Objective: Hepatitis B virus infection is hyperendemic in Kiribati (~15% prevalence rate), with vaccination and antiviral treatment being the mainstays of control. Prevalence, knowledge and attitudes among health-care workers and antenatal mothers are poorly understood. Methods: A cross-sectional, descriptive study was conducted among health-care workers and antenatal mothers at Tungaru Central Hospital on South Tarawa, Kiribati in 2022. The study included hepatitis B virus serology and a bilingual questionnaire. Results: Fifty-one health-care workers and 49 women receiving antenatal care participated in the study. Most health-care workers (98.0%) had heard of the hepatitis B virus and most (54.9%) exhibited a moderate level of knowledge. Less than half (46.9%) of the antenatal mothers had heard of the hepatitis B virus and most (63.3%) had a low level of knowledge. Most health-care workers (60.8%) and half of antenatal mothers (49.0%) had satisfactory attitudes towards screening, care-seeking and vaccination, and 93.9% approved of adult catch-up vaccination. Hepatitis B virus prevalence was 23.0% (15.7% of health-care workers, 30.6% of antenatal mothers). Discussion: Extensive educational campaigns for antenatal mothers are needed to enhance awareness of the infection, while training for health-care workers on transmission, prevention and treatment is critical for informing and galvanizing action on hepatitis B virus.

Problem: Antiviral therapy for chronic hepatitis B (CHB) reduces morbidity and mortality and improves quality of life. Achieving high levels of adherence is challenging due to multiple barriers, including medication fatigue, stigma, transportation and limited health literacy. Context: Suboptimal adherence to antiviral therapy for CHB is problematic in Kiribati, particularly among high-risk groups including pregnant women and individuals with cirrhosis. Action: During January–August 2025, a community volunteer intervention was initiated on Kiritimati, a remote island of Kiribati, to address adherence to CHB antiviral therapy. Community volunteers were assigned to patients positive for hepatitis B surface antigen who were commencing antiviral therapy and were pregnant or had cirrhosis. During home visits, volunteers provided education and encouraged medication adherence and clinic follow-up. Adherence in the intervention group was compared with adherence in positive patients being treated on other remote islands without the intervention. Outcome: Adherence was measured by medication bottle counts. Outcomes were assessed by overall group adherence and individual adherence >80%. Group adherence was 77.4% (240.5/310.75) in the volunteer intervention group compared with 52.5% (700/1333) in the group without it (P < 0.001). Overall adherence among pregnant women in the intervention group was 89.7% (52/58). Individual adherence >80% was met in 58.8% (30/51) of the intervention group and 34.1% (70/205) in the control group (P = 0.0012). Discussion: Although findings are preliminary and the intervention and control groups were not matched, this pilot suggests community volunteers are a promising intervention to improve CHB treatment adherence in a high-prevalence Pacific island setting. This strategy could also be explored for other chronic conditions where adherence is important.