Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: how much, who and why?

Knowledge of hepatitis B infection, hepatitis B vaccine, and vaccination status with its associated factors among healthcare workers in Kampot and Kep Provinces, Cambodia

BACKGROUND

Healthcare Workers (HCWs) are susceptible to hepatitis B virus (HBV) infection and are advised to receive vaccination. However, vaccination rates remain low in developing countries. There is little data concerning Hepatitis B (HepB) vaccination and information regarding HBV knowledge among HCWs in Cambodia. This study aimed to evaluate the knowledge of HBV infection, HepB vaccine, and vaccination status with its associated factors among HCWs in Cambodia.

METHODS

A Cross-sectional study was conducted among HCWs in Kampot and Kep Provinces, Cambodia, from September to October 2023 using a questionnaire survey. A total of 261 HCWs were recruited from 1,309 individuals working in all 83 health facilities using systematic random sampling methods. Statistical analyses including the χ2-test and multivariate logistic regression were conducted to identify factors associated with vaccination among the participants.

RESULTS

Among 259 participants, 62.9% showed good knowledge of HBV infection, and 65.6% demonstrated good knowledge of the HepB vaccine. 59.8% of the participants had received the HepB vaccine, while 40.2% remained unvaccinated. Analysis showed that HCWs working at Provincial Health Department/Operational Districts and Provincial Referral Hospital/Referral Hospitals were more likely to be vaccinated compared to those at Health Centers [AOR = 6.5; CI = 1.1-39.5, p = 0.0403; AOR = 2.8, CI = 1.0-7.8, p = 0.0412], respectively. Furthermore, individuals with good knowledge of the HBV infection and vaccine were more likely to receive the vaccine compared to those with inadequate knowledge [AOR = 6.3; CI = 3.3-12.3, p < .0001; AOR = 3.7, CI = 1.9-7.4, p = 0.0001], respectively. Within the unvaccinated HCWs, 32% reported high vaccine costs as a barrier, 33% mentioned workplace vaccine was not for adults, and 59% reported insufficient education on adult HepB vaccination.

CONCLUSIONS

The HepB vaccination coverage among HCWs is at 59.8%, which is below the World Health Organization's (WHO) recommendation rate of 100%. Knowledge of HBV infection and HepB vaccine were good predictive factors for vaccination. The high cost of vaccine, workplace vaccine not for adults, and insufficient education on adult vaccination were found as barriers to vaccination. This study underscores the importance of providing education to HCWs on HBV infection and the HepB vaccine. Furthermore, it highlights the need for a policy that ensures free vaccination for HCWs.

Hepatitis B immunisation and immune status of nurses in a regional hospital in central South Africa

BACKGROUND

 The hepatitis B virus (HBV) is one of the most important biological occupational hazards for healthcare workers. A high percentage of HBV infections are attributable to percutaneous occupational exposure. This study aimed to describe the HBV immunisation and current immune status of all the nurses employed in a regional hospital in central South Africa.

METHODS

 A descriptive record review included all the nurses (N = 388) employed in a regional hospital in central South Africa from 01 January 2018 to 31 January 2020. A total of 289 health records were included in the study. Data were analysed using descriptive statistics. Logistic regression analysis was used to establish factors associated with full immunisation.

RESULTS

 Most nurses were females (87.9%), working in medical (27.0%) wards. Only 20.4% of nurses received one dose of vaccine, while 51.2% received the three prescribed doses. However, 91.2% of nurses did not receive the vaccine at the correct intervals. Most of the tested nurses (71.0%) were immune. Immunisation status was significantly associated with religion (p  0.001) and schedule (p = 0.003). Nurses who were non-Christians were 35.9% less likely to be fully vaccinated compared to Christians.

CONCLUSION

 Half of the nursing staff received three doses as prescribed. All nurses should receive the vaccine against HBV and their immune status monitored to minimise the risk of an infection. It is therefore recommended that proof of immunity should be a requirement.Contribution: This study found a high percentage of nurses with HBV antibodies, which will ensure workplace safety.

Prevalence of Hepatitis B Virus Infection in Tanzania: A Systematic Review and Meta-Analysis

Methods

We systematically searched the PubMed, Web of Science, African Journals Online, Embase, Cochrane Library, and Google Scholar databases for studies conducted up to March 1, 2023, that estimated the prevalence of HBV in Tanzania based on HBV surface antigen measurements. The DerSimonian-Laird random effects model was used to estimate the overall prevalence of HBV with 95% confidence intervals (CIs). Potential sources of heterogeneity were also investigated.

Results

Thirty-one studies with a total sample size of 37,988 were included in the meta-analysis. The overall average HBV prevalence estimate in Tanzania was 6.91% (95% CI = 5.18-8.86%). Subgroup analysis revealed the highest prevalence in the northern zone (9.32%, 95% CI; 2.24-20.36%), among the blood donors (18.72%, 95% CI: 17.43-20.05%) and among the community volunteers (8.76%, 95% CI: 4.55-14.15%). The lowest prevalence was observed in the lake zone at 4.66% (95% CI: 3.49-5.99) and in pregnant women at 4.72% (95% CI: 3.42-6.21). The overall between-study variability showed significant heterogeneity (I 2 = 97.41%, P < 0.001).

Conclusions

Our results showed that Tanzania is a country with moderately high HBV endemicity, with large interregional differences and significantly high numbers of HBV infections within the community. This underscores the need for immediate development of targeted prevention strategies and further epidemiological studies to better understand the pattern of the disease.

Completion of three-dose hepatitis B vaccination cycle and associated factors among health care workers in the Greater Accra Region of Ghana

BACKGROUND

Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana.

METHODS AND MATERIALS

An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05.

RESULTS

A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine.

CONCLUSION

Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.

Combined Hepatitis B Virus and Hepatocellular Carcinoma Screening Using Point-of-Care Testing and Ultrasound in a Tanzanian Emergency Department

The WHO aims to detect 90% of global cases of hepatitis B virus (HBV) by 2030. Sub-Saharan Africa carries a disproportionate burden of HBV and hepatocellular carcinoma (HCC). In this study, we sought to assess the utility of a combined HBV and HCC screening program in Tanzania. We conducted a prospective, serial cross-sectional study of patients who participated in a combined HBV and HCC screening program at a regional referral hospital emergency department (ED) in Arusha, Tanzania, between April 19, 2022 and June 3, 2022. All patients completed a study questionnaire and were tested for HBV surface antigen. Patients who were HBV positive were screened for HCC via point-of-care ultrasound (POCUS). The primary outcome was the number of new HBV diagnoses. Data were analyzed with descriptive statistics. A total of 846 patients were tested for HBV (primary ED: 761, clinic referral: 85). The median age of patients was 44 ± 15 years, and 66% were female. Only 15% of patients reported having a primary care doctor. Thirteen percent of patients had been previously vaccinated for HBV. There were 17 new HBV diagnoses (primary ED: 16, clinic referral: 1), which corresponds to a seroprevalence of 2.0% (95% CI: 1.2%, 3.2%). No patients had liver masses detected on POCUS. An ED-based, combined HBV and HCC screening protocol can be feasibly implemented. This study could serve as a model for HBV/HCC screening in regions with high HBV endemicity and low rates of community screening.

