Background: Chronic hepatitis B virus (HBV) seroprevalence varies globally but is
positively correlated with the prevalence of HIV since both have the same route of
transmission-contact with infected body fluids. Sierra Leone has a nascent hepatitis B
epidemic and there is a paucity of research data and public health awareness about the
infection. Bo where this research is done is the second largest city of Sierra Leone and is
the regional headquarters of southern Sierra Leone.
Aim: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) among
female healthcare seekers who used the main government referral hospital in Bo,
southern Sierra Leone.
Methodology: We retrospectively analysed the serological diagnostic results of HBsAg
for female healthcare seekers at the Bo Government Hospital. We later determined the
HBsAg seroprevalence for various categories of the study subjects; pregnant women,
lactating mothers, girls 5-18years and adults >18years for the period under review.
Place and Duration of Study: This study is a multicenter investigation conducted at the
Bo Government Hospital laboratory, the Departments of Community Health and Clinical
Sciences and Environmental Health Sciences at Njala University in Bo southern Sierra
Leone. All laboratory diagnostic tests for HBsAg diagnosis were conducted at the Bo
Government Hospital laboratories from May 2012 to June 2013. Literature review and
data analysis were done at Departments of Community Health and Clinical Sciences and
Environmental Health Sciences at Njala University
Study Subjects: A total of 2,218 female subjects took part in this investigation; girls 5-
18yrs (15.2%), adults females >18yrs (48.9%), pregnant women (17.4%), and lactating
women (18.3%). Study subjects were between 5-45yrs; mean age 26yrs; HBsAg+ mean
age was 24yrs; HBsAg- mean age was 29yrs.
Results: One thousand and fifty four (47.5%) of all females who sought healthcare
service at the Bo Government Hospital laboratory during the period under review were
tested positive for HBsAg; 159(7.1%) pregnant women, 168 (7.5%) lactating mothers, 154
(6.9%) were girls 5-18yrs and 573 (25.8%) were >18yrs. Forty-five percent (154/339) of
all girls between 5-18years who took part in this study were HBV seropositive.
Discussions: Few independent investigations in Sierra Leone have estimated the
national HBsAg seroprevalence at 2.6%-5.1%. One import of this study is the high
154/2218(6.9%) HBsAg seroprevalence rate among girls 5-18 years which can be
attributed to multiple sex partners, unsafe sex practice and other socioeconomic and
behavioral factors that might have been prevailing during the period under review. The
generally high HBsAg seroprevalence rate in our study can also be as a result of our
large cohort size and the low sensitivity and specificity of the Rapid Determine diagnostic
test kits used in our study compared to previous similar studies conducted in Sierra
Leone.
Conclusions: The high seroprevalence rate of HBsAg among girl between 5-18years in
this study emphasizes the need for a robust public health preventive and control
measures for HBsAg including HBsAg vaccination, routine blood screening, and safe sex
practice as a means of reducing the spread and prevalence of HBV infection in Bo.