HBV) infection remains a major occupational hazard among healthcare workers (HCWs), particularly in sub-Saharan Africa, where high endemicity, low vaccination coverage, and inadequate occupational health systems increase the risk of transmission. Sierra Leone is a highly HBV-endemic country, yet comprehensive information on the serological status of HCWs in rural healthcare settings remains limited. This study assessed the HBV serological profiles, vaccination status, and occupational determinants of HBV infection among HCWs at Bo Government Hospital and Mercy United Methodist (UMC) Hospital in Bo District, Sierra Leone. An analytical cross-sectional study was conducted among 296 HCWs selected through proportionate stratified random sampling, including 267 from Bo Government Hospital and 29 from Mercy UMC Hospital. Data were collected using a structured questionnaire covering socio-demographic characteristics, professional cadre, occupational exposure, duration of employment, and HBV vaccination history. Venous blood samples were analyzed using chemiluminescence immunoassay (CLIA) on the MAGLUMI 4000 Plus platform for HBsAg, total anti-HBc, and anti-HBs. Data were analyzed using descriptive statistics and Pearson’s chi-square test at a 5% significance level. The findings showed substantial occupational vulnerability to HBV infection. Overall, 64.5% (n = 191) of HCWs were susceptible to infection, 10.8% (n = 32) had active HBV infection, 10.8% (n = 32) had naturally acquired immunity following previous infection, and only 13.9% (n = 41) had vaccine-induced immunity. Vaccination coverage was critically low, with 75.7% (n = 224) reporting no previous HBV vaccination and only 18.9% (n = 56) having completed the recommended three-dose schedule. All HBsAg-positive cases occurred among unvaccinated or partially vaccinated HCWs. HBsAg prevalence increased significantly with duration of employment, from 4.5% among HCWs employed for less than one year to 6.7% among those with one to five years of service and 14.8% among those employed for more than five years (χ² = 8.94, p = 0.003), demonstrating cumulative occupational risk. Although females had a slightly higher HBsAg prevalence than males (11.8% vs. 9.3%), comparable infection rates among State Registered Nurses indicated that professional role, rather than biological sex, was more important in explaining occupational risk. The study demonstrates a critical gap in occupational HBV protection among HCWs in rural Bo District, characterized by high susceptibility, low vaccination uptake, inadequate vaccine-induced immunity, and continued occupational exposure. The findings highlight the urgent need for mandatory pre-employment HBV screening, universal vaccination of HCWs, routine post-vaccination serological testing, strengthened infection prevention and control measures, and effective institutional occupational health policies. These interventions are essential for protecting HCWs and supporting HBV elimination strategies in Sierra Leone and other high-endemic, resource-constrained settings.
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    Assessment of Hepatitis B Surface Antibody Levels and Post-Vaccination Immunity among Healthcare Workers in Rural Hospitals in Bo District, Sierra Leone
    (2026) Zoker, Exton Mohamed
    Hepatitis B virus (HBV) infection is a major occupational hazard among healthcare workers (HCWs), particularly in sub-Saharan Africa, where high endemicity and low vaccination coverage increase transmission risk.