Adherence to the three-component Hepatitis B virus vaccination protocol among healthcare workers in hepatitis B virus endemic settings in Ghana

Background

The WHO and CDC recommend that HCWs who are at risk of HBV infection should vaccinate as adults early in their career by receiving 3 doses of HB vaccine at a schedule of months 0,1,6 and perform post-vaccination serological testing 1-2 months after vaccination. This study assessed adherence to all three components of the HBV vaccination program.

Methods

The study was a hospital-based analytical cross-sectional study involving 340 HCWs who were randomly selected. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of HCWs adhering to the three components of the HBV vaccination protocol was computed. The multivariable analysis procedure identified the factors associated with overall adherence. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05.

Results

HBV vaccination coverage was 60.9 % and adherence to 3-doses, 0,1,6 vaccination schedules and post-vaccination serological testing were 46.8 %, 38 % and 13 % respectively. Overall adherence was intermediate at the population level with only 6.2 % of the study participants adhering to all three components of the HBV vaccination protocol. HCWs who had low-risk perception for HBV had the lowest odds of completely adhering to all three indicators recommended for HBV vaccination (aOR = 0.15; 95 %CI = 0.04-0.58). Also, male HCWs have lower odds of adhering to all three components of HBV vaccination compared to their female counterparts (aOR = 0.65; 95 %CI = 1.17-2.50).

Conclusion

Adherence to the three components of HBV vaccination recommended for HCWs is low in this study. Failure to receive the recommended three-dose series of HBV vaccine at the recommended 0,1,6 schedule has implications for achieving seroprotection or development of antibodies against HBV. Failure to perform post-vaccination testing 1-2 months after HBV vaccination has implications for timely PEP management following occupational exposures. All three components of an ideal HBV vaccination program are important and should be used collectively to guide facility led HCW vaccination programs. Occupational health and safety programs, Infection prevention and control, as well as health promotion campaigns in health facilities, should promote adherence to all three components of HBV vaccination programs.

Disparities in Healthcare and HBV Vaccination by Smoking Status: Findings from the National Health and Nutrition Examination Survey (NHANES) 2017-2018

Cigarette smokers face greater challenges in accessing healthcare compared with non-smokers. In the US, approximately 2.2 million individuals are chronically infected with hepatitis B virus (HBV). I used data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 to investigate the association between smoking status (current, former, and never smoker) and different health outcomes, including healthcare accessibility, HBV vaccination, general health condition, and health insurance. Multivariable logistic regressions were used to analyze healthcare disparity by smoking status. I found that current smokers had 40% higher odds (AOR = 1.4, 95% CI: 1.1, 1.8) of lacking routine healthcare access compared with non-smokers. Regardless of smoking status, I observed a high rate of HBV non-vaccination among all participants. Specifically, 64% of current smokers, 67% of former smokers, and 57% of non-smokers had not received a single dose of HBV immunization. My study sheds light on the persisting gaps in healthcare access, particularly for smokers, and the urgent need to promote awareness and vaccination against hepatitis B.

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.

Distribution of Hepatitis B prevention services in Wakiso District, Central Uganda

Hepatitis B Virus (HBV) infection remains a significant global public health challenge especially in low-and-middle income countries. Although there are significant global and national efforts to control Hepatitis B, equitable distribution and access to prevention services such as testing and vaccination remains a challenge. Efforts to increase access are hindered by inadequate evidence on the availability and distribution of HBV services. This cross-sectional study aimed at generating evidence of the distribution of HBV prevention services in Wakiso District, Uganda. A total of 55 healthcare facilities (HCFs) including 4 hospitals, and 51 primary care facilities were surveyed. Data were collected using an electronic structured questionnaire and analysed using STATA 14.0. A chi-square test was performed to establish the relationship between HCF characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used to generate maps to illustrate the distribution of hepatitis B prevention services. We found out that the hepatitis B vaccine was available in only 27.3% (15) of the HCF, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level (p = ≤0.001) and location (p = 0.030) of HCF. Availability of the hepatitis B vaccine at the time of the survey was associated with the level (p = 0.002) and location (p = 0.010) of HCF. The availability of hepatitis B testing services was associated with the level (p = 0.031), ownership (p≤0.001) and location (p = 0.010) of HCF. HCFs offering vaccination and testing services were mostly in urban areas, and close to Kampala, Uganda's capital. Based on this study, hepatitis B prevention services were sub-optimal across all HCF levels, locations, and ownership. There is a need to extend hepatitis B prevention services to rural, public and private-not-for-profit HCFs.

A national level survey on knowledge, attitude and practices among Indian nurses on viral hepatitis

BACKGROUND

Despite being preventable and treatable, viral hepatitis remains a major public health problem in India. In the line of their duties, nursing professionals are constantly at risk of infection. To combat viral hepatitis, it is essential to ascertain the level of knowledge, attitude, and practices among nursing professionals.

MATERIALS AND METHODS

A descriptive cross-section study was conducted at a tertiary public hospital, as a nation-wide online survey after ethical clearance and participants' consent. A convenience sampling, from November 2021 to September 2022, yielded a total of 4532 nurses, nursing students and educators. A self-administered 62-item questionnaire on viral hepatitis with four sections: demographic details, knowledge (33-items), attitude (5-items), and practice (24-itmes) was prepared by expert panel and had a content validity and reliability >0.8. The scale was compiled onto the SurveyMonkey app, field tested before administration and widely circulated on email.

