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Makan N, Song E, Kinge CW, Kramvis A. Hepatitis B virus immunity prior to and after administration of a ‘booster’ dose of vaccine among health-care students at a South African university. Vaccine X 2023; 14:100284. [PMID: 37063305 PMCID: PMC10090248 DOI: 10.1016/j.jvacx.2023.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Background Health-care students (HCSs) are at risk of occupational exposure to hepatitis B virus (HBV) infection despite an effective hepatitis B vaccine (HepB) being available. The majority of current HCSs are born after HepB was introduced into the South African Expanded Programme on Immunisation in 1995. Thus, it is assumed that having received HepB in infancy, a single 'booster' dose would suffice. This study aimed to investigate HBV immunity prior to and after administration of a HepB 'booster' dose. Methods Hepatitis B surface antibody (anti-HBs) levels were determined in first year HCSs at the University of the Witwatersrand, before and after receiving the 'booster'. Participant demographics and HepB history were captured using a structured questionnaire. Results Before receiving the 'booster', 56% (101/180) had anti-HBs < 10 mIU/mL and were non-immune. A further 35% had anti-HBs levels of 10 - 99 mIU/mL, and 9% had ≥100 mIU/mL. <30% of HCSs self-reported completion of a three-dose primary series, which was significantly associated with higher baseline anti-HBs levels compared to those with a partial schedule (p = 0.045). Following vaccination, 39% (71/180) returned for follow-up with a significant median (IQR) increase of 476 (151 - 966) mIU/mL (p < 0.001). Of the 45 students who had non-immune baseline levels, 73% (33/45) responded with ≥100 mIU/mL, 16% (7/45) with 10 - 99 mIU/mL and 11% (5/45) remained non-immune. Levels of ≥100 mIU/mL were achieved by 100% of students with baseline levels ≥10 mIU/mL (n = 26). Conclusion More than half of the HCSs were not immune to HBV prior to receiving the recommended 'booster' vaccine. Following vaccination, 7% (5/71) remained unprotected. This study highlights that in the absence of vaccination records and without confirming the immune status of HCSs, it cannot be assumed that HCSs will be protected following a 'booster'. Policy reform and inclusion of serological tests for immunity prior to HCSs initiating clinical exposure are recommended.
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Affiliation(s)
- Nisha Makan
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Leadership in Vaccinology Expertise (ALIVE), School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ernest Song
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Constance Wose Kinge
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Implementation Science, Right to Care, Centurion, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Corresponding author at: Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, University of the Witwatersrand, P.O. Wits 3, 2050, South Africa.
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Rahmani A, Montecucco A, Kusznir Vitturi B, Debarbieri N, Dini G, Durando P. Long-Term Effectiveness of Hepatitis B Vaccination in the Protection of Healthcare Students in Highly Developed Countries: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1841. [PMID: 36366350 PMCID: PMC9695994 DOI: 10.3390/vaccines10111841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 09/05/2023] Open
Abstract
Hepatitis B virus represents an important global health problem. In highly developed countries, mass vaccination campaigns of newborns in recent decades have drastically reduced the proportion of carriers. However, workers exposed to blood and body fluids, including healthcare students, can be at risk of exposure. In order to assess the proportion of susceptible individuals in the specific population of healthcare students in highly developed countries, a systematic review and meta-analysis was performed to summarize the evidence on the persistence of humoral immune protection induced by the primary cycle of hepatitis B vaccination, as well as the proportion of true non-responders. Forty-six studies were included in the final analysis (52,749 participants). Overall, the seroprotection prevalence at the pre-exposure assessment was equal to 73.8% (95% CI 69.1-78.0); the prevalence of anamnestic response following the administration of a challenge dose was 90.9% (95% CI 87.7-93.3), demonstrating a high proportion of persistence of vaccination-induced immunity. Among those without evidence of anamnestic response, 5.0% (95% CI 2.1-11.5) were non-responders following the completion of a secondary immunization cycle. These findings demonstrate that the majority of healthcare students vaccinated with the complete HBV primary cycle maintain an effective humoral immunity against this pathogen for over two decades.
