Assessment of Lassa Fever Seroprevalence and Risk Factors Among Hospital Workers in Ebonyi State Using a Community-Hospital Comparative Design

Lassa fever continues to cause significant mortality in Nigeria, with healthcare workers in endemic states at heightened occupational risk compared to the general community. This comparative cross-sectional study assessed Lassa fever seroprevalence and associated risk factors among healthcare workers and matched community controls in Abakaliki, Ebonyi State, in the South East geopolitical zone of Nigeria. Blood samples were collected from 200 healthcare workers across the Federal Teaching Hospital Abakaliki and 200 age- and sex-matched community controls from adjacent urban wards. Lassa virus IgG and IgM antibodies were detected by ELISA using validated commercial kits. Structured questionnaires collected occupational, behavioral, and environmental risk data. Healthcare workers had a significantly higher IgG seroprevalence at 14.5 percent compared to 8.0 percent in community controls (odds ratio 1.94, 95% CI 1.08 to 3.49). IgM positivity was 4.0 percent in healthcare workers versus 1.5 percent in community controls. Absence of full PPE use during febrile patient care, handling of body fluids without gloves, and working in emergency or obstetric units were independent risk factors for seropositivity among healthcare workers. Among community controls, exposure to Mastomys rats and food storage conditions were the dominant risk factors. These findings justify differential surveillance strategies for healthcare and community Lassa fever risk reduction in Ebonyi State. Keywords: Lassa fever, seroprevalence, healthcare workers, Ebonyi, risk factors.