Prevalence of hepatitis B virus infection and uptake of hepatitis B vaccine among healthcare workers, Makueni County, Kenya 2017

Hepatitis B in Healthcare Personnel: An Update on the Global Landscape

Despite the outstanding progress that has been made in the prevention, detection, and management of hepatitis B during the past decades, hepatitis B remains a problem among healthcare personnel (HCP) in many countries. We reviewed studies on all aspects of hepatitis B in HCP published from 2017 through April 2023. They revealed wide variations on the prevalence of infection among HCP, ranging from 0.6% in Europe to >8.7% in Africa, almost always in association with very low vaccination rates. Many studies found a significant association between HCP's knowledge about hepatitis B and hepatitis B vaccines, their vaccination status, and practices. This research also discloses global inequities regarding vaccination policies against hepatitis B, free-of-charge vaccinations, and access to post-exposure prophylaxis (PEP). Strategies to prevent and manage accidental exposures are needed in order to reduce the burden of hepatitis B on HCP, while written policies for all aspects of infection prevention, protective equipment, and PEP should be available. Lastly, HCP should be accordingly educated. These are all imperative given the decline of routine vaccinations in the COVID-19 era, particularly in countries with fragile vaccination programs, and the disruptions of interventions for hepatitis B that are expected to provide a pool of virus transmission to future generations.

Hepatitis B virus infection status and associated factors among health care workers in selected hospitals in Kisumu County, Kenya: A cross-sectional study

Poorly managed medical waste produced at the health facilities are potential source of infections including occupational exposure to Hepatitis B Virus (HBV). This study evaluated the prevalence of HBV infection among healthcare workers (HCWs) in Kisumu County. We determined prevalence of HBV infections among 192 HCWs from nine purposively selected high-patient volume public hospitals in Kisumu County. A structured questionnaire was administered, and 4.0 ml of venous blood sample collected for Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and total hepatitis B core antibody (anti-HBc) testing using enzyme immunoassay (EIA). Of 192 HCWs sampled, 52.1% were males and the median participants age was 34.4 years with interquartile range (IQR) of 11 (28-39) years. Most participants (44%) had worked for between 1-5 years. There was low HBV vaccine uptake with 35.9% completing the required 3 doses, while 40.6% had never been vaccinated. HBV prevalence was 18.8% (36/192), prevalence of past resolved infection was 25.5% (49/192), while 37.5% (72/192) of HCW had evidence of vaccine-derived immunity and 17.7% (34/192) were susceptible. HBV prevalence among HCW who had worked for less than one year and those who had never been vaccinated was 37.5% and 35.9% respectively. Significant risk of HBV lifetime exposure was noted among HCWs with one vaccine dose, those with no known exposure, while highest in those with knowledge on HBV transmission (aOR, 7.97; 95% CI, 2.10-153.3, p-value = 0.008). HCWs who had received ≥2 doses of HBV vaccine (aOR, 0.03; 95% CI, 0.01-0.10, p-value = <0.0001) had significant HBV protection. Duration of service was not associated with HBV among HCWs. HBV prevalence was high among HCWs from nine high patient volume public hospitals in Kisumu County. Efforts to strengthen HBV vaccination uptake and dose completion are needed to reduce HBV infections among HCWs.

Sero-prevalence of hepatitis B virus and compliance with hepatitis B vaccination schedules among outpatient clinic attendees in Nairobi

BACKGROUND

Hepatitis B is becoming a growing public health problem in Kenya. To combat the threat, HBV vaccination should be recommended, particularly for individuals who are not covered by the national immunization program. Vaccination provides sero-protection rates approaching 95% among healthy adults after completing the three-dose vaccination course, but decreases to 87% among those who receive only two doses, emphasizing the importance of completing the three-dose vaccination course. However, data on adult adherence to HBV multi-dose vaccines in Sub-Saharan Africa are limited, despite the fact that this information is critical for prevention. As a result, more research on HBV vaccine dose completion is required. The purpose of this study is to estimate the prevalence of hepatitis B virus infection among out-patient clinic attendees in Nairobi, Kenya, as well as to identify beneficiaries of free vaccination and barriers to completing the recommended vaccine doses.

METHODS

Between July 30th and September 30th, 2015, 2644 outpatient clinic attendees aged ≥ 4 were recruited from three hospitals in Nairobi County, Kenya: Mama Lucy, Riruta, and Loco. Self-administered questionnaires were used to collect socio-demographic information, and blood samples were tested for hepatitis B surface antigen (HBsAg) using the KEMRI HEPCELL Rapid® (Hepatitis B Detection kit) test kit. Individuals who tested negative for HBsAg were given a free course of three doses of HBV vaccine. The vaccination register provided information on the number of doses administered.

RESULTS

The average age of the study population was 31.4 years (range: 4-66), with females accounting for 59.2%. 1.82% (48/2644) of the participants tested positive for HBsAg. Among the 2596 individuals eligible for vaccination, 66% (1720/2596) received at least one dose, and 51.8% (1345/2596) received all three doses. Vaccination acceptance increased with age, with older patients more likely to return for subsequent dose (OR>1 for second and third dose). Unavailability and failure to contact client were cited as significant (p<0.0001) barrier to vaccination completion by 53.7% (666/1226, 95% CI 0.5-0.6) and 37% (454/1226, 95% CI 0.3-0.4) of respondents respectively.

CONCLUSION

The prevalence of HBV infection among outpatient clinic attendees highlights the importance of expanding HBV immunization programs in Kenya. However, given the low vaccination completion rate, there is a need for public awareness of the vaccine's importance in preventing HBV and HBV-related complications.

The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis

Background

Chronic Hepatitis B virus (HBV) infection causes liver cirrhosis and cancer and is a major public health concern in Kenya. However, so far no systematic review and meta-analysis has been conducted to estimate the burden of disease in the country. A better understanding of HBV infection prevalence will help the government implement efficient strategies at eliminating the disease. This systematic review and meta-analysis was therefore conducted to summarize and update the available information on the burden of HBV in Kenya.

Method

We systematically searched PubMed, Science Direct, Web of Science, Scopus, African Journals OnLine, and Google Scholar databases to retrieve primary studies conducted between January 1990 and June 2021 that assessed the prevalence of HBV infection in Kenya based on measurement of the Hepatitis B Surface Antigen (HBsAg). Meta-analysis was performed using the random effects model where HBsAg prevalence was estimated at a 95% confidence interval (CI) after simple pooling analysis. Potential sources of heterogeneity were also investigated.

Results

Fifty studies were included in the meta-analysis with a sample size of 108448. The overall pooled prevalence estimate of HBV in Kenya was 7.8% (95% CI: 5.8-10.1). Subgroup analysis revealed the highest prevalence among patients presenting with jaundice at 41.7% (95% CI: 13.5-73.3) whereas blood donors had the lowest prevalence at 4.1% (95% CI: 2.4-6.3). Prevalence in Human Immunodeficiency Virus (HIV)-infected individuals was 8.2% (95% CI: 5.8-11.0). An estimate of the total variation between studies revealed substantial heterogeneity (I² = 99%) which could be explained by the study type, the risk status of individuals, and the region of study.

Conclusion

We present the first systematic review and meta-analysis of the prevalence of HBV in Kenya. Our results show that the burden of HBV in Kenya is still enormous. This calls for an urgent need to implement public health intervention measures and strategic policies that will bring the disease under control and lead to final elimination.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=264859, identifier: CRD42021264859.

Prevalence of hepatitis B virus and immunity status among healthcare workers in Beira City, Mozambique

BACKGROUND

Hepatitis B virus (HBV) infection can be prevented by vaccination. Exposure to blood or body fluids poses a high risk of transmission of HBV in health care workers (HCWs). This study aimed to determine the prevalence of markers of exposure, susceptibility, and protection to HBV infection in HCWs in Beira, Mozambique.

METHODS

A cross-sectional study was conducted between June and August 2020 in Beira City, Mozambique, in HCWs based on self-administered questionnaires and blood samples. Plasma samples were tested for HBV surface antigen (HBsAg), antibodies to HBV core antigen (anti-HBc), antibodies to HBsAg (anti-HBs) and HBV viral load (HBV DNA).

RESULTS

Most of the 315 HCWs in the study were nurses (125; 39.7%). Of the HCWs, 5.1% (16; 95% Confidence Interval (CI): 2.9 to 8.1%) were infected by HBV (HBsAg and/or HBV DNA positive). Occult HBV infection (OBI) (HBV DNA positive and HBsAg negative) was found in 0.3% (1; 95% CI: 0.0 to 1.8%) of participants; 27.9% (88; 95% CI: 23.1 to 33.2%) were susceptible (negative for all markers), 6.3% (20; 95% CI: 3.9 to 9.6) were immune due to natural infection (anti-HBs and anti-HBc positive only), while 60% (189; 95% CI: 54.4 to 65.5) were immune due to vaccination (anti-HBs positive only).

CONCLUSION

This study showed a high intermediate prevalence of chronic hepatitis B among healthcare workers in Beira City, Central Mozambique, and one-third of healthcare workers were susceptible to HBV infection. There is a need to implement a national hepatitis B screening and vaccination strategy among healthcare workers in Mozambique.

