Assessment of hepatitis B knowledge, attitudes, and practices among healthcare workers in Herat, Afghanistan: a cross-sectional study

Hepatitis B virus (HBV) is a significant global health threat, with healthcare workers (HCWs) at high occupational risk. Despite effective vaccines, coverage among HCWs in low- and middle-income countries (LMICs) remains low. In Afghanistan, data on HCWs' knowledge, attitudes, and practices (KAP) regarding HBV are limited, hindering targeted prevention efforts. A cross-sectional study recruited 453 HCWs from 22 health facilities in Herat City between October and December 2023 using a convenience sampling method. Participants completed a self-administered questionnaire on their KAP regarding HBV infection, prevention, and vaccination. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression with SPSS version 27. Among participants, 39.7% (n = 180) demonstrated greater knowledge, 44.6% (n = 202) had better attitudes, and 47.5% (n = 215) showed better practices toward hepatitis B. Notable disparities were observed in knowledge and practices among HCWs. Males had higher knowledge than females (n = 111, 45.3% vs. n = 69, 33.2%; p = 0.009), and participants aged ≥ 35 years showed greater knowledge than those aged 25-29 years (n = 39, 54.2% vs. n = 59, 32.1%; p = 0.008). Education was also associated with knowledge: master's degree holders scored higher than diploma holders (n = 57, 53.3% vs. n = 49, 29.9%; p < 0.001), and among professions, medical doctors outperformed nurses (n = 88, 54.7% vs. n = 24, 25.5%; p < 0.001). In terms of practices, HCWs at Herat Regional Hospital demonstrated better performance than those at other health centers (n = 78, 53.1%; p = 0.007). Multivariate analysis confirmed these associations. Medical doctors had significantly greater knowledge compared to other professions (OR = 2.351, 95% CI = 1.081-5.112, p = 0.031). Likewise, HCWs in Herat Regional Hospital (OR = 4.744, 95% CI = 1.800-12.504, p = 0.002), Private Hospitals (OR = 3.845, 95% CI = 1.496-9.886, p = 0.005), and Governmental Clinics (OR = 4.844, 95% CI = 1.629-14.405, p = 0.005) demonstrated better practices compared to doctors' offices. HCWs in Herat demonstrate suboptimal knowledge and preventive practices toward HBV, despite relatively high vaccination coverage. Educational, institutional, and regional factors influence KAP, while professional experience and training improve outcomes. Strengthening HBV prevention through universal vaccination, post-vaccination testing, reliable reporting, and integrated training is essential to protect HCWs and patients and support Afghanistan's progress toward HBV elimination.