RESULT

The response rate of the survey was 77%. Frequency, percentage, and the odds ratio (at 95% confidence interval) were analyzed on SPSS v22.0. Majority were females (87.1%) aged <30 years (60%) with <5 years' experience (57.8%). Almost equal number worked in public or private sector and was holders of diploma (44.5%) or degree (43.8%). Overall poor knowledge (85.3%), unfavorable attitude (86.2%), and unsafe practices (55.6%) were exhibited by nurses; 42.2% encountered needle stick injury last year and 49.8% had never checked Anti-HBs titer. In the event of needle stick injury, 74.78% cleansed with soap and water; used antiseptics or washes (33.5%), placed finger in mouth (5.10%), forced wound bleed (17.3%), scrub wound (17.54%), or apply bandage (12.58%). Multivariate analysis of factors influencing knowledge of viral hepatitis was educational qualification, designation, and type of health facility.

CONCLUSION

As nursing professionals are constantly at risk, there is an urgent need to raise awareness about hepatitis, the post-exposure prophylaxis and vaccination status. Every healthcare facility should include training and capacity building for nurses about risk, prevention, transmission, and management of viral hepatitis, as an integral part of orientation and continuing education on-the-job; follow stringent policies; and set-up mechanisms for monitoring and follow up. Further, policymakers and statutory bodies need to ensure the standards of nursing practice and improve the health of nurses and their patients.

HBV Infection Is an Intermediate-Risk Disease, Whereas Anaemia Is a Mild-to-Moderate Public Health Problem in Young Ghanaian Adults: A Four-Year Retrospective Analysis of Students' Medical Records

Background

In sub-Saharan Africa, malaria, chronic viral diseases, nutritional deficiencies, and haemoglobinopathies are common causes of anaemia. Continual surveillance data is required to situate the anaemia and infectious disease burden within a given population. This study determined the 4-year trends of anaemia, hepatitis B virus (HBV), and HCV infections and factors associated with anaemia in young Ghanaian adults.

Methods

This retrospective study analysed the medical records of 21,716 fresh students at the University of Cape Coast. Data was presented as percentages and line graphs to show the yearly trends in anaemia, HBV, and HCV infections. Binary logistic regression was used to determine the increased odds of anaemia in participants.

Results

Although the 4-year anaemia prevalence was 14.2% (95% CI: 0.1403-0.1498), anaemia prevalence in women and men were 24.1% (95% CI: 0.2387-0.2562) and 6.6% (95% CI:0.0616-0.0705), respectively. Anaemia prevalence consistently remained mild (males) and moderate (females) public health problem over the four-year period. Adolescents were more represented in the anaemic group (18.7% prevalence), 70.9% of them being females. The prevalence of HBV and HCV infections were 5.4% (95% CI:0.0506-0.0567) and 0.9% (95% CI: 0.0082-0.0108), respectively; only 0.1% of participants had HBV and HCV coinfection. Males were more represented in both HBV (71.2%) and HCV (63.7%) infection groups. Moreover, 15.8% of the participants who were seropositive for HBsAg self-reported having previously been vaccinated, suggesting a breakthrough infection and/or vaccine nonresponse. Furthermore, female (COR: 4.545; p < 0.001), teenagers (COR: 1.697; p < 0.001), 20-29 years (COR: 1.221; p = 0.035), and positive sickling slide test (COR: 1.176; p = 0.003) were statistically significantly associated with increased odds of anaemia.

Conclusion

Intentional preventative public health campaigns regarding anaemia, HBV, and HCV infection should, respectively, target females and young adult males to increase chances of making real change in behavioural attitudes in these at-risk groups.

Hepatitis B vaccination coverage and associated factors among medical students: a cross-sectional study in Bosaso, Somalia, 2021

BACKGROUND

Hepatitis B virus (HBV) is a leading cause of liver cancer and remains a global public health concern. The risk of acquiring HBV is higher in HCWs than in non-HCWs. Medical students are considered a high-risk group because similar to HCWs, they tend to be exposed to body fluids and blood during training in clinical settings. New infections can be effectively prevented and eliminated with an increased coverage of HBV vaccination. The purpose of this study was to evaluate HBV immunization coverage and associated factors among medical students attending universities in Bosaso, Somalia.

METHODOLOGY

An institutional-based cross-sectional study was conducted. A stratified sampling method was employed to draw a sample from four universities in Bosaso. From each university, participants were selected using a simple random sampling technique. Self-administered questionnaires were distributed among 247 medical students. The data were analysed with SPSS version 21, and the findings are presented in tables and proportions. The chi-square test was used to measure statistical associations.

RESULTS

Although 73.7% of the respondents had an above-average knowledge level of HBV and 95.9% knew that HBV can be prevented by vaccination, only 2.8% were fully immunized, while 5.3% were partially immunized. The students reported six main reasons for not being vaccinated: unavailability of the vaccine (32.8%), high vaccine cost (26.7%), fear of vaccine side effects (12.6%), lack of trust in vaccine quality (8.5%), lack of awareness about where to get vaccinated (5.7%), and lack of time (2.8%). Occupation and the availability of HBV vaccination in the workplace were associated with HBV vaccine uptake (p values of 0.005 and 0.047, respectively).

CONCLUSION

HBV immunization coverage among medical students was extremely low (2.8%), indicating the urgent need for increased vaccination coverage in this population. This should start with evidence-based advocacy for the development of a clear national HBV elimination policy, followed by implementing effective, large-scale immunization strategies and interventions. Future studies should expand the sample size to include multiple cities for increased representativeness and conduct HBV titre tests among participants.

Low uptake of hepatitis B vaccination among healthcare workers in primary health facilities in Mwanza region, North-Western Tanzania

Background

Despite the availability of hepatitis B vaccines (HBV) in Tanzania, their uptake among healthcare workers (HCWs) in high-level facilities, such as tertiary hospitals where the vaccines are available, is low. However, their uptake among HCWs in primary health facilities remains understudied. The lack of this information limits the scaling up of HBV vaccination programs.

Methodology

A cross-sectional analytical study was conducted between June and July 2022 among HCWs in the Misungwi and Ilemela districts, which were purposefully selected. The sample size was calculated using the Taro Yamane formula, and data were collected using a self-administered questionnaire and analyzed using IBM SPSS^® version 25.

Results

A total of 402 HCWs were recruited, their mean age was 34.9 ± 7.77 years, and only 18% (76/402) reported being fully vaccinated. HCWs in Ilemela showed higher uptake (χ² = 23.64, df = 1, p = 0.00) of the vaccine than HCWs in Misungwi. Being male (aOR = 2.38, 95% CI 1.28-4.45, p = 0.006), working in an urban setting (aOR = 5.75, 95% CI 2.91-11.35, p = 0.00), and having an employment duration of more than 2 years (aOR = 3.58, 95%CI 1.19-10.74, p = 0.023) were significantly associated with higher odds of vaccination. Moreover, high perceived susceptibility to HBV infection (aOR = 2.20, 95% CI1.02-4.75, p = 0.044) and history of needle prick injuries (aOR = 6.87, 95%CI 3.55-13.26, p = 0.00) were significantly associated with higher odds of HBV vaccination.

