Prevalence and Predictors of Hepatitis B Virus Infection Among Sellers and Workers at West Africa′s Largest Market, Kejetia, Ghana: A Cross‐Sectional Study

Abstract

Background Hepatitis B virus (HBV) infection remains a major public health challenge in sub‐Saharan Africa, including Ghana, despite the infant vaccination programs. Limited data exist on HBV prevalence and predictors in informal sector populations, who may face unique occupational and behavioral exposures. This study assessed the prevalence and predictors of HBV infection among sellers and workers at Kejetia Market, Ghana′s largest commercial hub. Methods A cross‐sectional study was conducted among 489 adult market workers from December 4, 2024, to January 25, 2025. Participants were selected through stratified random sampling across occupational groups. Data on sociodemographic, occupational, and behavioral factors were collected using structured questionnaires. On‐site testing for Hepatitis B surface antigen (HBsAg) was performed using the Hightop One Step Rapid Test kit. Bivariate and multivariate logistic regression analyses were used to identify independent predictors of HBV infection. p < 0.05 was considered statistically significant. Results The overall prevalence of HBV infection was 7.36% (36/489), consistent with intermediate‐to‐high endemicity. Multivariate analysis identified three independent predictors of HBV infection. Female gender (aOR = 0.455, 95% CI: 0.221–0.937; p = 0.033) and absence of tattoos (aOR = 0.283, 95% CI: 0.110–0.730; p = 0.009) were associated with lower risk of HBV infection, whereas unvaccinated individuals had 3.37‐fold increased odds of getting the infection (95% CI: 1.395–8.142; p = 0.007). HBV prevalence declined progressively with increasing vaccine doses, from 9.2% in unvaccinated individuals to 2.3% among those who had completed three or more doses. Conclusion HBV infection is common among Kejetia Market workers, with prevalence exceeding both continental and global estimates. Gender, tattooing, and vaccination status were significant predictors of infection. These findings highlight the urgent need for targeted adult Hepatitis B vaccination programs and strengthened occupational health interventions. They also emphasize the importance of regulating high‐risk practices such as informal tattooing within Ghana′s informal sector to reduce HBV burden and achieve Ghana′s contribution to the WHO goal of eliminating HBV by 2030.