World Hepatitis Day 2021 – Community Awareness and Screening for Viral Hepatitis in Accra, Ghana

Background: In Ghana, Hepatitis B virus (HBV) infection remains a major public health threat as in many parts of the world. Even with an effective vaccine, there are shortfalls with low vaccine coverage among adults. To create awareness and encourage vaccination, community engagement and public-private partnerships are needed in endemic settings to help fund campaigns and offer vaccinations at no cost to under privileged people. Methods: Participants from the University of Ghana community and its immediate environs were registered, taken through pre-counselling sessions where they were educated on hepatitis transmission and prevention before consenting. Eligible participants were screened for HBV markers with rapid test kits. All HBsAb-negative participants were recommended for initial vaccination at the event, whilst the subsequent shots were administered. Hepatitis B surface Antigen-positive participants were counselled and referred for appropriate care. Results: A total of 297 people, comprising of 126 (42%) males and 171 (58%) females aged between 17 and 67 years were screened. Amongst these, 246 (82.8%) showed no detectable protective antibodies against HBV and all of them agreed to and were given the first dose HBV vaccine. Additionally, 19 (6.4%) individuals tested positive for HBsAg and were counselled and referred to specialists for further assessment and management. We found that 59 (19.9%) of our participants had previously initiated HBV vaccination and had taken at least one dose of the vaccine more than 6 months prior to this screening, 3 of whom tested positive for HBsAg. For the three-dose HBV vaccines deployed, a little over 20% (50/246) and a further 17% (33/196) did not return for the second and the third doses respectively, resulting in an overall 66% (163/246) of persons who completed all three vaccinations. Conclusions: A key lesson from this exercise is the need for partnerships between the health sector and corporate bodies to increase and improve awareness, care, and management of hepatitis. Additionally, home and school vaccination programmes may be adopted to enhance vaccine uptake and adherence to the vaccination schedule. We plan to extend this screening exercise to deprived and/or rural communities where HBV incidence may be higher than in urban communities.