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Affiliation(s)
- Alborz Rahmani
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | | | - Nicoletta Debarbieri
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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Sartorelli P, Occhialini F, Miceli R, Pietronigro A, Bianciardi L, Salini C, Messina G. The seroprevalence of the hepatitis B virus in Italian medical students after 3 decades since the introduction of universal vaccination. Int J Occup Med Environ Health 2022; 35:75-80. [PMID: 34448470 PMCID: PMC10464808 DOI: 10.13075/ijomeh.1896.01835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/19/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES Since 1991 hepatitis B vaccination has been mandatory for all newborns in Italy. The aim of the study was to verify the long-term seroprevalence and the efficacy of hepatitis B vaccination in medical students of the University of Siena. MATERIAL AND METHODS A cross-sectional observational study was conducted on a population of 850 medical students of the University of Siena (322 males and 528 females, mean age: 23 years) by obtaining from the medical reports the serological analysis data for the total anti-hepatitis B antibodies (HBsAb) and information on hepatitis B vaccination (number of vaccine doses, age at the first vaccination, time since the final vaccination dose, country of origin). Raw odds ratios (ORs) and 95% confidence intervals (CIs) were initially calculated to evaluate the association between 2 variables. The adjusted ORs were then calculated using a multivariate logistic regression model to study the association between the variables and the possible confounding factors. RESULTS Overall, 593 students (69.76%) were immunized against hepatitis B, while 257 (30.24%) had HBsAb antibody titer <10 mIU/ml. From the OR calculation, an inverse correlation emerged between seropositivity to hepatitis B and age, and between seropositivity to hepatitis B and the age at the first vaccination dose. There was also a correlation between seropositivity and the number of vaccination doses received. By performing the multivariate logistic analysis, correlations with these variables were confirmed. CONCLUSIONS A significant part of the studied population was not immunized against hepatitis B virus, despite the fact that vaccination had been carried out as prescribed by law. The results of the study reaffirm the importance of health surveillance in subjects at biological risk such as medical students. Int J Occup Med Environ Health. 2022;35(1):75-80.
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Affiliation(s)
- Pietro Sartorelli
- University of Siena, Department of Medical Biotechnology, Unit of Occupational Health Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Rosalia Miceli
- University of Siena, Postgraduate School of Occupational Medicine, Siena, Italy
| | | | - Laura Bianciardi
- University of Siena, Department of Medical Biotechnology, Siena, Italy
| | - Chiara Salini
- University of Siena, Postgraduate School of Public Health, Siena, Italy
| | - Gabriele Messina
- University of Siena, Department of Molecular and Developmental Medicine, Siena, Italy
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Trevisan A, Mason P, Nicolli A, Maso S, Fonzo M, Scarpa B, Bertoncello C. Future Healthcare Workers and Hepatitis B Vaccination: A New Generation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157783. [PMID: 34360071 PMCID: PMC8345783 DOI: 10.3390/ijerph18157783] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/08/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022]
Abstract
Before the introduction of universal vaccination, hepatitis B caused high morbidity and mortality, especially among healthcare workers. In the present study, the immune status against hepatitis B was assessed in a cohort of 11,188 students of the degree courses of the School of Medicine of the University of Padua (Italy) who had been subjected to mandatory vaccination in childhood or adolescence and who will be future healthcare workers. The variables that influence the antibody response to vaccination are mainly the age at which the vaccine was administered and sex. If vaccination was administered before one year of age, there is a high probability (around 50%) of having an antibody titer lower than 10 IU/L compared to those vaccinated after one year of age (12.8%). The time between vaccine and analysis is not decisive. Furthermore, female sex, but only if vaccination was administered after one year of age, shows a significant (p = 0.0008) lower percentage of anti-HBs below 10 IU/L and a greater antibody titer (p < 0.0001). In conclusion, the differences related to the age of vaccination induce more doubts than answers. The only plausible hypothesis, in addition to the different immune responses (innate and adaptive), is the type of vaccine. This is not easy to verify because vaccination certificates rarely report it.
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Affiliation(s)
- Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
- Correspondence:
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Annamaria Nicolli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Stefano Maso
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Marco Fonzo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, 35128 Padova, Italy;
| | - Chiara Bertoncello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (P.M.); (A.N.); (S.M.); (M.F.); (C.B.)
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Di Giampaolo L, Costantini E, Di Nicola M, Porreca A, D'Amore G, Coppeta L, Mangifesta R. "Titer of anti-HBs in health professions trainees: prevalence of antibody coverage in a University of Central Italy". Hum Vaccin Immunother 2021; 18:1886805. [PMID: 34166177 PMCID: PMC8942411 DOI: 10.1080/21645515.2021.1886805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: This observational retrospective study aims at verifying hepatitis-B-virus (HBV) vaccination coverage in students vaccinated before and after 1992, in order to optimize health surveillance and vaccination recall.Methods: Vaccination status was evaluated using the anti-HBs antibody titer (anti-HBs). Student t-test and the chi-square test were performed to identify the average age and the difference in antibody coverage between the two genders and in the two populations analyzed.Results: Our study outlined a prevalence of 21.83% uncovered trainees among those vaccinated at age 12 and 45.03% among those vaccinated in neonatal age.Conclusion: In conclusion, our data showed persistent protection against HBV infection in healthcare students.
