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Gaviola GC, McCarville M, Shendale S, Goodman T, Lomazzi M, Desai S. A review of health worker vaccination programs in low, middle and upper middle-income countries. PUBLIC HEALTH IN PRACTICE 2023; 6:100415. [PMID: 37547811 PMCID: PMC10400463 DOI: 10.1016/j.puhip.2023.100415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Health workers (HW) are at risk of contracting vaccine preventable diseases when caring for patients and communities. This study aims to evaluate the existing literature on the routine vaccination of health workers against a variety of antigens in low and middle income countries, focusing on facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Study design A PubMed Literature search. Methods A PubMed search was conducted to find articles that addressed vaccination programs and policies for HW in low-income countries (LIC), lower middle-income countries (LMIC), and upper middle-income countries (UMIC). Original articles, meta-analyses, and reviews published in English between January 2000 and July 2022 were included in the search. Inductive content analysis was used to identify themes that illustrate facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Results The search identified 4240 studies, 90 were used for analysis as they provided antigen specific details on immunization policies or programs. Hepatitis B was the most frequently discussed antigen, followed by Influenza, then Measles, Rubella and Mumps. With considerable variability by vaccine and country, in most cases the vaccination was not offered free to HW or included in a regular vaccination schedule. Utilizing existing immunization infrastructure such as the Expanded Programme on Immunization (EPI) and having effective management of vaccination programs were found to be key facilitators to vaccinate HW. Conclusions The low vaccination coverage of health workers in LMIC is of concern; attention towards the key considerations, barriers and facilitators of immunization implementation is central to the advancement of health worker vaccination coverage in LMIC's. The COVID-19 pandemic necessitated the swift vaccination of HW. Many LIC countries lacking established HW immunization infrastructure are now administering COVID-19 vaccines. As we move beyond the pandemic's acute phase, there is a chance for those countries to enhance their immunization initiatives and policies for HW concerning other antigens, even if it is not a standard practice currently.
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Affiliation(s)
- Gabriel C. Gaviola
- Department of Occupational Medicine, Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Maddison McCarville
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- World Federation of Public Health Associations, Geneva, Switzerland
| | - Stephanie Shendale
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tracey Goodman
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marta Lomazzi
- World Federation of Public Health Associations, Geneva, Switzerland
- University of Geneva, Institute of Global Health, Geneva, Switzerland
| | - Shalini Desai
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Abouqal R, Beji M, Chakroun M, Marhoum El Filali K, Rammaoui J, Zaghden H. Trends in Adult and Elderly Vaccination: Focus on Vaccination Practices in Tunisia and Morocco. Front Public Health 2022; 10:903376. [PMID: 35844850 PMCID: PMC9286557 DOI: 10.3389/fpubh.2022.903376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022] Open
Abstract
Vaccine preventable diseases (VPDs) are a prevailing concern among the adult population, despite availability of vaccines. Unlike pediatric vaccination programs, adult vaccination programs lack the required reach, initiative, and awareness. Clinical studies and real-world data have proven that vaccines effectively reduce the disease burden of VPDs and increase life expectancy. In Tunisia and Morocco, the national immunization program (NIP) focuses more on pediatric vaccination and have limited vaccination programs for adults. However, some vaccination campaigns targeting adults are organized. For example, influenza vaccination campaigns prioritizing at risk adults which includes healthcare professionals, elderly, and patients with comorbidities. Women of childbearing age who have never been vaccinated or whose information is uncertain are recommended to receive tetanus vaccination. Tunisia NIP recommends rubella vaccine mainly for women of childbearing age, while in Morocco, national vaccination campaigns were organized for girls and women (up to 24 years of age) to eliminate rubella. Further, travelers from both countries are recommended to follow all requirements and recommendations in the travel destination. The objective of this manuscript is to provide an overview of the global disease burden of common VPDs including (but not limited to) meningococcal diseases, pneumococcal diseases, hepatitis, and influenza. The review also provides an overview of clinical data and guidelines/recommendations on adult vaccination practices, with special focus on Tunisia and Morocco. Some European and North American countries have concrete recommendations and strategies for adult vaccination to keep the VPDs in check. In Morocco and Tunisia, although, there are sporadic adult vaccination initiatives, the efforts still need upscaling and endorsements to boost vaccination awareness and uptake. There is a need to strengthen strategies in both countries to understand the disease burden and spread awareness. Additional studies are needed to generate economic evidence to support cost-effectiveness of vaccines. Integration of private and public healthcare systems may further improve vaccination uptake in adults.