Assessment of Hepatitis B Vaccination Status and Associated Factors among Healthcare Workers in Bosaso, Puntland, Somalia 2020

Introduction

Hepatitis B virus disease is a viral infection caused by the hepatitis B virus (HBV), which is a major public health problem worldwide. According to the World Health Organization (WHO) estimate, two billion people worldwide have serologic evidence of past or present HBV infection. The risk of infection is high among health professionals due to the risk of occupational contact with fluids of infected patients and the risk of needle stick injury. This study is aimed at assessing HBV vaccination coverage and reasons for possible defiance of the vaccine among healthcare workers in Bosaso, Somalia. Methodology. An institution-based cross-sectional study was conducted by using a quantitative approach to identify hepatitis B virus vaccination coverage and reasons for vaccine defiance in Bosaso from September 2020 to November 2020. Healthcare workers (HCWs) in Bosaso city both in public and private health facilities who accepted to participate in this study were interviewed by using a structured questionnaire, and SPSS was used to analyze the collected data.

Results

We found that only (16.4%) of HCWs were fully vaccinated. The main reasons for not taking the vaccine by the participants were the unavailability of the vaccine (42%), high vaccine cost (28.7%), lack of time (20.7%), and fear of vaccine side effects (7.5%). The majority (69.7%) of HCWs demonstrated good knowledge about HBV infection. The vaccination uptake was significantly higher among midwives (p = 0.02; OR = 1.21; 95%CI = 1.39 - 67.41) and individuals aged under 30 years (p = 0.03; OR = 8.6; 95%CI = 1.17-63.26).

Conclusion

Our study revealed that vaccination coverage of HCWs in Bosaso was very low because of the unavailability of vaccines, high cost of the vaccine, lack of time, and fear of vaccine side effects. Therefore, the development and implementation of policies related to HBV vaccination are recommended.

Two-year immune effect differences between the 0-1-2-month and 0-1-6-month HBV vaccination schedule in adults

Background

The short-term 0–1–2-month hepatitis B virus (HBV) vaccination schedule was previously implemented in the adult population; however, its long-term immune effect remains unclear. The present study aimed to investigate (1) the 2-month and 2-year immune effects of HBV vaccination and (2) the compliance rate between the 0–1–2-month and 0–1–6-month vaccination schedules in adults.

Method

A total of 1281 subjects tested for hepatitis B surface antigen HBsAg(−) and hepatitis B surface antibody (anti-HBs)(−) were recruited. Participants from two distant counties were inoculated with the hepatitis B yeast vaccine at 10 µg per dose, with vaccination schedules of 0, 1, and 2 months (n = 606) and 0, 1, and 6 months (n = 675); sequential follow-up was performed at 2 months and 2 years after the 3rd injection.

Results

There were no significant differences in the anti-HBs seroconversion rates between the those in the 0–1–2-month and 0–1–6-month vaccination schedule groups at 2 months (91.96% vs. 89.42%, p = 0.229) and 2 years (81.06% vs. 77.14%, p = 0.217). The quantitative anti-HBs level in those in the 0–1–2-month vaccination schedule group was not different from that in those in the 0–1–6-month vaccination schedule group at 2 months (anti-HBs₁) (342.12 ± 378.42 mIU/ml vs. 392.38 ± 391.96 mIU/ml, p = 0.062), but it was higher at 2 years (anti-HBs₂) (198.37 ± 286.44 mIU/ml vs. 155.65 ± 271.73 mIU/ml, p = 0.048). According to the subgroup analysis, the 0–1–2-month vaccination schedule induced better maintenance (p = 0.041) and longer reinforcement (p = 0.019) than the 0–1–6 vaccination schedule. The 0–1–2-month vaccination schedule group also had a higher 3rd injection completion rate (89.49% vs. 84.49%, p = 0.010).

Conclusion

The 0–1–2-month vaccination schedule was associated with a similar short-term immune effect and might induce better long-term immune memory and a higher completion rate in the adult population.

Trial registration None

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07151-6.

Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia

Background:

Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients’ body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.

Objective:

This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.

Methods:

A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.

Results:

A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).

Conclusion:

This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.

Hepatitis B and C virus infection among healthcare workers in Africa: a systematic review and meta-analysis

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.

Increasing hepatitis B vaccination coverage of healthcare workers - global lessons for South Africa

Healthcare workers (HCWs) are at high risk of contracting hepatitis B (HB), a severe blood-borne vaccine-preventable disease, caused by HB virus (HBV) infection. Low HB vaccine (HepB) coverage has resulted in suboptimal protection and high HBV infection rates in South African HCWs. Studies from Africa have identified cost; unavailability/lack of access to HepB; and lack of awareness/knowledge of HB and HepB, as barriers to HCW uptake. Studies from Europe show little difference in HepB coverage between countries mandating versus recommending HepB. Providing easy and sustained access to free HepB to student HCWs, together with education about HB and HepB, are recommended to create demand for HepB. Only if this fails should mandatory vaccination be considered.

