Seroprevalence of markers and immunization for hepatitis B in community health workers: a scoping review

Amaral, Tauana de Souza; Souza, Sara Oliveira; Matos, Márcia Alves Dias de; Meireles, Gláucia Oliveira Abreu Batista; Paula, Cácia Régia de; Matos, Marcos André de

doi:10.1590/1980-220X-REEUSP-2025-0358en

Sumário Anterior Atual Seguinte

Sumário

REVIEW • Rev. esc. enferm. USP 60 • 2026 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0358en linkcopy

Seroprevalence of markers and immunization for hepatitis B in community health workers: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To map the scientific evidence concerning the prevalence of hepatitis B virus (HBV) and immunization among Community Health Workers (CHWs) worldwide.

Method: A scoping review was conducted using the LILACS, Medline (via PubMed), Embase, and Scopus databases, as well as grey literature (Google Scholar, Pro-Quest), employing the recommendations of PRISMA-ScR (extension for scoping review) and the Joanna Briggs Institute Manual.

Results: Eleven studies were included, all conducted in Brazil and without parameterization of the outcome measure. The estimated prevalence of HBV infection ranged from 8.2% to 11.1%, while vaccination coverage varied between 41% and 88.8%. Only one study used the anti-HBs serological marker to assess immunization, estimating that 71.6% of community health workers were immunized. Two additional studies were based on self-reported anti-HBs, with prevalences of 30.0% and 30.2%.

Conclusion: The overall estimate of HBV infection prevalence and immunization among community health workers could not be determined due to the scarcity and geographical limitations of existing studies, as well as the measurements deparameterization.

DESCRIPTORS
Community Health Workers; Hepatitis B; Biomarkers; Vaccination; Primary Health Care

