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This paper investigates linkage to care following community‐based screening for hepatitis B virus (HBV) in rural Senegal. HBV‐positive participants who completed a biological and clinical examination to assess liver disease and treatment eligibility were referred to a regional hospital (if eligible for treatment), invited to join the Sen‐B research cohort study (adults with detectable viral load) or referred to their local health centre (all others). Logistic regressions were conducted to investigate factors associated with (i) uptake of the scheduled post‐screening examination, and (ii) HBV management initiation. Obstacles to HBV management were identified using thematic analysis of in‐depth patient interviews. Of the 206 HBV‐positive participants, 163 (79.1%) underwent the examination; 47 of the 163 (28.8%) initiated HBV management. Women, people not migrating for >6 months/year, individuals living in households with more agricultural and monetary resources, with other HBV‐positive participants, and beneficiaries of the national cash transfer program, were all more likely to undergo the examination. The likelihood of joining the Sen‐B cohort increased with household monetary resources, but decreased with agricultural resources. Initiation of HBV management in local health centre was higher among participants with a non‐agricultural economic activity. Individuals reported wariness and confusion about HBV management content and rationale at various stages of the care continuum, in particular with respect to venous blood sampling and management without treatment. In conclusion, HBV community‐based test‐and‐treat strategies are feasible, but early loss to follow‐up must be addressed through simplified, affordable management and community support and sensitization. [ABSTRACT FROM AUTHOR]

Background: Although mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is prevalent in West Africa, epidemiological data on HBV infection in women remain scarce. We studied i) hepatitis B surface antigen (HBsAg) prevalence and its correlates, ii) HBV screening history and serological status awareness, iii) MTCT risk and treatment needs in Senegalese women. Methods: A cross-sectional population-based serosurvey for HBsAg positivity was conducted in 2018–2019 in the rural area of Niakhar (Fatick region, Senegal). Participants were offered home-based HBV screening and answered face-to-face questionnaires. HBsAg-positive participants underwent clinical and biological assessments. Data were weighted and calibrated to be representative of the area's population. Logistic regression models helped identify factors associated with HBsAg-positivity in adult women (> 15 years old). Results: HBsAg prevalence in adult women was 9.2% [95% confidence interval: 7.0–11.4]. Factors associated with HBsAg-positivity were being 15–49 years old (ref: ≥ 50), living in a household with > 2 other HBsAg-positive members, and knowing someone with liver disease. Only 1.6% of women had already been tested for HBV; no one who tested HBsAg positive was already aware of their serological status. In women 15–49 years old, 5% risked MTCT and none were eligible for long-term antiviral treatment. Conclusions: Adult women have a high HBsAg prevalence but a low MTCT risk. Low rates of HBV screening and serological status awareness argue for the adoption of systematic screening during pregnancy using free and rapid diagnostic tests. Additionally, screening household members of HBsAg-positive women may greatly improve the cascade of care in rural Senegal. Trial registration: ClinicalTrials.gov identifier (NCT number): NCT03215732. [ABSTRACT FROM AUTHOR]

Senegal introduced the infant hepatitis B virus (HBV) vaccination in 2004 and recently committed to eliminating hepatitis B by 2030. Updated epidemiological data are needed to provide information on the progress being made and to develop new interventions. We estimated the prevalence of hepatitis B surface antigen (HBsAg) in children and adults living in rural Senegal and assessed hepatitis B treatment eligibility. A cross‐sectional population‐based serosurvey of HBsAg was conducted in 2018‐2019 in a large sample (n = 3,118) of residents living in the Niakhar area (Fatick region, Senegal). Individuals positive for HBsAg subsequently underwent clinical and biological assessments. Data were weighted for age and sex and calibrated to be representative of the area's population. Among the 3,118 participants, 206 were HBsAg positive (prevalence, 6.9%; 95% confidence interval [CI], 5.6‐8.1). Prevalence varied markedly according to age group in individuals aged 0‐4, 5‐14, 15‐34, and ≥35 years as follows: 0.0% (95% CI, 0.00‐0.01); 1.5% (95% CI, 0.0‐2.3); 12.4% (95% CI, 9.1‐15.6); and 8.8% (95% CI, 6.1‐11.5), respectively. Of those subsequently assessed, 50.9% (95% CI, 41.8‐60.0) had active HBV infection; 4 (2.9%; 95% CI, 0.9‐9.4) were eligible for hepatitis B treatment. Conclusion: In this first population‐based serosurvey targeting children and adults in rural Senegal, HBsAg prevalence was very low in the former, meeting the World Health Organization's (WHO) < 1% HBsAg 2020 target; however, it was high in young adults (15‐34 years old) born before the HBV vaccine was introduced in 2004. To reach national and WHO hepatitis elimination goals, general population testing (particularly for adolescents and young adults), care, and treatment scale‐up need to be implemented. [ABSTRACT FROM AUTHOR]

Sub‐Saharan Africa's hepatitis B virus (HBV) burden is primarily due to infection in infancy. However, data on chronic HBV infection prevalence and associated risk factors in children born post‐HBV vaccination introduction are scarce. We estimated hepatitis B surface antigen (HBsAg) prevalence and risk factors in Senegalese children born during the HBV vaccination era. In 2018–2019, a community‐based cross‐sectional survey was conducted in Senegal among children born between 2004 and 2015 (ie after the three‐dose HBV vaccine series was introduced (2004) but before the birth dose's introduction (2016)). HBsAg‐positive children were identified using dried blood spots. A standardized questionnaire collected socioeconomic information. Data were age‐sex weighted and calibrated to be representative of children living in the study area. Risk factors associated with HBsAg positivity were identified using negative binomial regression. Among 1,327 children, 17 were HBsAg‐positive (prevalence = 1.23% (95% confidence interval [CI] 0.61–1.85)). Older age (adjusted incidence‐rate ratio [aIRR] 1.31 per one‐year increase, 95% CI 1.10–1.57), home vs healthcare facility delivery (aIRR 3.55, 95% CI 1.39–9.02), stitches (lifetime) (aIRR 4.79; 95% CI 1.84–12.39), tattoos (aIRR 8.97, 95% CI 1.01–79.11) and having an HBsAg‐positive sibling with the same mother (aIRR 3.05, 95% CI 1.09–8.57) were all independently associated with HBsAg positivity. The low HBsAg prevalence highlights the success of the Senegalese HBV vaccination program. To further reduce HBV acquisition in children, high‐risk groups, including pregnant women and siblings of HBsAg‐positive individuals, must be screened. Vital HBV infection prevention measures include promoting delivery in healthcare facilities, and increasing awareness of prevention and control procedures. [ABSTRACT FROM AUTHOR]