Dah Ter Tiero Elias, Couderc Clotilde, Coulibaly Alou, Kouamé Malan Jean-Baptiste, Agboyibor Mawuényégan Kouamivi, Traoré Issa, Maradan Gwenaëlle, Rojas Castro Daniela, Mensah Ephrem, Anoma Camille, Dembélé Keita Bintou, Spire Bruno, Laurent Christian
Association African Solidarité, Ouagadougou, Burkina Faso.
Institut National de Santé Publique, Centre Muraz, Bobo Dioulasso, Burkina Faso.
Open Forum Infect Dis. 2019 May 23;6(7):ofz249. doi: 10.1093/ofid/ofz249. eCollection 2019 Jul.
Although men who have sex with men (MSM) are at high risk of hepatitis B virus (HBV) infection, they do not have access to vaccination in West Africa, which is a highly endemic region. We investigated HBV prevalence and associated factors, as well as acceptability and difficulties of vaccination in MSM enrolled in an operational research program in Burkina Faso, Côte d'Ivoire, Mali, and Togo.
We followed up 779 MSM in 2015-2018. Participants who were negative for both hepatitis B surface antigen (HBsAg) and antibodies (anti-HBs) at enrollment were offered HBV vaccination. Factors associated with HBV infection were identified using logistic regression models.
Overall, HBV prevalence was 11.2% (95% confidence interval [CI], 9.0%-13.6%). It was lower in Togo than in Côte d'Ivoire (2.7% vs 17.3%; adjusted odds ratio [aOR], 0.12; 95% CI, 0.02-0.28) and higher in participants with 6+ recent male sexual partners (21.0% vs 9.3%; aOR, 1.48; 95% CI, 1.12-1.97). Of 528 participants eligible for vaccination, 484 (91.7%) were willing to be vaccinated and received at least 1 dose (ranging from 68.2% in Abidjan to 96.4% in Bamako; < .001). Of the latter, 390 (80.6%) received 3 or 4 doses. The proportion of participants for whom the minimum required time between each dose was respected ranged from 10.9% in Bamako to 88.6% in Lomé ( < .001).
MSM in West Africa should be targeted more for HBV screening and vaccination. Although vaccination is well accepted by MSM, greater training of health care workers and education of MSM are required.
尽管男男性行为者(MSM)感染乙型肝炎病毒(HBV)的风险很高,但在西非这个乙肝高流行地区,他们无法获得疫苗接种服务。我们调查了在布基纳法索、科特迪瓦、马里和多哥参与一项运营研究项目的男男性行为者中HBV的流行情况及相关因素,以及疫苗接种的可接受性和困难程度。
我们在2015年至2018年期间对779名男男性行为者进行了随访。对入组时乙肝表面抗原(HBsAg)和抗体(抗-HBs)均为阴性的参与者提供HBV疫苗接种。使用逻辑回归模型确定与HBV感染相关的因素。
总体而言,HBV流行率为11.2%(95%置信区间[CI],9.0%-13.6%)。多哥的流行率低于科特迪瓦(2.7%对17.3%;调整优势比[aOR],0.12;95%CI,0.02-0.28),近期有6个以上男性性伴侣的参与者流行率更高(21.0%对9.3%;aOR,1.48;95%CI,1.12-1.97)。在528名符合疫苗接种条件的参与者中,484名(91.7%)愿意接种并至少接种了1剂(从阿比让的68.2%到巴马科的96.4%;P<0.001)。在后者中,390名(80.6%)接种了3剂或4剂。各剂之间遵守最低所需时间的参与者比例从巴马科的10.9%到洛美的88.6%不等(P<0.001)。
西非的男男性行为者应成为HBV筛查和疫苗接种的更主要目标人群。尽管男男性行为者对疫苗接种接受度良好,但仍需要对医护人员进行更多培训,并对男男性行为者进行教育。