In 2017, the World Health Organization (WHO) reported that hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were responsible for 96% of all hepatitis mortality. An increasing trend of HBV deaths is predominated by primary hepatocellular carcinoma, followed by liver cirrhosis [1].

HBV is endemic with different prevalence in different regions of the world. The seroprevalence of hepatitis markers of B virus infection is an indicator that has been appreciated in various ways among the blood donor in the world: 20% in Tanzania, 14% in Nigeria, 10.01% in Equatorial Guinea, 10.0% in Cameroon, 4.7% in Ethiopia, 2.8% in Rwanda, 1.2% in Nepal, 1.1% in India and 0.6% in Namibia[2].

HBV infection is a common public health problem especially in developing countries² as the province of South Kivu particularly in its Kabare North part precisely in Lwiro among family blood donors. It is associated with serious consequences such as liver cirrhosis and hepatocellular carcinoma [3]. 

In the DRC, the seroprevalence of the hepatitis B virus among blood donors is 1.6% to 8.01% in Lubumbashi [3-6] , 4.2% in Bukavu [7] , 3.9% in Moba[5], 2.2% in Mbuji-Mayi [8] and 1.6% in Kamina [9].

In fact, among the identified factors associated with HBV infection were increased age [10,11], being married, having a lower educational level, having specific occupations, family history of HBV infection and lack of immunization [11].

However, voluntary blood donors are the safest pool of blood donors, as they typically have better health-seeking behaviours than other blood donor groups [12]. The region’s voluntary blood donors have played a crucial role in maintaining adequate blood supply for patients in need of transfusions [13].

The aim of this study is to determine the prevalence of hepatitis B among family and volunteer blood donors at the Lwiro Pediatric hospital (HPL).

This is a prospective study on the seroprevalence of hepatitis B in voluntary and family blood donors. The study took place over a period of one year, from January 1, 2021 to December 31, 2021.

Our target population was made up of all voluntary and family blood donors who came to donate to patients who had consulted the Lwiro Pediatric Hospital and presented with anemia. Made up of 647 patients including 216 donors, our sampling is exhaustive. The study included all blood donors (volunteers, family) who were listed in the laboratory registers of the said hospital during the study period.

Serodiagnosis on each donation was carried out using the following reagents: Determine™ HBs Ag Abbott for HBV and HCVSCAN for hepatitis C as well as RPR. We collected data from pre-established data collection sheets, monthly blood transfusion registers

The data collected were encoded, entered, processed and analyzed using the R software. The descriptive analysis was carried out using the calculations of the proportions for the qualitative variables and the different frequency comparisons were quantified using the Pearson's Chi-square test and Fisher's test if necessary. We set the threshold for statistical significance at p<0.05.

Non-anemic patients were more numerous (66.61%) than anemic patients (33.38%) and the relative risk is 0.5. There is no difference between the number of hospitalized patients with regard to the two sexes (male and female). Male blood donors were more numerous (57.41%) than females (42.59%) and 93.52% of cases were HBSAg negative against 14% of HBSAg positive cases, of which 7.26% of men against 5% were HBSAg positive. 16.66% of cases occurred in November, 13.42% in October, 11.11% in December and 10.18% in January. (Table 1)

Anemic patients were more numerous (33.38%) and the relative risk is 0.5.  Male blood  donors  were  more numerous (57.41%) than females (42.59%) and 14% of cases were HBSAg positive cases, of which 7.26% of men against 5% were HBSAg positive. 16.66% of cases occurred in November, 13.42% in October, 11.11% in December and 10.18% in January. The low proportion of women among blood donors blood would be explained by many contraindications to blood donation including, among others, the gestation, anemia, menstruation, lactation, etc. [14]. 

We noticed that male donors had a high seroprevalence of hepatitis B compared to compared to female donors, these results do not corroborate with those reported by a study conducted in 2017 in Moba (DRC)⁶. However, our results are consistent with those found in the literature. Ntonga in 2017 in Gabon, and with those of Kabinda in 2014 in eastern DRC [15].

Table 1: Distribution of patients

Numbers in parentheses indicate Percentage. ** indicate the 5% significance level. 

Hepatitis B is a real public health problem that is rampant in our environment and increases the risk of transmission of the disease and is possible if transfusion safety is not taken into account. Out of a total of 647 patients admitted to hospital, 216 of them presented with decompensated anemia requiring blood transfusion, i.e. 33.38%. Of the 216 family donors, 6.48% tested positive for HBSAg, which is not negligible.