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Affiliation(s)
- Redouane Abouqal
- Laboratory of Biostatistics, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Acute Medical Unit, Ibn Sina University Hospital, Rabat, Morocco
| | - Maher Beji
- Department of Internal Medicine, Military Hospital Bizerte, Bizerte, Tunisia
- Faculty of Medicine of Tunis, University El Manar, Tunis, Tunisia
- Tunisian Society of Tropical Medicine and Travel, Tunis, Tunisia
| | - Mohamed Chakroun
- Infectious Diseases Department, University Hospital, Monastir, Tunisia
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Maamor NH, Muhamad NA, Mohd Dali NS, Abdul Mutalip MH, Leman FN, Aris T, Lai NM, Abu Hassan MR. Seroprevalence of Hepatitis B Among Healthcare Workers in Asia and Africa and Its Association With Their Knowledge and Awareness: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:859350. [PMID: 35570890 PMCID: PMC9096243 DOI: 10.3389/fpubh.2022.859350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/04/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction The hepatitis B virus (HBV) is a blood-borne virus that can be transmitted by percutaneous and mucocutaneous contact with infected bodily fluid. Healthcare workers (HCWs) are more exposed to HBV infection. They must have a thorough understanding of HBV infection since they can contract and spread the virus. In this study, we systematically reviewed all published evidence on the seroprevalence of Hepatitis B virus (HBV) infection among HCWs. and synthesize evidence on the association between knowledge and awareness with HBV infection. Methods We searched PubMed, EMBASE, Cochrane Library and Scopus for studies reporting on HBV seroprevalence from January 1997 to September 2021 among healthcare workers. We used random-effects meta-analyses to estimate the pool prevalence of HBV infection. Results We identified 25 studies that met our inclusion criteria, with data on 10,043 adults from 11 countries and two regions: Africa and Asia. The overall seroprevalence of HBV was 5.0% (95% confidence interval [CI] 3.6%), with Africa reporting higher estimates (5.0%, 95% CI 3.7%) than Asia population (4.0%, 95% CI 1.9%). The highest pooled prevalence estimate in African countries came from studies published in the Cameroon region (8.0%, 95% CI 5–10%) while the lowest came from Ethiopia (4.0%, 95% CI 2.6%). The overall seroprevalence estimates in the African population were significantly higher than those in the Asian group. Studies in Africa found that the average knowledge and seroprevalence were 1.4% and 11.0%, respectively where, eight studies (53.3%) reported good knowledge and seven studies (46.7%) reported average knowledge. In Asia, two studies (40.0%) reported good knowledge, one study (20.0%) reporting average knowledge, and two studies (40.0%) reporting poor knowledge. African studies demonstrated good knowledge despite the fact that their HBV infection rate was higher than 6.7%. Conclusion Africa and Asia have the highest seroprevalence of HBV infection. Improving the comparability of epidemiological and clinical studies constitutes an important step forward. More high-quality data is needed to improve the precision of burden estimates. Systematic Review Registration PROSPERO CRD42021279905.
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Affiliation(s)
- Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nor Soleha Mohd Dali
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Institute for Public Health, National Institute of Health, Ministry of Health, Setia Alam, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Tahir Aris
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Muhammad Radzi Abu Hassan
- Department of Medicine, Sultanah Bahiyah Hospital, Ministry of Health, Alor Setar, Malaysia.,Clinical Research Centre, Sultanah Bahiyah Hospital, Ministry of Health, Alor Setar, Malaysia
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Atlaw D, Sahiledengle B, Tariku Z. Hepatitis B and C virus infection among healthcare workers in Africa: a systematic review and meta-analysis. Environ Health Prev Med 2021; 26:61. [PMID: 34078258 PMCID: PMC8173813 DOI: 10.1186/s12199-021-00983-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare workers are at risk of acquiring hepatitis B and C virus infections through patients' blood and bodily fluids exposure. So far, there is no pooled data that shows the prevalence of HBV and HCV among health care workers in Africa. This study aimed to determine the pooled prevalence of hepatitis B and C infections among health care workers in Africa. METHODS Studies reporting the prevalence of HBV and HCV were identified from major databases and gray literature. PubMed, CINAHL, POPLINE, ScienceDirect, African Journals Online (AJOL), and Google Scholar were systematically searched to identify relevant studies. A random-effect model was used to estimate the pooled prevalence of hepatitis B and C among health care workers in Africa. The heterogeneity of studies was assessed using Cochran Q statistics and I2 tests. Publication bias was assessed using Begg's tests. RESULT In total, 1885 articles were retrieved, and 44 studies met the inclusion criteria and included in the final analysis. A total of 17,510 healthcare workers were included. The pooled prevalence of hepatitis B virus infection among health care workers in Africa is estimated to be 6.81% (95% CI 5.67-7.95) with a significant level of heterogeneity (I2 = 91.6%; p < 0.001). While the pooled prevalence of hepatitis C virus infection using the random-effects model was 5.58% (95% CI 3.55-7.61) with a significant level of heterogeneity (I2 = 95.1%; p < 0.001). CONCLUSION Overall, one in fifteen and more than one in twenty healthcare workers were infected by HBV and HCV, respectively. The high burden of HBV and HCV infections remains a significant problem among healthcare workers in Africa.
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Affiliation(s)
- Daniel Atlaw
- Department of Human Anatomy, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia.
