Knowledge, risk of infection, and vaccination status of hepatitis B virus among rural high school students in Nanumba North and South Districts of Ghana

BACKGROUND: Hepatitis B (HB) is a viral infection that affects the liver and can lead to life-threatening conditions including cirrhosis and liver cancer. Over a billion people are estimated to be infected globally with the hepatitis B virus, with over 240 million chronically infected. Sub-Saharan Africa including Ghana is an HBV endemic area and an estimated 5%– 10% of the population in the region is infected. Research on the knowledge and vaccination status of hepatitis B in rural communities in Ghana is lacking. OBJECTIVES: The objectives of this study proposed were to assess the HBV knowledge, risk of HBV infection, and vaccination status of high school students in two rural districts of the Northern region on Ghana. METHODS: A cross-sectional study of a random sample of 426 students from two senior high schools in the Nanumba North and South districts of the Northern region of Ghana on hepatitis B knowledge and vaccination status was conducted. Descriptive statistics were used to analyze and present data on demographic and knowledge variables. A Mann Whitney U test was used to compare the differences in HBV knowledge between male and female students and between students of the two high schools that were involved in the study. Pearson correlation coefficient was used to compute the association between HBV knowledge and age of students. Logistic regression was used to develop a model to predict variables that influenced vaccination against HB. RESULTS: The results of the study showed basic but not a good knowledge of HBV among the rural high school students, with a mean score of 11.8 (SD = 1.98) out of a maximum score of 16. Descriptive statistics also revealed that only 20% of 426 students ever tested for HBV and 96 (22.5%) were vaccinated against HBV. A Mann-Whitney U test results revealed no statistically significant difference in HBV knowledge between male and female students (p = 0.688, two-tailed) and between the two high schools (p = 0.24, two-tailed). A Pearson correlation showed no relationship between age and HBV knowledge (p = 0.486). Regression analysis showed that only taking the HBV test (p <0.05) and attending Bimbilla Senior High (p = 0.032) significantly predicted vaccination against HBV infection. CONCLUSION: The results of this study has re-echoed the high prevalence of HBV in Ghana. The poor state of knowledge and a high risk of HBV infection among young adults in rural communities have also been highlighted in the findings of this study. Vaccination against the HBV infection was found to be low and consistent with other findings. Finally, HBV screening is shown to be significantly associated with vaccination against the virus, hence the need for national screening and vaccination programs.