Hepatitis B virus infection and associated risk factors among medical students in eastern Ethiopia

BACKGROUND

Hepatitis B virus (HBV) is a highly contagious pathogen that has become a severe public health problem and a major cause of morbidity and mortality, particularly in developing countries. Medical students are at high occupational risk during their training. However, no facility-based studies were found among medical students in eastern Ethiopia. Thus, this study aimed to investigate the seroprevalence of Hepatitis B Virus and associated factors among medical students in eastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among 407 randomly selected medical students from March to June 2018. A pretested and structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. A 5ml blood was collected, and the serum was analyzed for Hepatitis B surface antigen (HBsAg) using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Outcome and explanatory variables were described using descriptive summary measures. Binary and multivariable logistic regression was conducted at 95% CI and an association at P-value < 0.05 was declared statistically significant.

RESULTS

The seroprevalence of hepatitis B virus surface antigen was 11.5% (95%CI = 8.6, 14.7). Poor knowledge of universal precaution guideline (AOR = 2.58; 95% CI = [1.35-4.93]), history of needle stick injury (AOR = 2.11; 95% CI = [1.07-4.18]) and never been vaccinated for HBV (AOR = 2.34; 95% CI = [1.17-4.69]) were found statistically significantly associated with HBsAg positivity after multivariate analysis.

CONCLUSION

Hepatitis B virus infection rate is high among health care trainees in eastern Ethiopia. Improvement at health care practice centers safety through training on universal precaution guidelines, and scaling up HBV vaccination is mandatory.

Assessing Level of Knowledge and Uptake of Hepatitis B Vaccination among Health Care Workers at Juba Teaching Hospital, Juba City, South Sudan

Background

Chronic hepatitis B (CHB) virus (HBV) infection remains a severe problem worldwide. An estimated 240–400 million persons are reported to have chronic HBV infection, and the annual mortality from HBV-related complications including cirrhosis and hepatocellular carcinoma was 600,000 persons. In Sub-Saharan Africa, the prevalence of HBV chronic infection is particularly high while in South Sudan, hepatitis B remains a serious problem of public health importance with health care workers being more at greater risk. Vaccination coverage against HBV is low among all age groups, yet vaccination status among health care workers is not even known in South Sudan. This study aimed at assessing viral hepatitis B vaccination uptake among health care workers at Juba Teaching Hospital, Juba City, South Sudan.

Objective

To assess the uptake of viral hepatitis B vaccination among health care workers in Juba Teaching Hospital, Juba City, South Sudan.

Methods

An analytical cross-sectional study design was conducted targeting 154 health workers. A convenient sampling procedure was used to recruit study participants. Questionnaires were used to collect data. SPSS version 20.0 was used for data analysis. Chi-square tests were used to determine the association between the uptake of hepatitis B vaccination and individual and health facility factors. Multivariable analysis was conducted. Adjusted OR was used to interpret the findings.

Results

Uptake of hepatitis B vaccination was found to be low at 44.20%, only 48.8% had received one dose, 29.1% received two doses, and 22.1% had received all three doses. Being married (p ≤ 0.008), knowing that hepatitis B can be prevented by vaccination (p ≤ 0.001), knowing that HBV can be got through unprotected sexual intercourse (p ≤ 0.001), awareness of where to get hepatitis B vaccination from (p ≤ 0.001), availability of vaccines in the health facility (p ≤ 0.027), and availability of guidelines followed by all health workers in this facility (p ≤ 0.006) were the factors independently associated with the uptake of hepatitis B vaccination.

Conclusion

The uptake of hepatitis B vaccination among health workers at Juba Teaching Hospital was low (22.1%), putting health workers at great risk of HBV infection. Having knowledge about hepatitis B vaccination and unprotected sexual intercourse were individual factors associated with hepatitis B vaccination. Availability of the vaccine and vaccination guidelines were the health-related factors associated with hepatitis B vaccination. The government of South Sudan through the Ministry of Health should first track approval of the viral hepatitis B vaccination policy and ensure that it is adopted and implemented by all hospitals. Health care workers must be prioritized and mandatorily vaccinated against viral hepatitis B.

Hepatitis B Awareness and Vaccination Patterns among Healthcare Workers in Africa

Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a P-value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, P < 0.001; 74% versus 58%, P < 0.001; and 62% versus 45%, P = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, P < 0.0001 and 52% versus 60%, P = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, P = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.

Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study

BACKGROUND

Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya's Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC).

METHODS

This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data.

RESULTS

Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC.

CONCLUSIONS

Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students.