Database	Search Strategy	Records Found (n)
PubMed/Medline	(“Community Health Workers” OR “Barefoot Doctor” OR “Barefoot Doctors” OR “Community Health Aide” OR “Community Health Aides” OR “Community Health Worker” OR “Family Planning Personnel” OR “Family Planning Personnel Characteristics” OR “Village Health Worker” OR “Village Health Workers” OR “health auxiliary” OR “asha” OR “accredited social health activist” OR “asha workers” OR “auxiliary health worker” OR “community health officers” OR “community health practitioner” OR “Lay health worker” OR “lay health advisor” OR “ lay health advisors” OR “lay health promoter” OR “lay health promoters” OR “lay health workers” OR “lay healthworker”) AND (“Hepatitis B” OR “Hepatitis B Virus Infection” OR “hbv infection” OR “hepatitis b infection” OR “hepatitis b viral infection” OR “hepatitis b virus infection” OR “infection by hbv” OR “infection by hepatitis b virus” OR “serum hepatitis” OR “type b hepatitis” OR “viral hepatitis b” OR “viral hepatitis type b” OR “virus hepatitis type b”)	53
Embase	(‘community health workers’/exp OR ‘community health workers’:ti,kw OR ‘barefoot doctor’/exp OR ‘barefoot doctor’:ti,kw OR ‘barefoot doctors’/exp OR ‘barefoot doctors’:ti,kw OR ‘community health aide’:ti,kw OR ‘community health aides’/exp OR ‘community health aides’:ti,kw OR ‘community health worker’/exp OR ‘community health worker’:ti,kw OR ‘family planning personnel’/exp OR ‘family planning personnel’:ti,kw OR ‘family planning personnel characteristics’/exp OR ‘family planning personnel characteristics’:ti,kw OR ‘village health worker’/exp OR ‘village health worker’:ti,kw OR ‘village health workers’:ti,kw OR ‘health auxiliary’/exp OR ‘health auxiliary’:ti,kw OR ‘asha’:ti,kw OR ‘accredited social health activist’/exp OR ‘accredited social health activist’:ti,kw OR ‘asha workers’/exp OR ‘asha workers’:ti,kw OR ‘auxiliary health worker’/exp OR ‘auxiliary health worker’:ti,kw OR ‘community health officers’/exp OR ‘community health officers’:ti,kw OR ‘community health practitioner’/exp OR ‘community health practitioner’:ti,kw OR ‘lay health worker’/exp OR ‘lay health worker’:ti,kw OR ‘lay health advisor’/exp OR ‘lay health advisor’:ti,kw OR ‘lay health advisors’/exp OR ‘lay health advisors’:ti,kw OR ‘lay health promoter’/exp OR ‘lay health promoter’:ti,kw OR ‘lay health promoters’/exp OR ‘lay health promoters’:ti,kw OR ‘lay health workers’/exp OR ‘lay health workers’:ti,kw OR ‘lay healthworker’/exp OR ‘lay healthworker’:ti,kw) AND (‘hepatitis b’/mj OR ‘hbv infection’/mj OR ‘hepatitis b infection’/mj OR ‘hepatitis b viral infection’/mj OR ‘hepatitis b virus infection’/mj OR ‘infection by hbv’/mj OR ‘infection by hepatitis b virus’/mj OR ‘serum hepatitis’/mj OR ‘type b hepatitis’/mj OR ‘viral hepatitis b’/mj OR ‘viral hepatitis type b’/mj OR ‘virus hepatitis type b’/mj)	21
BVS/Lilacs	(“Community Health Workers” OR “Barefoot Doctor” OR “Barefoot Doctors” OR “Community Health Aide” OR “Community Health Aides” OR “Community Health Worker” OR “Family Planning Personnel” OR “Family Planning Personnel Characteristics” OR “Village Health Worker” OR “Village Health Workers” OR “health auxiliary” OR “asha” OR “accredited social health activist” OR “asha workers” OR “auxiliary health worker” OR “community health officers” OR “community health practitioner” OR “Lay health worker” OR “lay health advisor” OR “ lay health advisors” OR “lay health promoter” OR “lay health promoters” OR “lay health workers” OR “lay healthworker”) AND (“Hepatitis B” OR “Hepatitis B Virus Infection” OR “hbv infection” OR “hepatitis b infection” OR “hepatitis b viral infection” OR “hepatitis b virus infection” OR “infection by hbv” OR “infection by hepatitis b virus” OR “serum hepatitis” OR “type b hepatitis” OR “viral hepatitis b” OR “viral hepatitis type b” OR “virus hepatitis type b”)	2
Web of Science	(TS = (“Community Health Workers” OR “Barefoot Doctor” OR “Barefoot Doctors” OR “Community Health Aide” OR “Community Health Aides” OR “Community Health Worker” OR “Family Planning Personnel” OR “Family Planning Personnel Characteristics” OR “Village Health Worker” OR “Village Health Workers” OR “health auxiliary” OR “asha” OR “accredited social health activist” OR “asha workers” OR “auxiliary health worker” OR “community health officers” OR “community health practitioner” OR “Lay health worker” OR “lay health advisor” OR “ lay health advisors” OR “lay health promoter” OR “lay health promoters” OR “lay health workers” OR “lay healthworker”)) AND TS = (“Hepatitis B” OR “Hepatitis B Virus Infection” OR “hbv infection” OR “hepatitis b infection” OR “hepatitis b viral infection” OR “hepatitis b virus infection” OR “infection by hbv” OR “infection by hepatitis b virus” OR “serum hepatitis” OR “type b hepatitis” OR “viral hepatitis b” OR “viral hepatitis type b” OR “virus hepatitis type b”)	41