Conclusion

Low uptake of HBV vaccine among HCWs in primary health facilities was observed with a noteworthy difference between rural and urban settings. Therefore, advocacy campaigns and resource mobilization toward the promotion of HBV vaccination in primary health facilities are pivotal.

Health care workers' reactions to the newly introduced hepatitis B vaccine in Kalulushi, Zambia: Explained using the 5A taxonomy

Introduction

Hepatitis B virus (HBV) is highly infectious and deadly disease that is transmitted through blood and body fluids. Health care workers (HCWs) have a high risk of contracting HBV in health care settings, the Hep-B vaccine one of the recommended prevention intervention/tools. However, uptake of the vaccine among HCWs remains low in Sub-Saharan Africa. We aimed to explore the barriers and facilitators to uptake of the vaccine offered free of charge to HCWs and nursing students in Kalulushi district, Copperbelt Province of Zambia.

Methods

A total of 29 in-depth interviews (IDIs), either in person or via telephone, with participants before and after they received the vaccines were used to collect the data. We analysed the barriers and facilitators to full or partial vaccination using Penchasky and Thomas's (1981) 5A's (Access, Affordability, Awareness, Acceptance and Activation) taxonomy framework for vaccine hesitancy.

Results

All participants had access to the vaccine, and it was free of charge, making it affordable. Regarding awareness, all participants were aware of HBV infection as an occupational hazard, however, HCWs felt that more sensitization would be needed to increase awareness and knowledge of the vaccine. Acceptability of the vaccine was high among all completers and some non-completers as they felt it was safe and offered them protection. One non-completer felt coerced to accept the first dose due to supervisor expectations and would have preferred to have been given more time to decide. Most felt that vaccination should be compulsory for HCWs. Lastly, activation (vaccine uptake) among non-completers was hindered by late or no notification of appointments as the main reason for not completing the full vaccination schedule. HCWs advised that for countrywide roll-out, at least one weeks' notification would be necessary for HCWs to plan and be mentally prepared to be at their workstations when the vaccination is taking place.

Conclusions

The need to offer the vaccine free of charge locally to ensure easy access and affordability is essential to increase vaccine uptake. Vaccination policies and guidelines for health workers, ongoing training and knowledge sharing are required. Involving trained champions in the facility can also help encourage HCWs to get vaccinated.

Hepatitis B Virus vaccination post serological testing and antibody levels of vaccinated health care workers in Accra, Ghana

Introduction

Hepatitis B Virus (HBV) infection is an important occupational hazard to Health Care Workers (HCWs) all over the world. International health organizations have strongly recommended the use of the HBV vaccine, especially among individuals at risk of HBV infection. A laboratory test aimed at measuring Anti-HBs concentration (titer) 1-2 months following a 3-dose vaccination schedule is the most reliable approach for diagnosing seroprotection against HBV. This study sought to assess post-vaccination serological testing, seroprotection against HBV, and associated factors among vaccinated HCWs in Ghana.

Methods

A hospital-based analytical cross-sectional study involving 207 HCWs. Pretested questionnaires were used to collect data. 5mls of venous blood were collected from consenting HCWs under strict aseptic conditions and quantitatively analyzed for Anti-HBs using ELISA procedures. SPSS Version 23 was used to analyze data with the level of significance set at 0.05.

Results

Median age; 33, IQR of 29-39. The post-vaccination serological testing rate was 21.3 %. HCWs with high-risk perception and working at the regional hospital had lower odds of adherence to post-vaccination serological testing (aOR = 0.2; 95 % CI = 0.1-0.7) and (aOR = 0.1; 95 % CI = 0.1-0.6) p < 0.05. The seroprotection rate was 91.3 % (95 % CI = 87 %-95 %). Minority, 18 (8.7 %) of the 207 vaccinated HCWs had antibody titers below 10mIU/mL and were not seroprotected against HBV. Geometric Mean Titers (GMTs) were higher in those who received three doses, took a booster, and were less than 25 kg/m².

Conclusion

The post-vaccination serological testing practice was sub-optimal. The seroprotection rate was higher with higher GMTs in those who adhered to the 3-dose vaccination regimen, took a booster dose, and had BMI < 25 kg/m². It may be inferred that those with Anti-HBs below 10 IU/ml had their antibodies diminishing or waning off with time or they are true vaccine non-responders. This observation calls for strict adherence to post-vaccination serological testing, especially for HCWs who are at high risk of percutaneous and mucocutaneous exposures that could result in HBV infection.

Hepatitis B Vaccination Coverage among Bangladeshi Healthcare Workers: Findings from Tertiary Care Hospitals

Healthcare workers (HCWs) are at a four-fold higher risk of being infected with the hepatitis B virus in hospital settings. This study investigated the hepatitis B vaccination coverage among Bangladeshi HCWs in selected tertiary care hospitals. Between September 2020 to January 2021, a multicenter cross-sectional study was conducted in 11 hospitals across Bangladesh. Participants included physicians, nurses, cleaners, and administrative staff. A semi-structured questionnaire was used to collect data through face-to-face interviews. Descriptive and multivariate statistics were used to analyze the data. The overall hepatitis B vaccination coverage was 66.6% (1363/2046) among HCWs, with cleaning staff having the lowest at 38.8%. Among the unvaccinated, 89.2% of HCWs desired to receive the free vaccine in the near future. In the last year, over one-fourth of staff (27.9%) had at least one history of needlestick injury. Only 9.8% HCWs were found to have attended training on hepatitis B virus prevention and management in the previous two years. Multivariate analysis revealed that physicians (AOR: 7.13, 95% CI: 4.94-10.30) and nurses (AOR: 6.00, 95% CI: 4.09-8.81) were more likely to be vaccinated against hepatitis B than cleaners and administrative staff. Low uptake of hepatitis B vaccination among HCWs suggests policies that require vaccination are needed to achieve optimum vaccine coverage.