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Zerihun Tariku
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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From national HBV and HDV screenings to vaccination and treatment in healthcare workers: The Mauritanian pilot study. Vaccine 2021; 39:2274-2279. [PMID: 33752951 DOI: 10.1016/j.vaccine.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hepatitis B and D infections are highly endemic in Mauritania, with prevalences ranging from 10 to 20%. With the present prospective transversal pilot study, we aimed to evaluate the prevalences of HBV, HCV, and HDV infections in healthcare workers (HCWs), and offer treatment or vaccination as required. METHODS At inclusion, each HCW was screened for anti-HBc Ab (followed by HBsAg assay when positive). Additional biological analyses were performed for HBsAg + cases. Depending on the results, HBV vaccination or anti-viral treatment was offered. RESULTS A total of 3,857 HCWs were included, of whom 1,363 tested negative for anti-HBc Ab and received full vaccination. Of the 2,494 HCWs who were positive for anti-HBc Ab, 1,246 were positive for anti-HBs Ab and 418 were positive for HBsAg. Three HCWs were positive for HBeAg; 66 and 18 had HBV DNA levels respectively > 2,000 and > 20,000 IU/mL; and 48 were positive for anti-HDV Ab among whom 10 were positive for HDV RNA. HCV prevalence was 0.5%. Only seven HCWs fulfilled the criteria for treatment and five of them were treated. CONCLUSION Few HCWs in Mauritania are immunised against HBV. The prevalences of anti-HBc Ab and HBsAg observed in this work were similar to those observed in our earlier works, whereas prevalence of active HDV infection was less high. HBV and HDV infections are a serious health concern in Mauritania. New recommendations developed in accordance with WHO guidelines should include mandatory HBV screening and immunisation for HCWs.
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Bentouhami MR, Chakib A, El Fane M. Hepatitis B knowledge, attitudes and practices among Moroccan college students. Rev Epidemiol Sante Publique 2019; 67:397-402. [PMID: 31561941 DOI: 10.1016/j.respe.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 06/16/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Viral Hepatitis B (HBV) prevalence in Morocco is estimated at 1.81%. University students are an exposed population due to their risky behaviors. Their knowledge about HBV is still unknown. The aim of our study was to assess the knowledge, attitudes and practices of college students in Casablanca about HBV. METHODS A cross-sectional study was carried out in January 2015 among the students of the eight schools of Hassan II University in Casablanca using a self-administered questionnaire. A knowledge score was calculated to compare the groups with sufficient and insufficient knowledge. A logistic regression adjusted on gender was performed to explore the factors associated with a sufficient knowledge about HBV (P<0.05). RESULTS The response rate was 90.2% (n=652). The median age was 21 years old. From our sample, 97.5% knew the existence of "hepatitis". The main means of information were media and relatives. The most known way of infection was blood transmission (50.3%) while 11.5% believed in the effectiveness of the traditional methods of treatment. Eating with an HBV infected person was thought to be a risky behavior for 38% of the students. A knowledge level that was deemed to be sufficient was scored by 31.1% of the students. The sufficient knowledge was correlated to being a health care student, being vaccinated and being married. CONCLUSION Casablanca's student knowledge about HBV remains limited. We believe that improvements in awareness and access to immunization are needed. These measures would likely help decreasing HBV incidence in students and ensure a better social integration of patients.
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Affiliation(s)
- M R Bentouhami
- Department of infectious diseases, Ibn Rochd Hospital, Casablanca, Morocco.
| | - A Chakib
- Department of infectious diseases, Ibn Rochd Hospital, Casablanca, Morocco
| | - M El Fane
- Department of infectious diseases, Ibn Rochd Hospital, Casablanca, Morocco
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Babanejad M, Izadi N, Alavian SM. A Systematic Review and Meta-analysis on the Prevalence of HBsAg in Health Care Workers from Eastern Mediterranean and Middle Eastern Countries. Int J Prev Med 2019; 10:144. [PMID: 31516685 PMCID: PMC6716224 DOI: 10.4103/ijpvm.ijpvm_111_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aimed to determine the prevalence of HBsAg in Health Care Workers (HCWs) in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries from 2000 to 2016. METHODS In a meta-analysis study, the databases of PubMed, ISI, Ovid, Scopus, Google Scholar, and Persian databases were searched for relevant articles on the prevalence of HBsAg in HCWs in EMRO and Middle Eastern countries. Homogeneity was assessed based on Cochran's Q-test results. RESULTS A total of 43 articles (110,179 people) were included. The pooled prevalence of HBsAg in HCWs of EMRO and Middle East countries was found 2.77% (95%CI: 2.64-2.83). The specific prevalence of HBsAg was 2.84% (95% CI: 2.6-3.11) in EMRO and 2.22% (95%CI: 2.13-2.31) in Middle Eastern countries. The highest and lowest prevalence rates of HBsAg among HCWs for countries with more than one study were 6.85% (95% CI: 5.74%-8.16%) in Sudan and 1.00% (95% CI: 0.94%-1.07%) in Turkey, respectively. The trends of HBsAg prevalence among HCWs decreased from 2000 to 2016. CONCLUSIONS Based on the World Health Organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected in HCWs of EMRO and Middle East countries during 2000-2016.
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Affiliation(s)
- Mehran Babanejad
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed M. Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Abounouh K, Aitraise I, Benabou A, Boussakri I, Doumir MA, El Boussairi C, El Idrissi S, El Mahdaoui C, Qouar DE, Ennahal A, Fathi S, Hafidi M, Lachker L, Ratib C, Tanouti IA, Maaroufi A, Benjelloun S, Guessous F, Pineau P, Ezzikouri S. Virus-associated human cancers in Moroccan population: From epidemiology to prospective research. INFECTION GENETICS AND EVOLUTION 2019; 75:103990. [PMID: 31386915 DOI: 10.1016/j.meegid.2019.103990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/24/2022]
Abstract
Eight human viruses have been classified by the International Agency for Research on Cancer as carcinogenic or probably carcinogenic for humans. Infection with high risk human papillomaviruses, hepatitis B and C viruses, Epstein-Barr virus (EBV), human T-Cell Lymphotropic Virus Type 1 (HTLV-1), Human herpesvirus 8 (HHV-8), Merkel cell polyomavirus and human immunodeficiency virus-1 (HIV1) alone or in combination with other agents are the main etiologic factors of many cancers. This review highlights some aspects of virus-associated human cancers, potentially responsible for >14,000 malignancies per year in Morocco. Given that not all individuals infected with these viruses develop cancer, somatic alterations, genetic predisposition, and lifestyle or environmental factors obviously play potentializing roles modulating viral activity. These viral, host genetic signatures and lifestyle interactions may represent a reservoir of biomarkers for early detection, prevention of cancer and rationale-based therapy.
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Affiliation(s)
- Karima Abounouh
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco; Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Imane Aitraise
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Anas Benabou
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | | | | | | | | | - Dalal El Qouar
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Afaf Ennahal
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Sofia Fathi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Maria Hafidi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Lamyae Lachker
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Chorouk Ratib
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | - Abderrahmane Maaroufi
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Fadila Guessous
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Pascal Pineau
- Unité Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, Paris, France
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.
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Abiodun O, Shobowale O, Elikwu C, Ogbaro D, Omotosho A, Mark B, Akinbola A. Risk perception and knowledge of hepatitis B infection among cleaners in a tertiary hospital in Nigeria: A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bedaso A, Duko B, Fedlu R. Knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital, Hawassa, southern Ethiopia: a cross sectional study. BMC Res Notes 2018; 11:912. [PMID: 30572933 PMCID: PMC6302467 DOI: 10.1186/s13104-018-4023-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 12/17/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The study was conducted to assess the knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital. RESULT From the total 258 questionnaire prepared for the study participant, data was collected from 241 participants making the response rate of 93.4%. Regarding socio-demographic characteristics of respondents 98 (40.7%), and 159 (66%) were females and Bachelor of Science graduates respectively. Only 73 (30.3%) respondents reported that they are vaccinated for hepatitis B vaccine. But only 16 (21.9%) received three doses of Hepatitis B vaccine, which was 6.6% of the total health care workers. More than half 146 (60.6%) of the respondents had good knowledge about hepatitis B virus infection and 120 (49.8%) had good knowledge about hepatitis B vaccine. Regarding knowledge about hepatitis B virus infection prevention and control methods, 131 (28.5%) of the respondents have good knowledge.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, SNNPR, Ethiopia.
| | - Bereket Duko
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, SNNPR, Ethiopia
| | - Remla Fedlu
- Hawassa University Comprehensive Specialized Hospital, Hawassa, SNNPR, Ethiopia
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Ayalew MB, Horssa BA, Getachew N, Amare S, Getnet A. Knowledge and attitude of health care professionals regarding hepatitis B virus infection and its vaccination, University of Gondar Hospital, Ethiopia. Hepat Med 2016; 8:135-142. [PMID: 28008291 PMCID: PMC5167489 DOI: 10.2147/hmer.s120477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Hepatitis B is a global public health problem affecting approximately 10% of the world population. Health care professionals (HCPs) are at an increased risk of acquiring hepatitis B infection due to occupational exposure. Having enough knowledge and proper attitudes toward the infection and its vaccination is crucial in preventing the infection. This study aimed to assess knowledge of and attitudes toward hepatitis B virus (HBV) infection as well as its vaccination among HCPs working in University of Gondar Hospital. Methods An institution-based cross-sectional study design was employed from April 1 to May 1, 2016 on 297 HCPs working at University of Gondar Hospital. A self-administered questionnaire prepared in the English language was used to collect the data. The questionnaire contained sociodemographic characteristics, knowledge, and attitude-related questions. Data were entered and analyzed using SPSS software version 20.1. Descriptive statistics, cross-tabs, and binary logistic regression were utilized. P<0.05 was used to declare association. Results From a total of 297 HCPs participated in the study 73.1% have good knowledge of HBV transmission, progress, and its vaccination. The majority (91.3%) of the respondents believe that their job puts them at risk of HBV infection. The majority of study participants (94%) believe vaccination is necessary. Medical doctors have 8.4 times better knowledge of HBV and its vaccination than other professionals (adjusted odds ratio =8.399, CI =1.536–45.936). Conclusion The majority of HCPs working in University of Gondar Hospital have good knowledge of HBV transmission, progress, and its vaccination. The majority of HCPs believe that their job puts them at greater risk for HBV and vaccination is necessary. Knowledge of the HCPs significantly varies across professions.
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Affiliation(s)
| | | | - Nardose Getachew
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sitotaw Amare
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Getnet
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hussein WM, Anwar WA, Attaleb M, Mazini L, Försti A, Trimbitas RD, Khyatti M. A review of the infection-associated cancers in North African countries. Infect Agent Cancer 2016; 11:35. [PMID: 27512409 PMCID: PMC4979152 DOI: 10.1186/s13027-016-0083-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/09/2016] [Indexed: 02/08/2023] Open
Abstract
Cancer is typically classified as a leading non-communicable disease; however, infectious agents, such as Helicobacter pylori (H. pylori), hepatitis B virus (HBV), hepatitis C virus (HCV) and human papilloma virus (HPV), contribute significantly to the pathogenesis of various cancers. Less developed countries, including countries of the North African (NA) region, endure the highest burden of infection-related cancers. The five most common infection-associated cancers in NA in order of incidence are bladder cancer, cervical cancer, liver cancer, stomach cancer, and nasopharyngeal carcinoma. This review aims to outline the epidemiologic pattern of infection-associated cancers in five NA countries (namely: Morocco, Algeria, Tunisia, Libya and Egypt) highlighting the similarities and differences across the region. The present study employed an initial literature review of peer-reviewed articles selected from PubMed, ScienceDirect and World Health Organization (WHO) databases based on key word searches without restriction on publication dates. Original research articles and reports written in French, as well as data from institutional reports and regional meeting abstracts were also included in this extensive review. Egypt, Libya, Tunisia, Algeria and Morocco were selected to be the focus of this review.
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Affiliation(s)
- Wafaa Mohamed Hussein
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Wagida A Anwar
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Mohammed Attaleb
- Biology and Medical Research Unit, National Center of Energy, Sciences and Nuclear Technics, Rabat, Morocco
| | - Loubna Mazini
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany ; Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | | | - Meriem Khyatti
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
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Borzooy Z, Streinu-Cercel A, Mirshafiey A, Khamseh A, Mahmoudie MK, Navabi SS, Nosrati M, Najafi Z, Hosseini M, Jazayeri SM. IL-17 and IL-22 genetic polymorphisms in HBV vaccine non- and low-responders among healthcare workers. Germs 2016; 6:14-20. [PMID: 27019828 DOI: 10.11599/germs.2016.1084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/25/2015] [Accepted: 12/30/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Healthcare workers constitute a population at high risk for HBV infection. Efficient vaccination options are available; however, the individual response to HBV vaccination may vary widely between subjects, potentially due to cytokine profiles and genetic variations. In the present study, we investigated the relationship between IL-17 and IL-22 gene polymorphisms versus non- and low-responsiveness to HBV vaccination in healthcare workers. METHODS We selected the following IL-17 and IL-22 polymorphisms: rs4711998 (A/G) from IL-17 and rs2227501 (A/T), rs2227503 (A/G), rs1026786 (A/G) from IL-22 sequences genes. These were determined by polymerase chain reaction restriction fragment length polymorphisms. RESULTS The IL-17 rs4711998 GG genotype had a significantly lower frequency in non-responders compared to low-responders (p=0.025). However, we did not identify a relationship between IL-22 rs1026780, rs2227501 and rs2227503 genotypes and the anti-HBs response following HBV vaccination. CONCLUSION These data suggest that genetic variation in rs4711998 polymorphisms in the IL-17 cytokine may influence vaccine-induced immune responses to HBV vaccine in healthcare workers.
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Affiliation(s)
- Zohreh Borzooy
- PhD student, Department of Infectious Diseases, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Immunology and Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Adrian Streinu-Cercel
- MD, PhD, Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Institute of Infectious Diseases, "Prof. Dr. Matei Balş", Bucharest, Romania
| | - Abbass Mirshafiey
- Ms, PhD, Head of the department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Khamseh
- Bs, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Karkhaneh Mahmoudie
- Bs, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Sadat Navabi
- Ms, Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Nosrati
- Bs, Department of Infection Control, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Najafi
- Ms, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Ms, PhD, Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Jazayeri
- MD, PhD, Clinical Virologist, Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Knowledge of Hepatitis B Virus Infection, Immunization with Hepatitis B Vaccine, Risk Perception, and Challenges to Control Hepatitis among Hospital Workers in a Nigerian Tertiary Hospital. HEPATITIS RESEARCH AND TREATMENT 2015; 2015:439867. [PMID: 25685549 PMCID: PMC4320901 DOI: 10.1155/2015/439867] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/31/2014] [Indexed: 01/29/2023]
Abstract
Background. Studies had reported high rate of hepatitis B infection among hospital workers with low participation in vaccination programmes, especially those whose work exposes them to the risk of HBV infection. The study assessed knowledge of hepatitis B virus infection, risk perception, vaccination history, and challenges to control hepatitis among health workers. Methods. A descriptive cross-sectional study. Consenting health care workers completed a self-administered questionnaire that assessed respondents' general knowledge of HBV, vaccination history and HBsAg status, risk perception, and challenges to control hepatitis. Data was analysed using descriptive and inferential statistics. Results. Three hundred and eighty-two health care workers participated in the study. There were 182 males and 200 females. The respondents comprised 94 (25%) medical doctors, 168 (44%) nurses, 68 (18%) medical laboratory technologists, and 52 (14%) pharmacists. Over 33% had poor knowledge with 35% not immunized against HBV. Predictors of good knowledge include age less than 35 years, male sex, being a medical doctor, previous HBsAg test, and complete HBV immunisation. Identified challenges to control hepatitis include lack of hospital policy (91.6%), poor orientation of newly employed health workers (75.9%), and low risk perception (74.6%). Conclusion. Hospital policy issues and low risk perception of HBV transmission have grave implications for the control of HBV infection.
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Knowledge of Hepatitis B Virus Infection, Immunization with Hepatitis B Vaccine, Risk Perception, and Challenges to Control Hepatitis among Hospital Workers in a Nigerian Tertiary Hospital. HEPATITIS RESEARCH AND TREATMENT 2015. [PMID: 25685549 PMCID: PMC4320901 DOI: 10.1155/2015/439867 10.1155/2015/439867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Studies had reported high rate of hepatitis B infection among hospital workers with low participation in vaccination programmes, especially those whose work exposes them to the risk of HBV infection. The study assessed knowledge of hepatitis B virus infection, risk perception, vaccination history, and challenges to control hepatitis among health workers. Methods. A descriptive cross-sectional study. Consenting health care workers completed a self-administered questionnaire that assessed respondents' general knowledge of HBV, vaccination history and HBsAg status, risk perception, and challenges to control hepatitis. Data was analysed using descriptive and inferential statistics. Results. Three hundred and eighty-two health care workers participated in the study. There were 182 males and 200 females. The respondents comprised 94 (25%) medical doctors, 168 (44%) nurses, 68 (18%) medical laboratory technologists, and 52 (14%) pharmacists. Over 33% had poor knowledge with 35% not immunized against HBV. Predictors of good knowledge include age less than 35 years, male sex, being a medical doctor, previous HBsAg test, and complete HBV immunisation. Identified challenges to control hepatitis include lack of hospital policy (91.6%), poor orientation of newly employed health workers (75.9%), and low risk perception (74.6%). Conclusion. Hospital policy issues and low risk perception of HBV transmission have grave implications for the control of HBV infection.
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Elzouki AN, Elgamay SM, Zorgani A, Elahmer O. Hepatitis B and C status among health care workers in the five main hospitals in eastern Libya. J Infect Public Health 2014; 7:534-41. [PMID: 25151657 DOI: 10.1016/j.jiph.2014.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/19/2014] [Accepted: 07/11/2014] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study was to determine the frequency of hepatitis B and C transmission to health care workers (HCWs) in five major hospitals in eastern Libya and to analyze how the risk of these infections are affected by the type of occupation, hospital work place and working period. From July 2008 to June 2009, 601 HCWs (mean age: 32.90 ± 8.85 years) were tested for HBV and HCV markers using ELISA techniques. Polymerase chain reaction (PCR) was performed on all positive samples of HBsAg and Anti-HCV antibody to determine the level of HBV-DNA and HCV-RNA viremia, respectively. The overall frequency of HBsAg positivity was 1.8%. Anti-HBc, HBeAg and Anti-HBe antibodies were found in 8.5%, 0.7% and 8.0% of samples, respectively. The HBV-DNA level was positive in 55% of all HBsAg-positive samples. Approximately half of the HCWs (51.4%) were Anti-HBs antibody positive. The overall positivity rate of Anti-HCV antibodies was 2.0%, and HCV-RNA was positive in 33.3% of these samples. Overall, 52% of HCWs reported receiving full vaccination doses (three doses) against HBV infection. Among them, anti-HBs positivity was approximately 98.0%. 3.9% of those who never received any HBV vaccination dose were HBsAg positive, compared to 1.3% HBsAg positive in those HCWs who had received one or two doses of hepatitis B vaccine (p=0.01 for all comparisons). Nurses and nurse-aides had the highest rates of both HBsAg and Anti-HCV among the studied HCWs (HBsAg: 2.1% and 3.2%; Anti-HCV: 3.2% and 4.9%, respectively). It is noteworthy that doctors also had a relatively high prevalence rate of Anti-HCV (2.2%). Obstetric wards, isolation room, dialysis units and dentist work places had higher frequencies of HBV. HCV was found to be higher in the medical and surgical wards (the prevalence varied between 3% and 5.6%). There was no significant difference between HBsAg status and the work period of HCWs. In conclusion, universal precautions should be applied for the care of all patients by all HCWs. Further, HBV vaccines should be more readily available for Libyan HCWs by reinforcing current vaccination programs.
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Affiliation(s)
- Abdel-Nasser Elzouki
- Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Weill Cornell Medical College, Qatar.
| | | | - Abdeulaziz Zorgani
- Department of Microbiology and Immunology, Faculty of Medicine, Tripoli University, Tripoli, Libya
| | - Omer Elahmer
- National Center for Diseases Control, Tripoli, Libya
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Homoud AHA. Knowledge, attitudes and practice of primary healthcare physicians concerning the occupational risks of hepatitis B virus in Al Jouf Province, Saudi Arabia. J Infect Public Health 2014; 7:257-70. [PMID: 24602770 DOI: 10.1016/j.jiph.2013.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/25/2013] [Accepted: 08/05/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a well-recognized occupational risk for all healthcare workers (HCWs) worldwide. AIM This study aimed to assess the knowledge, attitudes, and practices of primary healthcare (PHC) physicians regarding the occupational risks of HBV. METHOD In this cross-sectional study, a questionnaire survey was administered to 145 physicians of primary care centers in the Al Jouf Province of Saudi Arabia. The questionnaire contained questions concerning the knowledge base, attitudes and practices of physicians regarding the occupational risks of HBV. RESULT The response rate of 82.8% yielded 120 questionnaires for analysis. The majority of physicians surveyed, 99 (82.5%), felt at high risk of contracting and spreading HBV. The vast majority, 115 (95.6%), considered the HBV vaccine safe for all ages. Of the total, 101 (84.2%) were vaccinated. Only 44 (36.7%) physicians recognized that HBV is resistant to alcohol and to some detergents. During surgical procedures, only a minority of the physicians always use double gloves and wear glasses. Almost all physicians were willing to subscribe to regular training programs concerning HBV. CONCLUSIONS A lack of knowledge was determined, and the practices of our physicians concerning the occupational risks of HBV appeared inappropriate. More education focusing on HBV is recommended.
