An Assessment of the Prevalence, Determinants of Viral Hepatitis B and Impact of Infant Vaccine and Circumcision as Preventive Measures in Malawi

Abstract

Hepatitis B virus is one of the neglected public health diseases leading to deaths in Malawi. However, few studies have examined the burden and factors associated with disease acquisition. The study aimed to assess the prevalence of hepatitis B infection and the factors associated with it in the Malawian population. This retrospective study used secondary data from the scan form register, pulling and analysing data from Jan 2023 to July 2025. Out of 1.9 million total tests, 1.6% (32566) were hepatitis B positive. Hepatitis B burden among males and non-pregnant females was 2.4% (14839/611,970). Males had a higher prevalence of 3% (9,873/334,299) than non-pregnant females at 1.7% (4962/284958). Bivariate analysis showed that males were twice as likely to have hepatitis B compared to females OR = 2, p < 0. 0001. Infant-vaccinated clients were 77% less likely to be infected than the non-vaccinated (OR = 0.3, p < 0.0001). Pregnant women were less likely to be hepatitis B infected than non-pregnant women (OR = 0.8, P < 0.001). The study reveals that hepatitis B is less prevalent than in earlier studies done in Malawi. The Infant Vaccine seems effective in reducing hepatitis B infection among infants who receive this vaccine. Male gender, not being pregnant, and being circumcised increased the risk for hepatitis B infection. Further studies need to be carried out to study the role of circumcision and the association between pregnancy and Viral hepatitis.