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Affiliation(s)
- Luca Di Giampaolo
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Erica Costantini
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University G. d'Annunzio Chieti-Pescara, Pescara, Italy
| | - Gioele D'Amore
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Luca Coppeta
- Department of biomedicine and prevention, Occupational Health Service Tor Vergata University, Rome, Italy
| | - Rocco Mangifesta
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
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Ssekamatte T, Isunju JB, Zirimala PAK, Etajak S, Kamukama S, Seviiri M, Nakafeero M, Nalugya A, Tsebeni Wafula S, Atusingwize E, Bukenya JN, Mugambe RK. A positive attitude among primary healthcare providers predicts better hepatitis B prevention practices: evidence from a cross-sectional survey in Wakiso district, Central Uganda. Health Psychol Behav Med 2021; 9:298-314. [PMID: 34104561 PMCID: PMC8158224 DOI: 10.1080/21642850.2021.1904935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Hepatitis B Virus (HBV) infection is an important occupational health risk among primary healthcare providers (PHCPs). However, there is limited evidence on whether PHCPs’ level of knowledge and attitude can predict better HBV infection prevention practices. This study established the relationship between knowledge, attitude, and HBV infection prevention practices among PHCPs in Wakiso district, Central Uganda. Methods: A cross-sectional study design was used. Data were collected from 306 PHCPs, using a structured questionnaire. PHCPs were randomly selected from 55 healthcare facilities. STATA version 14.0 was used to analyse data. A ‘modified Poisson’ regression model was used for inferential statistics. Results: About 42.2% of PHCPs exhibited poor knowledge of HBV infection transmission and prevention, 41.8% had a negative attitude, and 41.5% exhibited poor prevention practices. Age (PR 1.82, 95% CI: 1.24–2.66) was positively associated with the level of knowledge. Healthcare facility level (PR 0.53, 95% CI: 0.34–0.84), main department of work (PR 0.69, 95% CI: 0.51–0.95), years in service (PR 0.66, 95% CI: 0.44–0.99), working in private not-for-profit healthcare facilities (PR 0.59, 95% CI: 0.34–0.99), and public healthcare facilities (PR 0.58, 95% CI: 0.42–0.80) were negatively associated with the level of knowledge. There was a negative association between the location of healthcare facility (PR 0.76, 95% CI: 0.62–0.93) and attitude, and a positive association between level of knowledge (PR 1.36, 95% 1.12–1.65) and attitude. Working in a public healthcare facility (PR 0.80, 95% CI: 0.64–0.99) was negatively associated with practices while having a positive attitude (PR 1.60, 95% CI: 1.28–1.99) predicted better HBV infection prevention practices. Conclusion: PHCPs who were more knowledgeable about HBV infection were more likely to have a positive attitude. In turn, having a positive attitude was associated with better HBV infection prevention practices. There is a need to sensitise PHCPs on HBV infection, and provision of screening and vaccination services in order to address the KAP gaps.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | | | - Samuel Etajak
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Saul Kamukama
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Mathias Seviiri
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Mary Nakafeero
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Edwinah Atusingwize
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine N Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Cocchio S, Baldo V, Volpin A, Fonzo M, Floreani A, Furlan P, Mason P, Trevisan A, Scapellato ML. Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus. Vaccines (Basel) 2021; 9:vaccines9040323. [PMID: 33915763 PMCID: PMC8067181 DOI: 10.3390/vaccines9040323] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022] Open
Abstract
The burden of hepatitis B virus (HBV) infection is a serious public health problem all over the world. Vaccination remains the most effective prevention measure, and safe and effective HBV vaccines have been available since 1982. Health care workers (HCWs) vaccinated against HBV and prospectively followed up for at least 14 years were classified by their antibody titers after primary vaccination as: poor responders (10–99 mIU/mL); moderate responders (100–999 mIU/mL); and good responders (≥1000 mIU/mL). The incidence of antibody loss was calculated for 1000 person-years and the anti-HBs persistence was calculated. The analysis concerned 539 HCWs: 494 good responders (91.7%); 37 moderate responders (6.9%); and eight poor responders (1.5%). The incidence of anti-HBs loss was 52.1 per 1000 person-years for the poor responders, 11.3 per 1000 person-years for the moderate responders, and 1.4 per 1000 person-years for the good responders. The mean persistence of anti-HBs differed significantly between the three groups, being: 19.2 years (95% CI: 15.6–22.8), 25.4 years (95% CI: 23.0–27.9), and 31.0 years (95% CI: 30.5–31.5) for the poor, moderate and good responders, respectively. In conclusion, our findings demonstrate a good persistence of protective anti-HBs titers in HCWs exposed to occupational risk for up to 30 years after a primary vaccination cycle (even without a booster dose) if their titer was initially higher than 100 mIU/mL.
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Affiliation(s)
- Silvia Cocchio
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Vincenzo Baldo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
- Correspondence:
| | - Anna Volpin
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Marco Fonzo
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Annarosa Floreani
- Scientific Institute for Research, Hospitalization and Healthcare Negrar, 37024 Negrar, Italy;
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35124 Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Paola Mason
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Andrea Trevisan
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padua, 35100 Padova, Italy; (S.C.); (A.V.); (M.F.); (P.F.); (P.M.); (A.T.); (M.L.S.)
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9
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Rostkowska OM, Peters A, Montvidas J, Magdas TM, Rensen L, Zgliczyński WS, Durlik M, Pelzer BW. Attitudes and Knowledge of European Medical Students and Early Graduates about Vaccination and Self-Reported Vaccination Coverage-Multinational Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3595. [PMID: 33808446 PMCID: PMC8036942 DOI: 10.3390/ijerph18073595] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
Vaccination is one of the most useful preventive interventions in healthcare. The purpose of our study was to gain overview of the opinions, knowledge, and engagement in vaccination practices among medical students (MS) and junior doctors (JD) in Europe. The survey was distributed from March 2016 until August 2016 via the e-mail and social media of the European Medical Students' Association. In total, 1821 responses from MS and JD from 34 countries in the European region were analysed. The majority of respondents agreed that vaccines are useful (98.7%) and effective (97.2%). Although the necessity of revaccination was supported by 99.2%, only 68.0% of the respondents went through with it. Even though the potential benefit of the flu vaccination seems to be acknowledged by our participants, only 22.1% of MS and JD declared getting the flu shot every or every other season. MS and JD were in favour of specific mandatory vaccination for medical staff (86.0%) and medical students (82.7%). Furthermore, we analysed the self-reported vaccination coverage of our participants regarding 19 vaccines. Of the respondents, 89.5% claimed to provide advice about vaccination to their friends and family. In conclusion, European MS and JD have a very positive attitude towards vaccination. However, their behaviour and knowledge demonstrate certain gaps which should be further addressed in medical education.
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Affiliation(s)
- Olga M. Rostkowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland;
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
| | - Alexandra Peters
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
- Department of Surgery, Klinikum Porz am Rhein, Urbacher Weg 19, 51149 Cologne, Germany
| | - Jonas Montvidas
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
- LUHS Hospital Kaunas, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania
| | - Tudor M. Magdas
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Strada Victor Babeș 8, 400000 Cluj-Napoca, Romania
| | - Leon Rensen
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
- Leiden University Medical Center, Faculty of Medicine, University of Leiden, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Wojciech S. Zgliczyński
- School of Public Health, Centre of Postgraduate Medical Education, Kleczewska 61/63, 01-826 Warsaw, Poland;
| | - Magdalena Durlik
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland;
| | - Benedikt W. Pelzer
- European Medical Students’ Association (EMSA), Rue Guimard 15, 1040 Brussels, Belgium; (A.P.); (J.M.); (T.M.M.); (L.R.)
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Str. 62, D-50931 Cologne, Germany
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Mastrodomenico M, Muselli M, Provvidenti L, Scatigna M, Bianchi S, Fabiani L. Long-term immune protection against HBV: associated factors and determinants. Hum Vaccin Immunother 2021; 17:2268-2272. [PMID: 33522392 PMCID: PMC8189074 DOI: 10.1080/21645515.2020.1852869] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In Italy, vaccination against hepatitis B became compulsory for all the newborns and 12-years-old adolescents in 1991. The main purpose of this study was to evaluate the persistence of long-term protection against HBV in medical students of the University of L’Aquila and in postgraduates Medical Doctors (HCWs) working in San Salvatore Hospital. The second aim was to study the variables associated with a protective anti-HBs antibody level, such as age at vaccination, gender, time elapsed from the last dose of vaccination. Three hundred and forty-two subjects were enrolled from January 2017 to January 2019 and a blood sample was collected to evaluate the levels of serum HBsAg, anti-HBs and anti-HBc. Statistical analysis calculated a multivariable logistic regression model to examine predictors of a protective anti-HBs titer. The larger part (239, 70%) of the students had an anti-HBs titer >10 mIU/mL, those were statistically significant older (26.7 vs 24.5 years, p < .001), vaccinated at age 12 years (83.5% vs 59.9% among vaccinate at infancy, p < .001) and more frequently attending postgraduate medical school (80.8% vs 57.5% among healthcare profession school, p < .001). The multivariable logistic regression model showed that HBV vaccination at age of 12 was significantly and independently associated with protective titers (OR = 10.27, p = .019). The results agreed with literature on HBV vaccination, confirming the efficacy of vaccination after 20 years. In particular, our results suggest that adolescent administration is the main predictor of a protective title, regardless of gender, course and years since vaccinations.