Citation (author and year)	State/Country	Study objective	Type of study and data collection period	Population (n)	HCW Sample (n)	CHW Sample (n)	Tests/ strategies	Serological markers	HBV prevalence	Vaccination prevalence	Immunization Prevalence	Associated factors
Sanches, 2007(¹⁵)	Mato Grosso do Sul/Brazil	To assess the immune status of primary healthcare professionals in relation to hepatitis B, as well as to outline the epidemiological factors comprising the representative picture of this disease in these professionals.	Analytical cross-sectional study, conducted between September 2005 and December 2006.	Not specified	347 healthcare workers were surveyed, but for operational reasons, the authors collected 332 blood samples.	59	Commercial kits from the ABBOTT brand using the microparticle enzyme immunoassay methodology.	HBsAg HBeAg anti-HBc anti-HBs anti-HBe	13.5% (95% CI = 4.78%–22.22%)	It does not address	It does not address	It does not address
Garcia and Facchini, 2008(³⁵)	Santa Catarina/Brazil	To verify the prevalence of complete hepatitis B vaccination, to stimulate the prevalence of confirmed immunity, and to investigate the factors associated with completing the vaccination schedule among healthcare workers in the municipality of Florianópolis, Santa Catarina, Brazil.	Analytical cross-sectional study, conducted between October and December 2006.	1332	1249	Not specified	Self-report of vaccination	No marker	It does not address	55%	It does not address	It does not address
Assunção et al., 2012(³⁶)	Minas Gerais/Brazil	To identify factors associated with hepatitis B vaccination in municipal health workers.	Analytical cross-sectional study, conducted in 2009.	1808	1770	Not specified	Self-report of vaccination	No marker	It does not address	84.1%	It does not address	It does not address
Costa et al., 2013(³⁷)	Minas Gerais/Brazil	To investigate the prevalence and factors associated with hepatitis B vaccination among primary healthcare workers, and to analyze the factors considered important in determining hepatitis B vaccination.	Analytical cross-sectional study, conducted in 2009.	797	761	480	Self-report of vaccination	No marker	It does not address	41% (95% CI = 36.59%–45.41%)	It does not address	It does not address
Souza et al., 2015(³⁸)	Bahia/Brazil	To assess the prevalence and factors associated with hepatitis B vaccination among Primary Care and Medium Complexity healthcare workers in a municipality in Bahia.	Cross-sectional analytical study conducted in 2011.	707	506	Not specified	Self-report of vaccination	No marker	It does not address	65.3%	It does not address	It does not address
Rezende, 2016(³²)	Goiás/Brazil	To analyze the biological risk in the work practice of community health workers.	Descriptive cross-sectional study, conducted between September and November 2015.	89	80	80	Vaccination card and self-reported vaccination	No marker	It does not address	82.5% (CI= 74.17–90.83%), however 52.5% had all three doses on their vaccination card, and 30% reported completing the schedule.	30.0% (95% CI = 19.96%–40.04%) through self-reported anti-HBs testing.	It does not address
Souza and Araújo, 2016(³⁹)	Bahia/Brazil	To investigate the vaccination status for the four vaccines guaranteed by the National Immunization Program, evaluating the prevalence of vaccination among occupational categories and the completeness of the vaccination schedule among primary care and medium complexity care workers in municipalities of Bahia.	Descriptive cross-sectional study, conducted between 2010 and 2012.	6.191	3.084	Not specified	Self-report of vaccination	No marker	It does not address	88.8%	It does not address	It does not address
Costa et al., 2017(³³)	Minas Gerais/Brazil	To investigate the prevalence of post-vaccination immunization verification against hepatitis B among primary health care workers and its association with occupational factors, general health conditions, and self-care measures.	Cross-sectional analytical study, data collected between August and December 2011.	797	400	197	Self-reported vaccination and anti-HBs test results.	No marker	It does not address	Not specified	30.2% (95% CI = 23.79%–36.61%), through self-reported anti-HBs testing.	It does not address
Rocha, 2017(⁴⁰)	Minas Gerais/Brazil	To analyze the vaccination status of Community Health Workers in Primary Health Care units in a municipality in the Zona da Mata region of Minas Gerais.	Cross-sectional analytical study, data collected between July and October 2015; and October 2016 to February 2017.	500	400	400	Self-report of vaccination	No marker	It does not address	87.8% (95%CI = 84.59%–91.01%)	It does not address	The time in the occupation of the CHW was associated with the hepatitis B vaccine.
Pinto et al., 2020(⁴¹)	Espírito Santo/Brazil	To identify the adherence of CHWs to hepatitis B vaccination, to determine the causes of non-adherence to hepatitis B vaccination, and to investigate whether the prevalence of vaccination differs among the surveyed towns.	Analytical cross-sectional study, carried out between April 2016 and April 2017.	664	516	516	Self-report of vaccination	No marker	It does not address	59.7% (95%CI = 55.48%–63.92%)	It does not address	More than five years of experience in the occupation was associated with adherence to hepatitis B vaccination.
Amaral et al., 2023(¹⁶)	Goiás/Brazil	To identify the vaccination and serological status against hepatitis B among Community Health Workers, to vaccinate against the hepatitis B virus, and to evaluate the immune response of susceptible CHWs.	A descriptive cross-sectional study was conducted between July and December 2019, followed by a cohort study conducted from January to May 2020.	172	172	109	Vaccination record card and serological tests. For the detection of HBsAg, a rapid test from the brand Bioclin, Brazil was used; and for the other anti-HBc and anti-HBs markers, the chemiluminescence method was used (Architec i1000tm, Abbott Diagnostics).	HBsAg anti-HBc anti-HBs	8.2% (95% CI = 4.4%-15.5%)	68.8% (95% CI = 59.6%–76.7%)	71.6% (95% CI = 62.5%–79.2%)	It does not address

location_on

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS