Iraq's Hepatitis B Prevention Challenges and Opportunities: Focusing on Vertical Transmission and Vaccine Series Completion

Rawaa Behlul; Dhuha Abdullah  Kadhim; Ali M Hussein  Abdulhadi

doi:10.17605/cajmns.v6i2.2791

Rawaa Behlul Department of clinical laboratory science, Faculty of pharmacy, university of kufa, Iraq
Dhuha Abdullah Kadhim Jabir ibn hayyan University for Medical and Pharmaceutical Sciences, Faculty of Medicine, Najaf, Iraq
Ali M Hussein Abdulhadi Jabir ibn hayyan University for Medical and Pharmaceutical Sciences, Faculty of Medicine, Najaf, Iraq

DOI: https://doi.org/10.17605/cajmns.v6i2.2791

Keywords: Hepatitis B Virus, Vaccination Coverage, Iraq, Healthcare Workers, High-Risk Populations, Barriers to Vaccination, Prevalence

Abstract

Hepatitis B virus (HBV) infection remains a significant public health concern in the Eastern Mediterranean Region. This study aimed to assess HBV vaccination coverage, identify barriers to vaccination, and determine prevalence rates among diverse risk groups in Iraq. A cross-sectional analysis was conducted using national vaccination and screening data from healthcare facilities across Al-Najaf city. Vaccination records were analyzed for high-risk populations, including healthcare workers (HCWs), contacts of diagnosed patients, and occupational risk groups. HBV screening results were examined across 15 distinct risk categories (n=103,550). Barriers to vaccination were assessed through structured surveys of healthcare providers. Among 103,550 individuals screened, overall HBV prevalence was 0.095% (98 positive cases). Highest absolute numbers of cases were found among surgical patients (24.5% of positives), blood donors (22.4%), and pre-marital screening participants (12.2%). Children born to infected mothers showed 100% positivity rate, while contacts of diagnosed patients demonstrated 3.57% positivity. Vaccination data revealed significant dose completion challenges, with 624 first doses administered compared to only 335 third doses completed. Healthcare workers received 73.4% of all vaccine doses. Primary barriers to vaccination included vaccine availability (50%), safety concerns (45%), and insufficient training (40%). Non-compliance among HCWs stemmed from perceived ineffectiveness (37%), perception of low disease prevalence (35%), and safety concerns (30%). This study identifies critical gaps in Iraq's HBV prevention strategy, particularly regarding vertical transmission prevention and vaccine series completion. The substantial drop off between first and third vaccine doses highlights systemic challenges in the vaccination program. Targeted interventions should address identified barriers, particularly vaccine supply issues and safety concerns. Strengthening screening and vaccination efforts for contacts of diagnosed patients and children born to infected mothers represents a high-impact opportunity for infection control. Comprehensive policies addressing gender disparities in screening access and enhanced professional education are needed to improve Iraq's HBV prevention landscape.

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