Hepatitis B virus testing, vaccination, and hepatitis B surface antigen prevalence among adult inpatients at an urban polyclinic in Accra, Ghana: a cross-sectional study

Abstract

Background: Hepatitis B virus (HBV) infection is endemic in Ghana, mostly due to vertical transmission and limited vaccine coverage. We estimated hepatitis B surface antigen (HBsAg) prevalence and assessed HBV infection, testing, vaccination, and associated risk factors among adult inpatients receiving care at an urban polyclinic. Methods: tests and binary logistic regression were used to assess factors associated with HBsAg positivity, prior testing, and HBV vaccination. Results: Participants' average age was 43.2 (±12.2 SD) years, and the majority were married (71.9%) and male (54.6%). HBsAg prevalence was 14.4% (95% confidence interval [CI]: 10.7-18.8). Prior HBV testing occurred in 32.6%, and full vaccination (≥3 doses) in 11.8%. None of the fully vaccinated participants were HBsAg-positive. Family history was positively associated with infection (adjusted odds ratio [AOR]: 2.54; 95% CI: 1.05-6.16), while low monthly income was associated with reduced odds of hepatitis B testing (AOR: 0.18, 95% CI: 0.05-0.62) and vaccination (AOR: 0.55, 95% CI: 0.17-1.82). Vaccination was protective in those who received it. Conclusion: This study found a high prevalence of HBsAg positivity, low testing, and inadequate vaccine coverage among inpatients in an urban polyclinic. To reduce transmission risks, population-specific interventions that raise public knowledge of HBV transmission and prevention are required. Findings also support routine HBV screening and subsidized vaccination for adult inpatients, with targeted outreach to low-income groups and household contacts of known cases.