Knowledge, attitudes and practices regarding prevention of hepatitis B virus mother-to-child transmission among health professionals in a semi-rural health district of Cameroon: a cross-sectional study

Abstract Background Hepatitis B virus (HBV) infection remains a major public health problem in Cameroon, a country of high endemicity where mother-to-child transmission accounts for a substantial proportion of chronic infections, with more than 90% of infections acquired at birth progressing to chronicity compared with less than 5% among adults. Prevention of HBV mother-to-child transmission (PMTCT) depends directly on the knowledge, attitudes, and practices of health workers providing maternity and immunization services, which remain poorly documented in semi-urban and rural health districts of Cameroon. This study aimed to assess these three dimensions among health professionals in the Obala Health District and to identify the factors associated with each. Methods An analytical cross-sectional study was conducted from April to June 2026 among health workers providing antenatal, maternity, and immunization services across the 33 health facilities of the Obala Health District, Centre Region, Cameroon. All 145 eligible staff were approached exhaustively; data were collected using a structured, pre-tested questionnaire under strict conditions of anonymity and confidentiality, and analyzed using IBM SPSS version 27.0. Scores were expressed as a percentage of the theoretical maximum and dichotomized at the 85% threshold (good/appropriate/adequate versus the remaining categories combined) for multivariable analysis. Multivariable binary logistic regression identified factors associated with good knowledge, appropriate attitudes, and adequate practices at p < 0.05. Results Of 145 eligible professionals, 118 (81.4%) participated; the sample was predominantly female (68.6%) and young (≤ 35 years: 76.3%), with nurses the largest professional group (59.3%). Mean scores were 80.1 ± 13.0/100 for knowledge, 85.5/100 for attitudes, and 62.8 ± 22.8/100 for practices. While 36.4% had good knowledge and 56.8% held appropriate attitudes, only 19.5% reported adequate practices; 21.2% of reported practices were classified as harmful, a pattern most pronounced among general practitioners (40%) and nursing aides (33.3%). The leading barriers were unavailability of vaccines or immunoglobulins (84.7%), lack of staff training (63.6%), and the cost of immunoglobulins for patients (62.7%). Working in the Essong (aOR = 0.10, 95% CI 0.01–0.88; p = 0.039) or Etoud-Ayos (aOR = 0.07, 95% CI 0.007–0.68; p = 0.022) health areas was associated with insufficient knowledge. Appropriate attitudes were associated with good knowledge (aOR = 8.23, 95% CI 1.70–39.74; p = 0.009) and more than five years of professional experience (aOR = 2.23, 95% CI 1.02–4.86; p = 0.044). Recent in-service training was the only factor associated with adequate practices (aOR = 3.03, 95% CI 1.15–7.98; p = 0.032). Conclusions Health professionals in the Obala Health District had acceptable knowledge and generally favorable attitudes toward HBV PMTCT, but adequate clinical practice remained the exception, and a striking share of reported practices were frankly harmful, particularly among physicians and nursing aides. This disruption of the knowledge-attitudes-practices continuum is driven primarily by structural barriers rather than staff motivation, and jeopardizes national progress toward the WHO's 2030 viral hepatitis elimination targets. Securing the monovalent vaccine and immunoglobulin supply chain, intensifying in-service training and supervision in the most isolated health areas, and specifically targeting physicians and nursing aides for retraining are priority, actionable levers for this district and comparable settings.