From this study, it is necessary to recommend to health authorities to provide hospitals with AgHBS tests. Hospitals to set up a club of voluntary blood donors that they can control and have a blood bank. Sterilization of all materials used for tattoos and piercings and thus those used in dentistry. Always practice safer sex for those with multiple partners. To the Congolese State, to promote the vaccination campaign or to integrate the anti-hepatitis B vaccine into the vaccination schedule. Make the HBSAg test obligatory in all pregnant women during the prenatal consultation. Make single use of syringes for samples, drug injections and for all intravenous drug addicts. Detect all cases of hepatitis B in the community and why not in the country and if possible map the disease in the country. Educate infected people of the risk they carry and possible subsequent complications. It is imperative to screen the blood to be transfused apart from the HIV test, but also do it with the HBSAg tests. Integrate the anti-hepatitis B vaccine into the vaccination schedule from the 1st day of life of the newborn.

1. World Health Organization (WHO).Global Hepatitis Report. World Health Organization, 2017. Accessed June 2020. https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/.

2. Mulubwa, N.K. et al. “Séroprévalence de l’hépatite B chez les donneurs de sang à Kolwezi, République Démocratique du Congo.” Revue de l’Infirmier Congolais, vol. 2, 2018, pp. 27–31.

3. Jefferies, M. et al. “Update on Global Epidemiology of Viral Hepatitis and Preventive Strategies.” World Journal of Clinical Cases, vol. 6, no. 13, 2018, pp. 589–599. https://doi.org/10.12998/wjcc.v6.i13.589.

4. Kakisingi, C.N. et al. “Profil épidémiologique et séroprévalence des donneurs de sang aux cliniques universitaires de Lubumbashi, République Démocratique du Congo.” Pan African Medical Journal, vol. 23, 2016, p. 175.

5. Organisation Mondiale de la Santé (OMS). L’hépatite virale 2016-2021. Global Hepatitis Programme. OMS, 2016. Accessed July 2017. http://apps.who.int/iris/bitstream/10665/250577/1/WHO-HIV-2016.06-fre.pdf.

6. Kabemba, B.H. et al. “Seroprevalence of Hepatitis B Virus Infection (HBsAg) in Rural Blood Donors, Moba, Tanganyika Province, Democratic Republic of Congo (2014 to 2016).” Open Access Library Journal, vol. 4, no. 3, 2017, pp. 1–5.

7. Kabamba, M.N. et al. “HIV and HBV Seroprevalence in Volunteer Blood Donors in Lubumbashi.” SOJ Immunology, vol. 3, no. 4, 2015, pp. 1–37.

8. Ciamala, M.P. et al. “Seroprevalence of Hepatitis B among Blood Donors in Mbuji-Mayi, ‘Case of Dipumba General Hospital’ (DRC).” Open Access Library Journal, vol. 4, 2017, e3503.

9. Kabamba, M.N., and B.I. Kabyla. “Prévalence des marqueurs infectieux chez les donneurs de sang en milieu rural. Cas de l’hôpital général de référence de Kamina.” Santé Publique, vol. 25, no. 2, 2013, pp. 213–217.

10. El Beltagy, K.E. et al. “Prevalence of Hepatitis B Virus Markers among Blood Donors in a Tertiary Hospital in Tabuk, Northwestern Saudi Arabia.” International Journal of Infectious Diseases, vol. 12, no. 5, 2008, pp. 495–499. https://doi.org/10.1016/j.ijid.2008.01.010.

11. Abdullah, S.M. “Prevalence of Hepatitis B and C in Donated Blood from the Jazan Region of Saudi Arabia.” Malaysian Journal of Medical Sciences, vol. 20, no. 2, 2013, pp. 41–46.

12. Motayo, B.O. et al. “Seroprevalence of Transfusion Transmissible Infections (TTI), in First Time Blood Donors in Abeokuta, Nigeria.” African Health Sciences, vol. 15, no. 1, 2015, pp. 19–24. https://doi.org/10.4314/ahs.v15i1.3.

13. World Health Organization (WHO). “WHO Continues Life-Saving Support to Yemen’s Blood Transfusion Centres.” WHO Yemen News, 2018. Accessed June 2020. http://www.emro.who.int/yem/yemen-news/who-continues-life-saving-support-to-the-yemens-blood-transfusion-centres.html.

14. Mavenyengwa, R.T. et al. “Prevalence of Human Immunodeficiency Virus, Syphilis, Hepatitis B and C in Blood Donations in Namibia.” BMC Public Health, vol. 14, 2014, p. 424.

15. Kabinda, J.M. et al. “Les hépatites B et C chez les donneurs bénévoles de sang et non rémunérés de l’Est de la République Démocratique du Congo.” Transfusion Clinique et Biologique, vol. 21, no. 3, 2014, pp. 111–115.

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