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. 2019 May 3;19(1):381.
doi: 10.1186/s12879-019-4013-4.

Prevalence of hepatitis B surface antigen (HBsAg) positivity and its associated factors in Rwanda

Jean Damascene Makuza  1 , Jean Olivier Twahirwa Rwema  2 , Corneille Killy Ntihabose  3 , Donatha Dushimiyimana  3 , Justine Umutesi  3 , Marie Paul Nisingizwe  4 , Janvier Serumondo  3 , Muhamed Semakula  3 , David J Riedel  5 , Sabin Nsanzimana  3
Affiliations

Prevalence of hepatitis B surface antigen (HBsAg) positivity and its associated factors in Rwanda

Jean Damascene Makuza et al. BMC Infect Dis. .

Abstract

Background: The epidemiology of hepatitis B virus (HBV) infection in the general population in Rwanda is not well known. This study examined the prevalence of HBV surface antigen (HBsAg) positivity and associated risk factors among people aged 25 years and over in an organized national screening campaign.

Methods: This is a cross-sectional study using data from a nationwide HBV screening campaign organized by the Rwanda Biomedical Centre from March to October 2018. This campaign targeted individuals aged > 25 years old from 24 of 30 districts of Rwanda. Sensitization was done through multimedia announcements, community health workers and local church leaders. During the campaign, a structured interview was administered by trained healthcare workers to collect information on socio-demographic, clinical and behavioral characteristics of participants; HBV screening was performed with HBsAg using enzyme-linked immunosorbent assays (ELISA) testing. Bivariate and multivariate logistic regressions were used to assess factors associated with HBsAg positivity in the screened participants.

Results: A total of 327,360 individuals were screened during the campaign. Overall 12,865(3.9%) were HBsAg positive. The highest prevalence (4.2%) was found in the 35-44-year-old group, but the difference from other groups was not significant (Odds Ratio [OR = 1.057, 95% Confidence Interval(CI) (0.904-1.235)]. Being male [OR = 1.348, 95% CI (1.30,1.40)]; being single [OR = 1.092, 95% CI (1.10-1.16)] compared to married; a previous positive TB screening test [OR = 2.352, 95% CI (1.63-3.39)]; history of surgical operation [OR = 1.082, 95% CI (1.00,1.17)]; exposure to traditional operational practices and scarification [OR = 1.187, 95% CI (1.13, 1.24)]; and having a person in the family with viral hepatitis [OR = 1.367, 95% CI (1.21, 1.53)] were significantly associated with HBV infection.

Conclusions: These data provide the first national estimate of the prevalence of HBsAg seropositivity and its associated factors in Rwanda. The study identified people with the highest risk of HBV infection who should be the priority of future prevention efforts in Rwanda and in similar settings.

Keywords: Hepatitis B; Prevalence; Risk factors; Rwanda.

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Conflict of interest statement

Ethics approval and consent to participate

The ethical procedures for the collection of these data were governed by the Medical Research Council of Rwanda and site authorizations were obtained from the Ministry of Health for hosting sites. Secondary analyses of routinely collected data are exempt by the Rwanda Biomedical Center. Approval (No. 2048/RBC/2019) for utilization of the data was obtained by RBC. Verbal consent was obtained from all eligible participants to HBV screening before blood sample and interview based data collection and ethical review approval was conferred due to the routine nature of the data.

Consent for publication

Not Applicable

Competing interests

This study used routine data collected by Rwanda Biomedical center, there is no conflict of interest with any person.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prevalence of HBs Ag by age category of Participants
Fig. 2
Fig. 2
Geographical repartition of prevalence of HBs Ag in Rwanda. B Kurujyishuri , JD Makuza et al. Kigali, Dec 2019.
See this image and copyright information in PMC

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