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Affiliation(s)
- Marianna Mastrodomenico
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luca Provvidenti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Scatigna
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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11
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Evaluation of the Hepatitis B Vaccination Programme in Medical Students in a Dutch University Hospital. Vaccines (Basel) 2021; 9:vaccines9020069. [PMID: 33498258 PMCID: PMC7909269 DOI: 10.3390/vaccines9020069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 12/21/2022] Open
Abstract
Healthcare workers (HCW) are at increased risk of contracting hepatitis B virus (HBV) and are, therefore, vaccinated pre-exposure. In this study, the HBV vaccination programme for medical students in a university hospital in the Netherlands was evaluated. In the first part, the effectiveness of the programme, which consisted of a vaccination with Engerix-B® at 0, 1, and 6 months, was retrospectively evaluated over 7 years (2012-2019). In the second part of this study, we followed students (the 2019 cohort) who had previously been vaccinated against HBV vaccination (4-262 months prior to primary presentation) in order to investigate the most efficient strategy to obtain an adequate anti hepatitis B surface antigen titre. In the latter, titre determination was performed directly during primary presentation instead of giving previously vaccinated students a booster vaccination first. The vaccination programme, as evaluated in the retrospective first part of the study, was effective (surpassed the protection limit of 10 IU/L) in 98.8 percent of the students (95% CI (98.4-99.2)). In the second part of our study, we found that 80 percent (95% CI (70-87)) of the students who had previously been vaccinated against HBV were still sufficiently protected and did not require a booster vaccination. With this strategy, the previously vaccinated students needed an average of 1.4 appointments instead of the 2 appointments needed with the former strategy. This knowledge is important and can save time and resources in the process of occupational HBV vaccination of HCW.
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12
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Holt SG, Locarnini S, Sasadeusz J. Hepatitis B related dilemmas in the renal unit. Nephrology (Carlton) 2020; 26:287-293. [PMID: 33155307 DOI: 10.1111/nep.13815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/07/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022]
Abstract
Testing for hepatitis B in dialysis patients is routine, but newer and more sensitive detection methods mean that there is sometimes confusion around viral loads and occult infection. There are frequently difficult choices surrounding isolation and treatment. Here we describe the use of HBV serology and DNA testing in decisions around patients with end-stage renal disease. We also suggest isolation decisions based on our current understanding of the virus and its infectivity.
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Affiliation(s)
- Stephen G Holt
- Department of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia.,Abu Dhabi Health Services Company (SEHA) Kidney Care, Abu Dhabi, UAE
| | - Stephen Locarnini
- Research and Molecular Development, Peter Doherty Institute of Infection and Immunity, Melbourne, Victoria, Australia.,Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute of Infection and Immunity, Melbourne, Victoria, Australia
| | - Joe Sasadeusz
- Abu Dhabi Health Services Company (SEHA) Kidney Care, Abu Dhabi, UAE.,Research and Molecular Development, Peter Doherty Institute of Infection and Immunity, Melbourne, Victoria, Australia.,Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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13
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Acikgoz A, Cimrin D, Kizildag S, Esen N, Balci P, Sayiner AA. Hepatitis A, B and C seropositivity among first-year healthcare students in western Turkey: a seroprevalence study. BMC Infect Dis 2020; 20:529. [PMID: 32698841 PMCID: PMC7374894 DOI: 10.1186/s12879-020-05247-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 07/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background The risk of viral hepatitis among healthcare students (HCSs) is greater than that among the general population. Therefore, this study was conducted to investigate the seroprevalence of the hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among first-year HCSs at a university in Turkey and as a secondary objective, to determine the factors associated with HAV and HBV seropositivity. Methods This cross-sectional study was performed in first-year HCSs in Izmir, western Turkey. Data were collected using a self-administered questionnaire including items on sociodemographic characteristics, medical history, and hygiene. A total of 650 HCSs were tested for the HAV, HBV and HCV markers. Categorical variables were compared using the chi-square test. The association between independent variables and anti-HAV seropositivity and anti-HBs seropositivity was assessed by multinomial logistic regression analysis. Results The overall frequency of total anti-HAV seropositivity was 34.9%. HBsAg, total anti-HBc and anti-HBs seropositivity were found in 0.3, 1.2 and 93.7% of samples, respectively. All of the HCSs were negative for anti-HCV. Total anti-HAV seropositivity was found to be 1.73 times higher in those ≥21 years old, and it was 1.61 times higher in those who perceived their economic status to be average and 2.75 times higher in those who perceived their economic status to be low. Total anti-HAV seropositivity was found to be 4.37 times higher in those who lived in provinces with intermediate human development index levels. Total anti-HBs seropositivity was found to be 2.48 times higher in those ≤20 years old, and it was 2.13 times higher in those who perceived their economic status to be average. Conclusions Approximately two out of three HCSs were susceptible to HAV infection. Since HCSs are at high risk for HAV infection, they should be vaccinated before medical clerkships begin. Our results indicate that there is a high prevalence of anti-HBs seropositivity among HCSs. This result may be largely attributed to the implementation of a successful vaccination program in Turkey since 1998.