Assessing the level of knowledge, uptake of hepatitis B virus vaccine, and its determinants among health workers across various levels of health facilities in Ondo, South West, Nigeria

Problem considered

Research has shown that health care personnel is at higher risk of acquiring the disease than the general population. In spite of this challenge, there has been a low vaccination record among the Health Workers

The aim of this study was to investigate the relationship between knowledge, attitude, perception, and practice of hepatitis B vaccination among health workers in Akure South Local Government Area of Ondo State, Nigeria

Methods

An institution-based cross-sectional study was conducted with 260 health professionals working at primary health centers (40), private hospitals (60), and tertiary health institutions (160). Data was collected by using self-administered questionnaires distributed at the participant’s work unit and analyzed using SPSS version 20.

Results

The result showed that there was a statistically significant relationship between the knowledge of Health workers about the HBV vaccine and vaccine uptake.

While all the non-vaccinated health workers showed interest in taking the vaccine, the majority of them (80.4 %) suggested that the vaccine should be given free to health workers.

Conclusion

The study revealed that the health workers had a good knowledge of hepatitis infection but not the vaccination which affected vaccine uptake as a significant relationship exists between the two. Also, the greatest hindrance to the uptake of the vaccine is the cost of the vaccine. HBV vaccination should be made compulsory as part of occupational protection measures and made readily available gratis for all health workers.

Understanding hepatitis B vaccination willingness in the adult population in Indonesia: a survey among outpatient and healthcare workers in community health centers

Aim

This study aimed to assess factors associated with the willingness to be vaccinated against hepatitis B among Indonesia’s adult population, considering cultural and geographic differences by analysing the two provinces of Aceh and Yogyakarta.

Subject and methods

An institution-based cross-sectional survey was conducted in 16 community health centres. A multivariable logistic regression model stratified by province was employed to assess variables associated with the willingness to receive hepatitis B vaccination.

Results

We found that participants from Yogyakarta more often had a higher knowledge and risk perception of hepatitis B and were more often willing to get vaccinated than participants from Aceh. We also found that a high-risk perception of hepatitis B infection was associated with the willingness to be vaccinated against hepatitis B in participants from both Aceh and Yogyakarta. Furthermore, in Yogyakarta, a fair and high knowledge of hepatitis B infection and vaccination, being female, and having health insurance covering hepatitis B vaccination costs were associated with the willingness to be vaccinated. In Aceh, health care workers in high-risk units for hepatitis B had a higher willingness to be vaccinated than those who were not high-risk health care workers.

Conclusion

Given the different factors associated with the willingness to be vaccinated against hepatitis B in Aceh and Yogyakarta, this study also highlights the need of a locally adjusted, culture-based approach to improve the hepatitis B vaccination programme.

Occupational health hazards among healthcare providers and ancillary staff in Ghana: a scoping review

OBJECTIVE

The strict implementation of occupational health and safety policy curbs exposure to occupational hazards. However, empirical evidence is lacking in the Ghanaian context. This review primarily aimed to explore exposure to occupational hazards among healthcare providers and ancillary staff in Ghana.

DESIGN

A scoping review was conducted based on Arksey and O'Malley's methodological framework and Levac et al's methodological enhancement.

DATA SOURCES

Searches were conducted of the PubMed, MEDLINE, CINAHL, Embase, PsycINFO and Scopus databases, as well as Google Scholar and websites of tertiary institutions in Ghana, for publications from 1 January 2010 to 30 November 2021.

ELIGIBILITY CRITERIA

Quantitative studies that were published in the English language and focused on occupational exposure to biological and/or non-biological hazards among healthcare professionals in Ghana were included.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted the data based on the type of occupational exposure and descriptive characteristics of the studies. The data are presented in tables and graphs. A narrative summary of review findings was prepared based on the review research questions.

RESULTS

Our systematic search strategy retrieved 507 publications; however, only 43 met the inclusion criteria. A little over one-quarter were unpublished theses/dissertations. The included studies were related to biological, psychosocial, ergonomic and other non-biological hazards. 55.8% of the studies were related to exposure to biological hazards and related preventive measures. In general, health workers were reported to use and comply with control and preventive measures; however, knowledge of control and preventive measures was suboptimal.

CONCLUSION

Work is needed to address the issue of occupational health hazard exposure in Ghana's health system. More research is needed to understand the extent of these exposures and their effects on the health system.

Level of screening for and vaccination against hepatitis B among healthcare workers in the Eastern Democratic Republic of the Congo: a public health concern

Background

In low resource settings in sub-Saharan Africa healthcare workers (HCW) have a high risk of contracting hepatitis B infection. Vaccination of HCWs is to protect them from acquisition of hepatitis B from patients.

Objective

To evaluate the hepatitis B virus (HBV) serological and vaccination status of HCWs in the Butembo Antenna in the Eastern Democratic Republic of Congo (DR Congo) and to investigate the factors influencing hepatitis screening and vaccination.

Methods

A cross-sectional study using a structured questionnaire was carried out from 1^st to 30^th April 2021 among consenting HCWs in Butembo (≥18 years of age). Data was analysed using SPSS version 23.

Results

Of 373 participants, 178 (47.7%) had already been screened for HBV. Screening was more likely for HCWs in a rural or publicly owned facility (P<0.05). A total of 25 (6.7%) HCWs were fully vaccinated against HBV; the factors associated with full vaccination were: prior screening for HBV (odds ratio: 9.03 (2.51–38.61), P<0.0001), prior knowledge of the value of post-exposure prophylaxis (odds ratio 12.9 (2.89–80.44), P=0.0004), prior knowledge of hepatitis B vaccine benefits (adjusted odds ratio: 4.54 (1.66–13.05), P=0.002) and prior exposure to hepatitis B infection (adjusted odds ratio: 2.61 (1.08–6.39), P=0.039).

Conclusion

Screening and vaccination rates of HCWs for HBV are extremely low, and not high enough to prevent the spread of this serious illness and its complications. There is a dire need to increase vaccination rates among HCWs in Eastern DR Congo. The DRC government should issue vaccination against HBV as a recommendation at the national level.

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.

Immune response to hepatitis B vaccine: An evaluation

Background:

Hepatitis B virus infection is a major public health problem in India, and all health-care workers (HCWs) need to be immunized to prevent occupational exposure. This study was done to find the hepatitis B vaccination rates, immune response, and predictors of titer <10 mIU/ml among students and HCWs of a tertiary care institution in the state of Kerala.

