Hepatitis B and C Screening Coverage among High-risk Populations in Saudi Arabia: A National Analysis of Surveillance Data and Alignment with the World Health Organization Viral Hepatitis Elimination Targets (2016–2023)
Ahmed Abdulaziz AlmohammadiAbstract
Background:
Viral hepatitis B and C represent major global public health challenges, collectively responsible for approximately 1.1 million deaths annually. Saudi Arabia has historically demonstrated endemic hepatitis B transmission and carries a significant hepatitis C burden, yet comprehensive analyses of screening coverage among high-risk populations remain limited.
Objectives:
The objectives of the study were to characterize hepatitis B and C screening coverage patterns among high-risk populations in Saudi Arabia and evaluate alignment with the World Health Organization (WHO) Global Health Sector Strategy (GHSS) targets for viral hepatitis elimination by 2030.
Materials and Methods:
This cross-sectional descriptive study analyzed secondary data from the WHO Global Health Observatory estimates, Saudi Ministry of Health surveillance reports, and published epidemiological surveys (2016–2023). Screening coverage was assessed among defined high-risk groups including healthcare workers, blood donors, prisoners, patients on hemodialysis, and pregnant women. Descriptive statistics, including 95% confidence intervals (CIs), characterized coverage patterns by population group, geographic region, and temporal trends. Comparative analysis assessed alignment with the WHO GHSS targets.
Results:
Overall hepatitis B surface antigen (HBsAg) testing coverage among high-risk populations reached 74.3% (95% CI: 74.2–74.4) in 2023, while anti-hepatitis C virus (HCV) testing coverage reached 68.9% (95% CI: 68.8–69.0). Blood donor screening achieved near-universal coverage (99.8%, 95% CI: 99.79–99.81, for both HBsAg and anti-HCV). Healthcare worker screening demonstrated 81.4% (95% CI: 81.3–81.5) HBsAg and 76.2% (95% CI: 76.0–76.4) anti-HCV coverage. Hemodialysis patient screening reached 94.7% (95% CI: 94.4–95.0) for HBsAg. Antenatal screening for HBsAg achieved 89.3% (95% CI: 89.2–89.4) nationally. However, prisoner screening remained lowest at 41.2% (95% CI: 40.8–41.6) for HBsAg and 38.7% (95% CI: 38.4–39.0) for anti-HCV. Regional disparities persisted, with border regions demonstrating 15–22 percentage point gaps below national averages. Temporal analysis revealed a modest improvement from 61.4% (95% CI: 61.3–61.5) in 2016 to 74.3% (95% CI: 74.2–74.4) in 2023 for HBsAg screening overall.
Conclusions:
Saudi Arabia has achieved strong screening coverage in clinical high-risk groups, but critical gaps persist among incarcerated populations and in border regions. Targeted expansion of screening programs, integration with primary health care, and strengthened linkage to care are essential to achieve the WHO 2030 viral hepatitis elimination targets.