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Affiliation(s)
- Ayla Acikgoz
- Vocational School of Healthcare, Dokuz Eylul University, Balcova, 35340, Izmir, Turkey.
| | - Dilek Cimrin
- Vocational School of Healthcare, Dokuz Eylul University, Balcova, 35340, Izmir, Turkey
| | - Servet Kizildag
- Vocational School of Healthcare, Dokuz Eylul University, Balcova, 35340, Izmir, Turkey
| | - Nuran Esen
- Department of Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pinar Balci
- Department of Radiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ayca Arzu Sayiner
- Department of Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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14
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Verso MG, Costantino C, Vitale F, Amodio E. Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback. Vaccines (Basel) 2019; 8:vaccines8010001. [PMID: 31861551 PMCID: PMC7157657 DOI: 10.3390/vaccines8010001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/21/2022] Open
Abstract
Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. The students were examined during the first year of their Degree Course and were checked two years later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within one month. The proportion of students that were vaccinated during adolescence showing anti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus 31.7%; p-value < 0.001). Receiving HBV vaccination at adolescence was significantly associated with a fourfold increased possibility of having anti-HBsAg titers ≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers ≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy.
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Affiliation(s)
- Maria Gabriella Verso
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Occupational Health Unit, University of Palermo, Piazza Marina, 61, 90133 Palermo, PA, Italy
- Correspondence: ; Tel.: +39-368-396-7350
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Section of Hygiene, University of Palermo, Piazza Marina, 61, 90133 Palermo, PA, Italy; (C.C.); (F.V.); (E.A.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Section of Hygiene, University of Palermo, Piazza Marina, 61, 90133 Palermo, PA, Italy; (C.C.); (F.V.); (E.A.)
| | - Emanuele Amodio
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, Section of Hygiene, University of Palermo, Piazza Marina, 61, 90133 Palermo, PA, Italy; (C.C.); (F.V.); (E.A.)
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15
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STEFANATI A, BOLOGNESI N, SANDRI F, DINI G, MASSA E, MONTECUCCO A, LUPI S, GABUTTI G. Long-term persistency of hepatitis B immunity: an observational cross-sectional study on medical students and resident doctors. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E184-E190. [PMID: 31650052 PMCID: PMC6797890 DOI: 10.15167/2421-4248/jpmh2019.60.3.1315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/29/2019] [Indexed: 12/14/2022]
Abstract
Hepatitis B virus (HBV) is a main cause of chronic and acute hepatitis. Healthcare workers (HCWs), including medical students and resident doctors, have an occupational risk of HBV infection. The study aimed to evaluate the long-term persistence of protective anti-HBs antibody levels in healthcare students and resident doctors at risk for occupational exposure to HBV at 15 years after primary vaccination course. Further objective was to evaluate the anamnestic response observed in non-seroprotected subjects receiving a booster dose. Data were collected from the clinical documentation filled in during the occupational medical check of medical students and resident doctors undergoing Occupational Health Surveillance by the University of Ferrara. Of the 621 included individuals, 27.7% had an anti-HBs concentration < 10 mIU/mL. Subjects vaccinated during infancy had more frequently a concentration < 10 mIU/mL than those vaccinated during adolescence (42.7% vs 6.9%; p-value < 0.001). Multivariate analysis confirmed the statistical significance of the vaccination age. 94 subjects who had an anti-HBs concentration < 10 mIU/mL received a booster dose. The proportion of subjects who had an anamnestic response was higher in those vaccinated in infancy rather than during adolescence (94.1% vs 77.8% respectively). These findings suggest that the anti-HBs concentration decreases below 10 mIU/mL more frequently in subjects vaccinated during infancy. Immunological memory seems to persist after the decline of the anti-HB titer, as observed in response to a booster dose. In conclusion, vaccinated subjects at increased risk of HBV infection should be monitored and a booster dose administered if anti-HBs titer is below 10 mIU/mL.
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Affiliation(s)
- A. STEFANATI
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Correspondence: Armando Stefanati, University of Ferrara, Department of Medical Sciences, via Fossato di Mortara 64b, 44121 Ferrara, Italy - Tel. +39 0532 455569 - Fax. +39 0532 205066 - E-mail:
| | - N. BOLOGNESI
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, Ferrara, Italy
| | - F. SANDRI
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, Ferrara, Italy
| | - G. DINI
- Postgraduate School of Occupational Medicine, Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital of Genoa, Italy
| | - E. MASSA
- Postgraduate School of Occupational Medicine, Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital of Genoa, Italy
| | - A. MONTECUCCO
- Postgraduate School of Occupational Medicine, Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital of Genoa, Italy
| | - S. LUPI
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - G. GABUTTI
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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16
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Garzillo EM, Arnese A, Coppola N, Corvino A, Feola D, Monaco MGL, Signoriello G, Marsella LT, Arena P, Lamberti M. HBV vaccination status among healthcare workers: A cross-sectional study. J Infect Prev 2019; 21:23-27. [PMID: 32030100 DOI: 10.1177/1757177419873043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 07/28/2019] [Indexed: 01/13/2023] Open
Abstract
Objective The development of a vaccine against hepatitis B virus (HBV) is one of the improvements in strategy prevention during the last decades. Aim To evaluate HBV-related vaccine status in healthcare workers (HCW) exposed to biological risk. Methods The serum markers for HBV were collected from HCWs in two tertiary care hospitals in Naples (Italy). Multivariate statistical analysis was then performed to identify associated factors linked to the long-term immunogenicity of the HCWs. Results All HBV vaccinated individuals were screened for whole marker patterns; all were HBsAg/anti-HBc negative. Of individuals, 20% had an anti-HB antibody titre < 10 IU/L. Multivariate statistical analysis highlighted that women were more protected than men (73.6% vs. 26.4%, P < 0.05). Additionally, nurses seem to maintain a higher antibody titre than doctors and other staff, such as auxiliary technicians (P < 0.05). Conclusions Our data support the evidence of a strong immunogenicity against HBV, assessed through the circulating antibody titre, when prophylactic vaccination is conducted in non-infantile age, particularly for women. The outcome of the study supports the central role of occupational physicians within the hospital districts in terms of primary prevention and maximum protection of HCWs.