Materials and Methods:

This was a cross-sectional study conducted in the Department of Microbiology, Government TD Medical College, Alappuzha, Kerala, India, for a period of 1½ years between January 1, 2016, and June 30, 2017. Vaccination rates were collected through a screening proforma. Of the 1321 participants who filled the screening proforma, 5 ml of blood was collected aseptically from 579 participants who were fully vaccinated (all the three doses of vaccine) and stored at −20°C until antibody to hepatitis B surface antigen (anti-HBs) assay was done using Microlisa (Biorad). Data were analyzed using SPSS for Windows, version 16.0. (SPSS Inc., Chicago, IL, USA) (trial version).

Statistical Analysis:

Descriptive data were expressed using frequencies and percentages, and Chi-square test was applied to find the association between antibody titer <10 mIU/ml and independent variables.

Results:

Of the 1321 participants who filled up the screening proforma, the vaccination rate was 72.6%. Majority of the participants, i.e. 83.5% of doctors, 81.1% of nurses, 69.7% of students, and 21.4% of technicians, had taken all the three doses of hepatitis B vaccine. Of the fully vaccinated (n = 959) participants, 76.9% had the vaccination during adulthood and only 26.1% had it during childhood. The correlate of protection was defined as the presence of anti-HBs ≥10 mIU/ml. The mean antibody titer was 448 ± 284.97 mIU/ml ranging from 9.8 to 2000. Of the 579 participants whose titer was checked, 71 (12.3%) had a nonprotective titer of <10 mIU/ml. We found that age >35 (odds ratio [OR]: 3.85, 95% confidence interval [CI]: 2.12–6.99]), last dose >10 years (OR: 5.01, 95% CI: 2.94–8.55), no boosters or revaccination (OR: 2.94, 95% CI: 1.42–6.07), and body mass index (BMI) >25 (OR: 2.51, 95% CI: 1.44–3.39) were associated with nonprotective titer.

Conclusion:

More than a quarter of the study population who were at high risk of exposure were unvaccinated or partially vaccinated. Even after taking the full course of hepatitis B vaccine, 12.3% had titer <10 mIU/ml. Nonprotective titer was found to be associated with age >35 years, last dose taken >10 years ago, no boosters/revaccination, and BMI ≥25.

Unmet needs in occupational health: prevention and management of viral hepatitis in healthcare workers in Ho Chi Minh City, Vietnam: a mixed-methods study

OBJECTIVES

Vietnam is an endemic area for hepatitis B virus and hepatitis C virus infection (HBV-HCV), yet its largest city, Ho Chi Minh City (HCMC), has no comprehensive policy to educate, screen, treat and protect healthcare workers (HCWs) from viral hepatitis. We conducted a mixed-methods study to document HBV-HCV infection rates, risk factors, local barriers and opportunities for providing education, screening and medical care for HCWs.

DESIGN

This mixed-methods study involved an HBV and HCV serological evaluation, knowledge, attitude and practice survey about viral hepatitis and many in-depth interviews. Descriptive statistics and thematic content analysis using inductive and deductive approaches were used.

SETTING

HCMC, Vietnam.

PARTICIPANTS

HCWs at risk of viral hepatitis exposure at three hospitals in HCMC.

RESULTS

Of the 210 invited HCWs, 203 were enrolled. Of the 203 HCWs enrolled, 20 were hepatitis B surface antigen-positive, 1 was anti-hepatitis C antibody (anti-HCV Ab)-positive, 57 were anti-hepatitis B core Ab-positive and 152 had adequate anti-hepatitis B surface Ab (anti-HBs Ab) titre (≥10IU/mL). Only 50% of the infected HCWs reported always using gloves during a clinical activity involving handling of blood or bodily fluid. Approximately 50% of HCWs were still not vaccinated against HBV following 1 year of employment. In-depth interviews revealed two major concerns for most interviewees: the need for financial support for HBV-HCV screening and treatment in HCWs and the need for specific HBV-HCV guidelines to be independently developed.

CONCLUSIONS

The high HBV infection rate in HCWs coupled with inadequate preventive occupational practices among the population in HCMC highlight the urgent needs to establish formal policy and rigorous education, screening, vaccination and treatment programmes to protect HCWs from HBV acquisition or to manage those living with chronic HBV in Vietnam.

Healthcare students' vaccination status, knowledge, and protective behaviors regarding hepatitis B: a cross-sectional study in Turkey

AIM

We aimed to determine the vaccination status, knowledge, and protective behaviors of healthcare students related to hepatitis B and to examine the related factors.

METHOD

This cross-sectional study was conducted in seven universities from seven geographical regions of Turkey. The study group included 5451 healthcare students. Data were collected with a questionnaire including items on sociodemographic characteristics, vaccination status, knowledge and protective behaviors related to hepatitis B. Data were analyzed with Pearson's chi-square and logistic regression analyses.

RESULTS

86.0% of the students had hepatitis B vaccine while 7.6% did not. Vaccination was higher in nursing and midwifery students (aOR = 1.87, CI 95%: 1.26-2.77; aOR = 3.87, CI 95%: 2.14-7.02, respectively). Vaccination was 1.28 times higher in females (CI 95% 1.03-1.60). The ≥23 age group had 1.79 times higher vaccination rate than those in the ≤19 (CI 95%: 1.26-2.53). Vaccination was higher in students whose family's economic status is middle and high (aOR = 1.53, CI 95%: 1.07-2.19; aOR = 1.47, CI 95%: 1.03-2.19, respectively). Vaccination was higher in those living in towns and cities during childhood (aOR = 1.36, CI 95%: 1.06-1.74; aOR = 1.79, CI 95%: 1.34-2.38, respectively). Females had more knowledge of hepatitis B and protective behaviors. Both knowledge and protective behavior scores of vaccinated participants were significantly higher (p < .05).

CONCLUSION

We found that the vaccination rate in healthcare students was high, but lower than the country's targets. The students were sensitive about the protective behaviors from hepatitis B infection and had sufficient knowledge of HBV contamination.

Seroprevalence of hepatitis B virus infection, anti-HCV antibodies and HIV and knowledge among people who use drugs attending methadone therapy clinic in Tanzania; a cross-sectional study

Background

Methadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania.

Methods

We enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV.

Results

An overall seroprevalence of viral hepatitis (either hepatitis B surface antigen or anti-hepatitis C virus) was 6.3%, while that of hepatitis B virus mono infection was 3.5% and anti-hepatitis C antibodies was 3.5%. Seroprevalence of HIV was 12.6%. Viral hepatitis was strongly predicted by advanced age (> 35 years) (p = 0.02) and staying at Kirumba area (p = 0.004), and HIV infection was predicted by increased age (> 37 years) (p = 0.04) and female sex (p < 0.001). Regarding the knowledge of viral hepatitis, majority of the respondents were unaware of the transmission methods and availability of hepatitis B virus vaccines and only 17% were classified as well informed (provided ≥4 correct answers out of 7 questions). Good knowledge was highly predicted by higher education level of the individual (p = 0.001).