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Affiliation(s)
- Al-Hazmi Ahmad Homoud
- Department of Family Medicine, College of Medicine, Al Jouf University, P.O. Box 2014, Sakaka 75741, Saudi Arabia.
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Noah DN, Ngaba GP, Bagnaka SFE, Assi C, Ngantchet E, Njoya O. [Evaluation of vaccination status against hepatitis B and HBsAg carriage among medical and paramedical staff of the Yaoundé Central Hospital, Cameroon]. Pan Afr Med J 2013; 16:111. [PMID: 24778748 PMCID: PMC3998895 DOI: 10.11604/pamj.2013.16.111.2760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/23/2013] [Indexed: 11/25/2022] Open
Abstract
Introduction L’hépatite virale B est une affection à haut risque pour le personnel de santé. Au Cameroun, la vaccination contre le virus de l’hépatite B n'est pas obligatoire pour le personnel de santé. Le but de l’étude était d'évaluer l’état vaccinal contre l’hépatite virale B et la prévalence de l’Antigène HBs au sein du personnel médical et paramédical de l’Hôpital Central de Yaoundé. Méthodes Il s'agissait d'une étude prospective, transversale menée à l’Hôpital Central de Yaoundé du 1er juillet au 31 octobre 2011. Toute personne membre du corps médical et paramédical ayant signée la fiche de consentement éclairé était incluse dans l’étude. Ceux ayant refusé de signer la fiche de consentement éclairé ou dont la fiche d'enquête n'avait pas été complètement remplie étaient exclus de l’étude. Une recherche systématique de l’antigène HBs était effectuée chez chaque personne incluse dans l’étude. Résultats Au total 282 personnes ont participé à l’étude sur 760, soit un taux de participation de 37,1%. Les personnes ne connaissant pas leur statut sérologique vis-à-vis du virus de l’hépatite B était au nombre de 221 (85%). Deux cent vingt-cinq (86,5%) personnes n'étaient pas vaccinées contre l’hépatite B. Les personnes ayant reçu moins de 3 doses du vaccin contre l’hépatite virale B étaient au nombre de 23 (8,8%). Douze personnes (4,6%) déclaraient avoir reçu les 3 doses du vaccin contre l’hépatite virale B. La prévalence de l’antigène HBs était de 6,6% (n = 12). Conclusion Cette étude montre que la prévalence de l’hépatite virale B reste élevée chez le personnel de l’Hôpital Central de Yaoundé (6,6%). Il ya un besoin de sensibilisation du personnel médical aux risques liés à l’exercice de leur profession.
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Affiliation(s)
- Dominique Noah Noah
- Service de gastroentérologie de l'Hôpital Central de Yaoundé, Faculté de Médecine et des Sciences Pharmaceutiques de l'Université de Douala, Cameroun
| | - Guy Pascal Ngaba
- Hôpital de district de Bonassama, Faculté de Médecine et des Sciences Pharmaceutiques de l'Université de Douala, Cameroun
| | - Servais Fiacre Eloumou Bagnaka
- Service de gastroentérologie de l'Hôpital général de Douala, Faculté de Médecine et des Sciences Pharmaceutiques de l'Université de Douala, Cameroun
| | - Constant Assi
- CHU de Cocody, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire
| | | | - Oudou Njoya
- Service de gastroentérologie du Centre hospialier Universitaire de Yaoundé, Faculté de Médecine et des SciencesBiomédicales de l'Université de Yaoundé 1, Cameroun
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Ezzikouri S, Pineau P, Benjelloun S. Hepatitis B virus in the Maghreb region: from epidemiology to prospective research. Liver Int 2013; 33:811-9. [PMID: 23530901 DOI: 10.1111/liv.12135] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/28/2013] [Indexed: 12/21/2022]
Abstract
Hepatitis B virus (HBV) represents an important health problem in the Maghreb countries, Algeria, Libya, Mauritania, Morocco and Tunisia, but no detailed synthesis of its epidemiology is available. In this review, we systematically searched for data about HBV in the Maghreb in peer-reviewed databases and included in our analysis works written in English and French, as well as institutional reports and regional conference meeting abstracts. We estimated national and regional prevalence of chronic HBV infection. In addition, we discuss molecular features of the viral strains circulating in the region. Data analysis suggests that in the Maghreb region HBs antigen carriage concerns 1.8-4.9% of the population for an estimated number of 2.7 million persons. Genotype D, subtype D7, is predominant and mutations in the precore region of HBV genome are highly prevalent. This epidemiological situation requires obviously widespread active interventions for prevention and control. In addition, anti-hepatitis B vaccination programme should be applied with the utmost discipline in the five countries considered in this present review. This systematic review will, hopefully, increase knowledge at disposal of Public Health authorities, enabling better resource allocation and healthcare delivery. The present synthesis intends to stimulate policies aiming at preventing the spread of HBV, keeping in mind that eradication of the virus from Maghrebi populations should be the ultimate objective of Public Health authorities.
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Affiliation(s)
- Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco.
