A cross-sectional survey and comparative study of six major infections among local employees of Chinese enterprises and community residents in Sierra Leone

With increased Chinese enterprises involvement in Sierra Leone under the Belt and Road Initiative, understanding the prevalence of infectious diseases among local populations, particularly employees of Chinese firms, is crucial for enterprise management and public health interventions. This cross-sectional study aimed to assess the seroprevalence of HIV, HBV, HCV, syphilis, malaria, and tuberculosis among the local population, including co-infection prevalence and associated risk factors. A serological survey was conducted among 342 local employees from six Chinese enterprises and 165 community residents (controls). Blood samples were tested using rapid immunological kits. Demographic data, occupational details, body temperature, and blood pressure were collected. Seroprevalence rates and risk factors were analyzed, with a focus on co-infections. The seroprevalence rates, in descending order, were as follows: malaria parasites (14.6%, 95% CI: 11.64%–17.97%), HBV (10.1%, 95% CI: 7.58%–13.01%), HIV (6.1%, 95% CI: 4.20%–8.57%), tuberculosis (4.3%, 95% CI: 2.74%–6.50%), syphilis (3.7%, 95% CI: 2.27%–5.79%), and HCV (0.0%, NA) for both the company employees and community residents. For mono-infection, there is a significantly lower seroprevalence in HIV and syphilis among company employees than in community controls (4.4% vs 9.7%, <i>p</i> = 0.019; 2.3% vs 6.7%, <i>p</i> = 0.016). Both the co-infection rate (3.5% vs 8.5%, <i>p</i> = 0.017) and the overall infection rate (29.8% vs 39.4%, <i>p</i> = 0.032) are also significantly lower among company employees compared to community controls. This study provides insights into the prevalence of infectious diseases and co-infection levels among local employees of Chinese enterprises and community residents in Sierra Leone. It highlights the importance of pre-employment screenings and post-employment health evaluations. The findings underscore the need for broader epidemiological investigations and surveillance to combat infectious diseases in sub-Saharan Africa effectively.