Conclusions

Despite the efforts to curb viral hepatitis and HIV infections through Methadone clinics, infection rates among people who use drugs are still high and the general knowledge on preventive measures is inadequate.

Hepatitis B, C and D virus prevalence in children and adults in Mbeya Region, Tanzania: results from a cohort study 2002 - 2009

INTRODUCTION

sub-Saharan Africa bears a high prevalence for hepatitis B virus (HBV) infection. This analysis aims at elucidating the exposure to HBV across different age groups in Mbeya Region in Tanzania and determines prevalences of hepatitis C (HCV) and hepatitis delta antigen (HDV) infections.

METHODS

plasma samples from children and adults with defined HIV status were analysed for HBV, HCV and HDV markers.\.

RESULTS

hepatitis B (HBs)-antigen positivity was 8.3% (3/36) in the 0 to 5 years age group, 13.3% (8/60) in the 6 to 7 years, 17.2% (10/58) in the 8 to 14 years and 13.3% (8/60) in the 15 to 18 years age groups. In adults 5.0% of samples were HBs-antigen positive. Overall, 17.1% were HIV-1 positive. Adults infected with HIV-1 were significantly more often HBs-antigen positive (7.5%) than HIV-1 negative adults (4.5%; p<0.05). A serological sub-study including 174 adults showed that both total anti-HBs and total anti-HBc positivity increased with age in HBs-antigen negative participants. Across all age groups, HCV antibodies were found in 9 individuals, HDV antibodies in 3 individuals.

CONCLUSION

children presented a high prevalence of HBs-antigen carriers, with lower levels in the younger children. Among adults, the overall prevalence of HBs-antigen was lower than in children, either corresponding to clearance of HBV over time or due to a die-off effect. HBs-antigen positive adults had higher frequencies of anti-HBc- and anti-HBe-antibodies, indicating better immunological control of HBV infection than children. This supports claims that HBV infections in Africa are mostly acquired in childhood and to a large extent cleared again by adulthood. One in 20 adults remains chronically infected, emphasising the importance of HBV vaccination strategies.

Capacity building of healthcare workers: Key step towards elimination of viral hepatitis in developing countries

BACKGROUND

Lack of awareness about viral hepatitis (VH) potentially predisposes the healthcare workers (HCWs) to a higher risk of infection and may in turn increase the risk of transmission of the infection to their families and in the community. Thus, combating VH, requires adequate and updated training to the HCWs. With this objective, Project PRAKASH designed a meticulously planned training program, aimed to assess the effect of a one-day training on VH among in-service nurses.

METHODS AND MATERIAL

The content and schedule of scientific sessions of the training program were decided by subject experts to improve knowledge, attitude and practice(KAP) related to VH among in-service nurses. A 54-item questionnaire divided into four domains: Transmission and Risk Factors; Prevention; Treatment; Pathophysiology and Disease Progression were used to assess the KAP related to VH. The questionnaire consisted of four sections: demographic details, knowledge(30-items), attitude(12-items) and practice(12-itmes) with a total score of 30, 60 and 24 respectively in each section. The pre-post knowledge assessment was done and impact assessment survey was undertaken among the participants who completed six months post-training period. Paired-t-test was used to assess the effect of training on knowledge using SPSSv-22.

RESULTS

A total of 5253 HCWs were trained through 32 one-day trainings, however data for 4474 HCWs was included in final pre-post knowledge analysis after removing the missing/incomplete data. Mean age of participants was 33.7±8.4 with median experience of 8(IQR: 3-13). Mean improvement in knowledge score was found to be significant (p<0.001) with mean knowledge score of 19.3±4.4 in pre-test and 25.7±3.9 in the post-test out of 30. Impact assessment survey suggested change in attitude and practice of HCWs.

CONCLUSION

The one-day training programs helped the in-service nurses to enhance their knowledge related to viral hepatitis. The study provided a roadmap to combating viral hepatitis through health education among HCWs about viral hepatitis.

Knowledge, Vaccination Status, and Reasons for Avoiding Vaccinations against Hepatitis B in Developing Countries: A Systematic Review

(1) Background: The coverage of hepatitis B vaccination remains low in developing countries to date. This systematic review thus analyzes the determinants of people’s knowledge and vaccination status as well as the reasons why people in developing countries chose not to receive the hepatitis B vaccination. (2) Methods: We searched four databases to identify all studies from developing countries published within the past 10 years. Both low-risk and high-risk populations aged older than 15 years old were eligible for the study. The quality of studies was assessed by the Newcastle–Ottawa Scale assessment. (3) Results: This study identified 2443 articles, 89 of which were included in the analysis. Monthly income, occupational status, and profession as a health-care worker were the strongest predictive factors for both knowledge of hepatitis B and vaccination status. In addition, strong predictor variables of hepatitis B knowledge were knowing an infected person and level of education, while health insurance, management’s protection at workplace, infection training, and experience of hepatitis B exposure were strong influencing factors for vaccine uptake. (4) Conclusions: Exposure to information, support from institutions, and financial support related to vaccination cost have a positive impact on the knowledge about hepatitis B infection and vaccination coverage.

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.

Screening, Vaccination Uptake and Linkage to Care for Hepatitis B Virus among Health Care Workers in Rural Sierra Leone

This study reports on the prevalence and risk factors of chronic HBV among health care workers (HCWs) in a rural secondary hospital in Sierra Leone. Additionally, data on the uptake of HBV vaccination among negatively tested HCWs and on the linkage to care among positively tested HCWs are presented. In December 2019, 781 HCWs were invited to a screening and vaccination campaign at Koidu Government Hospital in Kono District. For each HCW, demographic information and data on their HBV risk history were captured, followed by a hepatitis B surface antigen (HBsAg) test. HCWs with a negative test result were offered an HBV vaccine on the same day, after one and six months. HCWs that were HBsAg positive were linked to a free HBV clinic. In total, 80% (632) of HCWs were screened. Among the screened, 97% had never received an HBV vaccine and 10.3% (n = 65) had chronic HBV. The following characteristics were associated with being HBsAg positive: aged less than 30 years old (aOR 2.17, CI 1.16–4.03, p = 0.01), male gender (aOR 2.0, CI 1.06–3.78, p = 0.03), working experience of 1–4 years (aOR 3.99, CI 1.15–13.73, p = 0.03) and over 9 years (aOR 6.16, CI 1.41–26.9, p = 0.02). For HBsAg-negative HCWs (n = 567), 99.8% (n = 566), 97.5% (n = 553) and 82.7% (n = 469) received their first, second and third dose of the vaccine, respectively. For HBsAg-positive HCWs (n = 65), 73.9% (n = 48) were successfully linked to an HBV clinic for further care. Most HCWs are unvaccinated for HBV, and the HBV prevalence amongst this at-risk group is high. Uptake of vaccination and linkage to care was successful.