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Gasim GI. Hepatitis B virus in the Arab world: where do we stand? Arab J Gastroenterol 2013; 14:35-43. [PMID: 23820498 DOI: 10.1016/j.ajg.2013.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 03/28/2013] [Accepted: 04/21/2013] [Indexed: 12/12/2022]
Abstract
The epidemiology of viral hepatitis is of great importance for planning and managing health provision for all the countries in the Arab world. However, data on viral hepatitis are not readily available in a large percentage of Arab countries. Hepatitis B virus (HBV) is considered to be one of the most important causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma. A systematic electronic search of published literature was conducted to extract data on epidemiology and risk factors for the analysis of HBV infection among the countries in the Arab world. The prevalence of chronic HBV infection was found to be decreasing in some Arab countries although it was still unacceptably high. This was particularly evident in the Arabian Gulf region, in Lebanon, Egypt and Libya. The age-specific prevalence varied from country to country with decline in prevalence being noted among children in the Gulf States and among Libyan women. These declines in prevalence are most likely to be related to the Expanded Immunization Programme. The alarmingly high prevalence of chronically infected patients in some areas and the widespread differences in HBV prevalence between Arab nations may be explained by the variation in risk factors involved. This situation calls for targeted approaches to tackle HBV-related mortality and morbidity. Precise HBV infection prevalence data are needed at the national and the sub-national level to estimate the disease burden, guide health intervention programmes and evaluate vaccine efficiency.
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Lu PJ, Euler GL. Influenza, hepatitis B, and tetanus vaccination coverage among health care personnel in the United States. Am J Infect Control 2011; 39:488-94. [PMID: 21288599 DOI: 10.1016/j.ajic.2010.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 10/05/2010] [Accepted: 10/06/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Health care personnel (HCP) are at risk for exposure to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is an essential prevention practice for HCP. We assessed the recent influenza, hepatitis B, and tetanus vaccination coverage among HCP in the United States. METHODS We analyzed data from the 2007 National Immunization Survey-Adult restricted to survey respondents aged 18 to 64 years. Influenza, hepatitis B, and tetanus vaccination coverage levels among HCP were assessed. Multivariable logistic regression was conducted to assess factors independently associated with receipt of vaccination among HCP. RESULTS Among HCP aged 18 to 64 years, 46.7% (95% confidence interval [CI]: 39.6%-53.8%) had received influenza vaccination for the 2006-2007 season, and 70.4% (95% CI: 63.9%-76.1%) received tetanus vaccination in the past 10 years; 61.7% (95% CI: 52.5%-70.2%) had received 3 or more doses of hepatitis B vaccination among HCP aged 18 to 49 years. Multiple logistic regression analysis showed that being married was associated with influenza vaccination coverage, higher education level was associated with hepatitis B vaccination coverage, and younger age was significantly associated with tetanus vaccination among HCP. Among those HCP who did not receive influenza vaccination, the most common reason reported was respondent concerns about vaccine safety and adverse effects. CONCLUSION By 2007, influenza and hepatitis B vaccination coverage among HCP remained well below the Healthy People 2010 objectives. Tetanus vaccination level was 70%, and this study provided a baseline data for tetanus vaccination among HCP. Innovative strategies are needed to further increase vaccination coverage among HCP.
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Affiliation(s)
- Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Kitab B, El Feydi AE, Afifi R, Derdabi O, Cherradi Y, Benazzouz M, Rebbani K, Brahim I, Salih Alj H, Zoulim F, Trepo C, Chemin I, Ezzikouri S, Benjelloun S. Hepatitis B genotypes/subgenotypes and MHR variants among Moroccan chronic carriers. J Infect 2011; 63:66-75. [PMID: 21640384 DOI: 10.1016/j.jinf.2011.05.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 05/02/2011] [Accepted: 05/09/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of Hepatitis B Virus (HBV) genotypes, subgenotypes, HBV surface antigen (HBsAg) subtypes and naturally occurring mutations in Major Hydrophilic region (MHR) of HBsAg among Moroccan patients with chronic HBV infection. METHODS The study included 200 patients chronically infected with HBV. The HBV genotypes, subgenotypes, HBsAg subtypes and MHR variants were determined by direct sequencing of the HBV surface (S) gene and phylogenetic analysis. RESULTS The S gene was successfully amplified in 134 patients. The mean age was 40.6 ± 12.2 years. Genotype D was predominant (90%, 120/134) and genotype A was less frequent (10%, 14/134). Genotype D strains belonged to subgenotypes D7 (70.8%, 85/120), D1 (25.8%, 31/120) and D2 (0.9%, 1/120). Three strains (2.5%) could not be classified in any subgenotype of genotype D. All genotype A strains belonged to subgenotype A2. HBsAg subtypes found were ayw2 (82.1%, 110/134), adw2 (10.4%, 14/134), ayw3 (3%, 4/134) and ayw4 (3%, 4/134). The global prevalence of MHR variants was 15% (20/134) with substitution P120T/S the most frequent (3.7%, 5/134). The occurrence of MHR variants was significantly associated with advancing age (>40 years) (p = 0.003) and independent of sex, HBeAg status, viral load, genotype, subgenotype and HBsAg subtype. CONCLUSIONS This study provides the first description of predominance of HBV subgenotype D7/subtype ayw2 among Moroccan HBV chronic carriers. It also showed a significant prevalence of naturally occurring MHR variants in Morocco.
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Affiliation(s)
- Bouchra Kitab
- Laboratoire des Hépatites Virales, Institut Pasteur du Maroc, Casablanca, Morocco
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