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Affiliation(s)
- Elpidio Maria Garzillo
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Antonio Arnese
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Nicola Coppola
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - AnnaRita Corvino
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Daniela Feola
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | | | - Giuseppe Signoriello
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Luigi Tonino Marsella
- Departiment of Biomedicine and Prevention, Università di Roma Tor Vergata, Rome, Italy
| | - Paola Arena
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
| | - Monica Lamberti
- Department of Experimental Medicine- University of Campania L. Vanvitelli, Naples, Italy
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Vaccination Status and Another Preventive Measures in Medical Schools. Big Needs and Opportunities. Arch Med Res 2018; 49:286-287. [PMID: 30301583 DOI: 10.1016/j.arcmed.2018.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 11/20/2022]
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18
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Schöffel N, Braun M, Bendels MHK, Brüggmann D, Groneberg DA. [Human hantavirus infections]. ZENTRALBLATT FUR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2018; 68:94-97. [PMID: 32288306 PMCID: PMC7123101 DOI: 10.1007/s40664-017-0223-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hantaviruses belong to the Bunyaviridae family. A large number of different subtypes are known worldwide that show a host-specific geographical distribution. Humans may become infected through contact with rodent urine, saliva or feces. In humans, hantavirus infections are an important and worldwide emerging zoonotic disease that may result in a variety of potentially life-threatening diseases, e. g. hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). There are various aspects of major occupational importance, particularly for agriculturists, veterinarians and forestry workers. This article reviews the current knowledge about epidemiology, pathology, diagnostics, therapy and prevention of human hantavirus infections worldwide.
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Affiliation(s)
- N. Schöffel
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland
| | - M. Braun
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland
| | - M. H. K Bendels
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland
| | - D. Brüggmann
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland
| | - D. A. Groneberg
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland
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Dini G, Toletone A, Barberis I, Debarbieri N, Massa E, Paganino C, Bersi F, Montecucco A, Alicino C, Durando P. Persistence of protective anti-HBs antibody levels and anamnestic response to HBV booster vaccination: A cross-sectional study among healthcare students 20 years following the universal immunization campaign in Italy. Hum Vaccin Immunother 2017; 13:440-444. [PMID: 27925503 PMCID: PMC5328216 DOI: 10.1080/21645515.2017.1264788] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Vaccination against Hepatitis B Virus (HBV) became mandatory in Italy for all newborns and 12 years-old individuals in the 1991. The immunogenicity of HBV vaccine and the effectiveness of the universal immunization strategy have been widely demonstrated. However the need to assess the antibody concentrations above the well known serological correlate of protection for HBV infection (≥10 mIU/mL), established in individuals immunized with a 3 doses vaccination course, is still recommended in subjects exposed to occupational risks in different settings, particularly the healthcare services. This practice has to be performed during the preventive medical examination, before the worker's exposure to biological hazards, as a fundamental part of Occupational Health Surveillance Programs in several Countries, including Italy: the goal is to assure individual protection, also providing booster doses when needed, after many years following the primary vaccination. During the 2011–2013 period, an observational study was performed in Healthcare students (HCSs) trained at a regional university acute-care hospital in North-Western Italy, properly immunized against HBV during infancy or adolescence, in order to evaluate the persistence of seroprotection and to assess the anamnestic response to booster vaccination. Data from 717 subjects undergoing HbsAg Ab and HBc Ab testing during the preventive medical examination, and receiving a booster dose of HBV vaccine when resulting with a non-protective titer (<10 mIU/mL), were collected and analyzed. Most of the HCSs (74.6%) included in the survey, mean age 24.8 y ( ± 4.6 SD), had received the primary vaccination course during the first year of life (3–5–11 months). Globally, 507 (70.7%) HCSs showed protective antibody titres, and an anamnestic response was observed in more than 95% subjects receiving the booster dose. Our study demonstrated the long-term persistence of protection of HBV vaccine, more than 20 y following the primary immunization, in HCSs who are exposed to occupational health risk. The anamnestic response observed in non-seroprotected subjects who received the booster further confirms the capability of the HBV vaccine to create a strong immunological memory.
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Affiliation(s)
- Guglielmo Dini
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Alessandra Toletone
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Ilaria Barberis
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Nicoletta Debarbieri
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Emanuela Massa
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Chiara Paganino
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Francesca Bersi
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Alfredo Montecucco
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
| | - Cristiano Alicino
- b Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Durando
- a Department of Health Sciences , Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, I.R.C.C.S. University Hospital San Martino - IST National Institute for Cancer Research , Genoa , Italy
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Guanche Garcell H, Villanueva Arias A, Guilarte García E, Alfonso Serrano RN. Seroprotection against Vaccine-Preventable Diseases amongst Health Care Workers in a Community Hospital, Qatar. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 7:234-40. [PMID: 27651085 PMCID: PMC6817962 DOI: 10.15171/ijoem.2016.864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 06/07/2016] [Indexed: 11/29/2022]
Abstract
Background: Health care workers (HCW) are at high risk of contracting various infectious diseases and play a dual role in the transmission of infections in health care facilities. Objective: To determine the seroprotection against hepatitis B, measles, rubella, and varicella among HCWs in a community hospital in Qatar. Methods: This is a cross-sectional survey conducted in a 75-bed community hospital in Dukhan, Qatar. From August 2012 to December 2015, 705 HCWs were tested for the presence of IgG antibodies for measles, rubella, and varicella, and also for hepatitis B surface antigen (HBsAg). They were also asked about previous history of hepatitis B vaccination. Results: 595 (84.4%) HCWs received a full hepatitis B vaccination schedule; 110 (15.6%) received a single dose. The full schedule was reported with higher frequency by nurses (90.2%) compared to physicians (74.1%) or technicians (79.7%). Those aged ≥30 years (90.4%) and <20 years of work experience had received a full vaccination schedule more frequently than younger and less experienced HCWs. Female HCWs (87.8%) received full schedule more frequently than males (78.8%). 73.4% of the staff had seroprotection against heaptitis B, with the lowest anti-HBsAg titers observed in physicians (58.8%) compared with other categories; males (64.9%) were less protected than females. The seropositivity was 85.6%(95% CI 82.4% to 88.4%) for measles, 94.7% (95% CI 92.2% to 97.3%) for rubella, and 92.2% (95% CI 89.7% to 94.7%) for varicella. Conclusion: HCWs, particularly physicians, are not enough protected against hepatitis B. The seroprotection against measles, rubella, and varicella.
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Hepatitis B Virus Vaccination Coverage in Medical, Nursing, and Paramedical Students: A Cross-Sectional, Multi-Centered Study in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030323. [PMID: 26999171 PMCID: PMC4808986 DOI: 10.3390/ijerph13030323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 03/02/2016] [Accepted: 03/08/2016] [Indexed: 01/05/2023]
Abstract
Students of health professions are at high risk of hepatitis B Virus (HBV) infection during their clinical training. The aim of this cross-sectional, multi-centered study was to investigate the HBV vaccination coverage in Greek medical, nursing, and paramedical students, to look into their attitudes towards the importance of vaccines and to reveal reasons associated with not being vaccinated. A self-completed, anonymous questionnaire was distributed to 2119 students of health professions in Greece, during the academic year 2013-2014. The HBV vaccination coverage of students was high (83%), being higher among medical students (88.1%, vs. 81.4% among nursing and 80.1% among paramedical students; p < 0.001). The vast majority of them (95%) have been vaccinated during childhood. In addition, 30% of the unvaccinated students declared fear over HBV safety. Our results indicate that the healthcare students achieved higher reported immunization rates compared to the currently serving healthcare workers, but also to the students of the last decade. The fact that nursing and paramedical students have lower coverage figures underlines the importance of targeted interventions for the different subgroups of healthcare students in terms of educational programs and screening for HBV markers in order to increase HBV vaccination uptake.
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Lamberti M, De Rosa A, Garzillo EM, Corvino AR, Sannolo N, De Pascalis S, Di Fiore E, Westermann C, Arnese A, Di Giuseppe G, Nienhaus A, Sobrinho APR, Coppola N. Erratum to: Vaccination against hepatitis b virus: are Italian medical students sufficiently protected after the public vaccination programme? J Occup Med Toxicol 2016; 11:3. [PMID: 26884804 PMCID: PMC4754886 DOI: 10.1186/s12995-016-0092-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 11/10/2022] Open
Abstract
[This corrects the article DOI: 10.1186/s12995-015-0083-4.].
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Affiliation(s)
- Monica Lamberti
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Alfredo De Rosa
- Department of Orthodontics, Second University of Naples, Naples, Italy
| | - Elpidio Maria Garzillo
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Anna Rita Corvino
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Nicola Sannolo
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Stefania De Pascalis
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy
| | - Eliana Di Fiore
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Claudia Westermann
- Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Antonio Arnese
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy
| | - Albert Nienhaus
- Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare Services, Hamburg, Germany
| | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy
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