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 Vaccination Uptake Rate and Predictors in Healthcare Professionals of Ethiopia

Introduction

Healthcare professionals continue to be at risk of acquiring occupation-related hepatitis B virus infection because of noncompliance for the 3-dose primary series of hepatitis B vaccine recommended. The objective of the study was to determine the rate of and to identify the predictors of hepatitis B vaccination uptake in healthcare professionals in Ethiopia.

Methods

A multicenter cross-sectional survey was conducted between May 19 2018 and June 15 2018. A stratified with systematic random sampling technique was used to select 260 healthcare professionals. A structured questionnaire was used to collect all the necessary primary data from samples. This survey analyzed hepatitis B vaccination uptake as the binary outcome variable ("noncomplete" vs "complete") with regard to the 30 potential predictor variables. Both descriptive and inferential statistical analysis techniques have been used to address the study objective.

Results

The rate of complete vs noncomplete hepatitis B vaccination uptake was 37.7% vs 62.3%. The significantly independent predictors of hepatitis B vaccination uptake were professional qualification (P=0.004), professional experience (P=0.013), household income (P=0.006), workload status (P=0.015), routine infant immunization program existence at the workplace (P=0.014), perceived susceptibility to infection (P=0.005), perceived safety of vaccine (P=0.001), prior occupational exposure to blood (P=0.006), training on universal precautions (P=0.015), and colleagues' suggestion (P=0.002).

Conclusion

The rate of hepatitis B vaccination uptake found was currently low. The significantly independent predictors of hepatitis B vaccination uptake included perceived safety, colleagues' suggestion, professional qualification, perceived susceptibility, household income, prior occupational exposure to blood, professional experience, existence of routine infant immunization program at the workplace facility, workload status, and universal precautions training.

Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

The hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia.

METHODS

Studies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed.

RESULTS

A total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p < 0.001), educational level of diploma and below (p = 0.003), health care providers who received training on infection prevention (p < 0.001), and those who had a history of exposure to blood and body fluids (p = 0.001), were factors significantly associated with full-dose hepatitis B virus vaccination.

CONCLUSION

The national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine.

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.

Post Hepatitis B vaccination sero-conversion among health care workers in the Cape Coast Metropolis of Ghana

Background

HBV vaccine is known to offer protection against transmission of HBV infection. Health care workers are mandated to have this vaccination as part of their occupational health safety measures. Post vaccination response data for HCWs in our setting is not available. This study therefore aimed to evaluate the anti-HBs titre levels after Hepatitis B vaccination among HCWs from selected heath facilities in the Cape Coast Metropolis, Ghana.

Methods

A multicenter (3 selected sites) analytical cross-sectional study involving 711 HCWs was conducted. Five (5mls) of blood samples were collected from each study participant and the serum used for HBV immunological profile testing anti-HBs quantification by ELISA test (Fortress Diagnostics Limited, Northern Ireland, United Kingdom). Data analyses were performed using Stata version 14.0 software (STATA Corp, Texas USA).

Results

The median age of participants was 29 years (IQR = 26–35 years). Majority (80.9%, n = 575) took their vaccination from Government health facilities compared with 19.1% (n = 136) from private vaccination sources. A total of 7 (3 males and 4 females) were found to be HBsAg positive giving prevalence of 1%. In all, 8.2% (n = 58) of the HCWs had anti-HBs titre levels <10IU/ml giving a sero-protection rate of 91.8%. HCWs who received 3 doses of HBV vaccine were more likely to be sero-protected as compared to those who received only one dose in multivariate analysis (aOR = 3.39, 95%CI: 1.08–10.67), p<0.037). Gender, cigarette smoking and alcohol consumption were not found to be associated with sero-protection.

Conclusion

There is a high HBV vaccine efficacy among HCWs in the Cape Coast Metropolis of Ghana with higher prevalence of anti-HBs titre level associated with full vaccine dose adherence. Post vaccination antibody titre determination could be an integral part of HBV vaccination protocol for HCWs in Ghana.

Hepatitis B vaccine uptake among healthcare workers in a referral hospital, Accra

Introduction

Hepatitis B vaccination among healthcare workers (HCWs) in Ghana has not been actively pursued despite the endemicity of the infection. This study measures the hepatitis B vaccine uptake among HCWs at the University of Ghana Hospital, Legon (UGHL) and identifies the factors associated with vaccination.

Methods

An analytical cross-sectional study involving all staff who have direct contact with patients was conducted. Self-administered questionnaires were used to collect data on vaccination status, age, sex, type of staff, duration of work in the facility, exposure to blood or blood products, blood stained linens/waste, sharp instruments and performance of invasive procedures. Data was analysed using STATA 14. Continuous variables were described using median values and interquartile ranges (IQR) and categorical variables as proportions. Bivariate and multivariate analysis were conducted to identify the factors associated with hepatitis B vaccination status.

Results

Of the 161 participants interviewed, 63.4% were females with median age 35 years (IQR: 27-45). Eighty-six (53.4%) of the respondents had taken the hepatitis B vaccine with 79.1% of them having completed the vaccination schedule. Factors associated with vaccination were working for more than 16 years (OR: 3.8, CI: 1.02-12.72), daily exposure to blood/blood products (OR: 4.1, CI: 1.43-11.81) and sharp instruments (OR: 4.45, CI: 1.39- 14.24), performing invasive procedures daily (OR: 3.0, CI: 1.07-8.45) and frequent exposure to blood stained linens/waste (OR: 6.1, CI: 1.41-26.51).

Conclusion

The lack of hepatitis B vaccination among some HCWs at UGHL puts them at risk of contracting hepatitis B infection.

Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy

Introduction

In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC).A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed.

Materials and methods

Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p < 0.05). The statistical analyses were performed by SPSS and Stata software.

Results

A total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females.The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%).

Conclusions

This study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside.