Prevalence of Hepatitis B Virus Infection Among Blood Donors at University Teaching Hospital in Lusaka, Zambia

Abstract

Hepatitis B virus (HBV) infection remains a major transfusion-transmissible infection in sub-Saharan Africa. Blood donor surveillance is essential for maintaining a safe blood supply. This study assessed the prevalence of HBV infection and associated risk factors among blood donors at the University Teaching Hospital (UTH) in Lusaka, Zambia. A cross-sectional retrospective study was conducted among 140 blood donors screened for hepatitis B surface antigen (HBsAg). Socio-demographic, behavioural, and clinical information was extracted from routine blood bank records. Associations between HBV seropositivity and donor characteristics were analyzed using chi-square tests, while significant variables were further assessed using multivariate logistic regression. The overall HBV prevalence was 10.0% (14/140). Donors were predominantly male (75.0%), aged 18–22 years (42.1%), urban residents (78.6%), with secondary (52.9%) or tertiary education (35.9%). HBV prevalence was higher among males (10.5%) than females (8.6%), though not statistically significant (p=0.735). Rural donors recorded significantly higher prevalence (20.0%) compared to urban donors (7.3%; p=0.038). HBV infection was most common among donors with primary education (25.0%; p=0.047). Behavioural factors showed strong associations: history of surgery/transfusion (25.0%; p=0.016), tattooing/scarification (33.3%; p=0.001), and multiple sexual partners (23.3%; p=0.007). None of the vaccinated donors were HBsAg-positive (0.0%; p=0.009). Multivariate analysis identified tattooing/scarification (AOR=6.8; p=0.004), multiple sexual partners (AOR=4.1; p=0.023), and vaccination status (AOR=0.001; p=0.002) as independent predictors of HBV infection. HBV prevalence among UTH blood donors remains substantial. Rural residence, low education level, invasive procedures, tattooing, and high-risk sexual behaviour increased risk, while vaccination provided full protection. Strengthened HBV vaccination, community-level health education, and rigorous donor risk assessment are recommended for improving blood safety.