Prevalence and risk factors of hepatitis B, hepatitis C, and syphilis among reproductive-age adults in the Tigray region, Northern Ethiopia: a community-based cross-sectional study

In World Health Organization’s (WHO) 2024 Global Hepatitis Report, viral hepatitis is the second leading infectious cause of death globally, and syphilis remains a major public health concern, particularly in sub-Saharan Africa. Ethiopia ranks among the countries most heavily burdened by hepatitis B virus (HBV) and hepatitis C virus (HCV). However, community-level data for the Ethiopia’s Tigray region is limited. To assess sero-prevalence and risk factors of HBV, HCV, and syphilis among the general population in the Tigray region, we conducted a cross-sectional survey from June 1 to September 30, 2024. Females aged 15–49 and men aged 15–54 were enrolled. A total of 6,010 study participants were recruited into the study. Data were collected via structured questionnaire using Open Data Kit (ODK) and venous blood samples were tested for infections. Binary logistic regression was used to identify factors associated with HBV and syphilis. The overall positivity rate was 3.6% (95% CI: 3.14 − 4.08%), with hepatitis B (2.1%) being the most prevalent, followed by syphilis (1.5%) and hepatitis C (0.2%). HBV was significantly higher in the Southeast Zone (Adjusted Odds Ratio, AOR = 2.04, 95% Confidence Interval, CI: 1.20 − 3.47). Slightly higher infection rates were observed among males, divorced individuals, student occupation and rural residents, but these differences were not statistically significant after adjustment. Syphilis sero-positivity was associated with age 35–54 (AOR = 3.43; 95% CI: 1.34–8.74), age 45–54 years (AOR = 6.77; 95% CI: 2.49–18.36), widowhood (AOR = 8.22; 95% CI: 1.75–38.65), urban residence (AOR = 1.90; 95% CI: 1.04–3.49), and smaller family size (1–3 members; AOR = 3.21; 95% CI: 1.72–5.97). These data indicate the need for targeted public health interventions and continuing surveillance in high-risk areas and vulnerable populations. The study highlights critical gaps in community-level data and calls for greater regional surveillance of diseases.