PREVALENCE OF HEPATITIS B VIRUS AND ASSOCIATED FACTORS AMONG SOLID WASTE WORKERS AT KITEEZI SANITARY LANDFILL, KAMPALA CITY, UGANDA

Abstract

Introduction: Hepatitis B is one of the silent but fast spreading infectious diseases with a global immersive public health burden accounting for a high number of deaths annually. This infection is of high risk and can be acquired through occupational exposure to contaminated waste. Most solid waste workers lack or have little awareness about the disease and the potentiality of waste exposing them to the infection. This study aimed at assessing the prevalence of Hepatitis B and associated factors among solid waste workers at Kiteezi Sanitary landfill, Kampala, Uganda. Findings from this study provided information needed for interventions geared towards preventing Hepatitis B infections among solid waste workers. Objective: To determine the prevalence and factors associated with occupational exposure to HBV infection among solid waste workers. Specifically, this study assessed prevalence of Hepatitis B infection as well as individual and institutional factors associated with the infection. Methods: A mixed methods study among 371 waste workers and 10 key informants at Kiteezi landfill was carried out between May and July 2019. Solid waste workers were selected using systematic random sampling and purposive sampling for the key informants. Data was collected using a key informants’ interview guide, a structured questionnaire and testing for Hepatitis B Antigen. This data was entered into the computer using Epidata version 3.1, and analyzed using STATA version 14.0. Quantitative data was analyzed using logistic regression and odds ratios with their 95% confidence Interval (CI) as the measure of association. Qualitative data was analyzed using conventional content analysis. Results: The overall prevalence of HBV among solid waste workers was 6.7% [95% CI 4.5 – 9.8]. Majority of the waste workers were waste sorters (38.3. %), had encountered needle stick at work (70.4%), had never experienced accidental injuries (57.5%) and had inadequate knowledge (76.3%) as well as inappropriate practices towards HBV prevention (91.1%). Majority of the waste workers had never received immediate response in cases of any accidents (70.1%) or medication in cases of any injuries (65.9%), trainings on infection control and safety (60.9%). However, they reported receiving job guidelines and aides (75.1%) as well as routine supervision (68.2%). Institutional factors influencing practices of waste workers included lack of trainings in safe handling of waste, poor enforcement of work policies and regulations on site, insufficiency in the leadership and management on the site, inappropriate waste workers’ welfare at the landfill and poor safety measures on the site. Multivariate analysis showed that: secondary education level and above [AOR = 0.10 (95% Cl 0.1004 - 0.766)], waste workers’ supervision [AOR = 0.35 (95% Cl 0.150 - 0.815)] and not involving directly in waste sorting were associated with HBV infection [AOR = 0.10; (95% CI 0.013 – 0.0788)]. Conclusion: Prevalence of HBV among solid waste workers was 6.7%.Level of education, not sorting or picking waste and supervision of the workers were significantly associated with Hepatitis B infection and had a protective effect towards HBV infection among the waste workers. . Findings from the study showed the necessity to train waste workers on safety and infection control, implementation of occupational and safety programme, vaccination of waste workers and health education is needed.