Knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital, Hawassa, southern Ethiopia: a cross sectional study

Hepatitis B vaccination coverage and associated factors among nurses working at health centers in Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

Hepatitis B virus (HBV) poses one of the most serious workplace health risks facing healthcare workers, especially nurses, due to occupational exposure. The HBV vaccination coverage among healthcare workers in Ethiopia ranged from 5.4 to 21.9%. However, little is known about HBV vaccination coverage and associated factors among nurses in Ethiopia. Therefore, the aim of this study was to assess HBV vaccination coverage and associated factors among nurses working in health centers in Addis Ababa, Ethiopia, in 2023.

METHODS

An institutional-based cross-sectional study was conducted from March 2 to March 31, 2023, among 428 nurses working in 32 health centers in Addis Ababa, Ethiopia. Data were entered into Epi-Info version 7.2.5.0 and then exported to SPSS version 27 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize the data on the study variables. Bivariate and multivariate logistic regression analyses were conducted to determine the strength of the association, and the statistical significance of associations between the variables was determined using adjusted odds ratio with a 95% CI and p values < 0.05.

RESULTS

HBV-full vaccination coverage among 428 nurses in health centers in Addis Ababa, Ethiopia, was 36.9%. Male nurses [AOR = 1.78, 95% CI: 1.08, 2.95], taking training on infection prevention [AOR = 1.73, 95% CI: 1.08, 2.78], having good knowledge about HBV vaccine [AOR = 1.98, 95% CI: 1.28, 3.04], and testing for HBV [AOR = 1.98, 95% CI: 1.08, 3.64] were more likely to have HBV full vaccination coverage, whereas monthly salary ≤ 7,071 Ethiopian Birr was 54% less likely to have HBV full vaccination coverage [AOR = 0.46, 95% CI: 0.25, 0.85] at p-value < 0.05.

CONCLUSION

This study revealed that the full HBV vaccination coverage of nurses working in health centers in Addis Ababa, Ethiopia, was low (36.9%), and consequently, the majority of nurses are at a high risk of being infected with HBV. Therefore, the Ministry of Health and health centers should promote awareness, implement prevention programs, provide diagnostic, treatment, and care services, enhance information generation and utilization, and strengthen the health system to increase vaccination coverage among nurses.

Prevalence of hepatitis B virus infection among pregnant women in Africa: A systematic review and meta-analysis

INTRODUCTION

Africa exhibits a considerably high prevalence of the hepatitis B virus among pregnant women. Furthermore, there is a discernible lack of a well-established surveillance system to adequately monitor and comprehend the epidemiology of the hepatitis B virus, particularly among pregnant women. The eradication efforts of the virus in Africa have been impeded by the significant disease burden in the region, and there is a lack of evidence regarding the pooled prevalence of the hepatitis B virus in Africa. Consequently, this systematic review and meta-analysis aims to determine the prevalence of hepatitis B virus infection among pregnant women in Africa.

METHODS

We conducted a systematic literature search using reputable databases such as PubMed, Advanced Google Scholar, Scopus, and the Cochrane Library. The search spanned from July 2013 to July 2023 and included all relevant articles published within this period. To identify potentially eligible articles, we conducted a comprehensive manual review of the reference lists of the identified studies. Our review encompassed articles from the African Journal Online. The analysis focused on observational studies published in peer-reviewed journals that reported the prevalence of hepatitis B surface antigen-positive testing among pregnant women. We utilized the Newcastle-Ottawa critical appraisal checklist to assess the methodological quality of each paper. Finally, a meta-analysis was conducted using a random-effects model.

RESULTS

Out of the 774 studies identified, 31 studies involving 33,967 pregnant women were selected for the meta-analysis. According to the random-effects model, the combined prevalence of hepatitis B virus among pregnant women was 6.77% [95% CI: 5.72, 7.83]. The I2 statistic was calculated to be 95.57% (p = 0.00), indicating significant heterogeneity among the studies. The high I2 value of 95.57% suggests a substantial degree of heterogeneity. A subgroup meta-analysis revealed that factors such as time-dependent bias, sample size dependence, or individual variation among study participants contributed to this heterogeneity (p-difference < 0.05).

CONCLUSION

According to the findings of this study, the pooled prevalence of hepatitis B infection among pregnant women in Africa was found to be intermediate-high. It is recommended that policymakers implement hepatitis B virus immunization programs targeting pregnant women and their new-born babies at higher risk of exposure.

Knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia: a cross-sectional study

Background

Ethiopia is a country with a high endemicity of the hepatitis B virus, and the primary mode of transmission for this virus is mother-to-child transmission. However, the country lacks a comprehensive plan for viral hepatitis surveillance, prevention, and control.

Objectives

To assess the knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia.

Design

A hospital-based cross-sectional study was conducted among pregnant women from October to November 2023 at a University Hospital in Central Ethiopia.

Methods

A total of 412 pregnant women were selected and included in the study using a systematic random sampling technique. An interviewer-administered questionnaire was used to collect the data. The collected data were imported into Epi-data version 3.1 and then exported to the Statistical Package for Social Sciences version 25 for analysis. In the bivariate analysis, variables with a p-value less than 0.25 were included in the multivariate analysis. A logistic regression model was used. A p-value <0.05 indicated statistical significance.

Results

The overall response rate was 94.1%. Of the total 412 respondents, 37.6% exhibited good practices. Notably, pregnant women within the age categories of 29-39 years (adjusted odds ratio (AOR): 0.31; 95% confidence interval (CI): 0.15, 0.64) and ⩾40 years (AOR: 0.17; 95% CI: 0.06, 0.50), residing in rural areas (AOR: 0.35; 95% CI: 0.17, 0.70), with smaller family sizes (AOR: 0.13; 95% CI: 0.07, 0.25), lacking information about hepatitis B virus infection (AOR: 5.15; 95% CI: 2.91, 9.13), having a positive attitude (AOR: 0.03; 95% CI: 0.02, 0.06), and possessing good knowledge (AOR: 0.38; 95% CI: 0.20, 0.71) were significantly associated with poor practice.

Conclusion

This study revealed that pregnant women had a low level of knowledge, attitudes, and practices related to hepatitis B virus infection prevention and control. A greater understanding is necessary to effectively prevent and control the spread of infection through prioritized health education programs targeting pregnant women. These programs must focus on raising awareness through campaigns that promote knowledge and immunization for their children.

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.

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.

Hepatitis B vaccination status and associated factors among students of medicine and health sciences in Wolkite University, Southwest Ethiopia: A cross-sectional study

Background

Hepatitis B virus (HBV) infection is a significant global public health problem. Health care providers and medical students in developing countries including Ethiopia are at an increased risk of contracting HBV due to the high burden of this infection. The most effective way of prevention against HBV infection is vaccination of health care providers. However, there is a paucity of data on the HBV vaccination coverage among students of health science in Ethiopia. Therefore, this study aimed to determine HBV vaccination coverage and associated factors, level of knowledge, attitudes, and practices (KAP) towards HBV among students of medicine and health science at Wolkite University.

Materials and methods

A cross-sectional study was conducted at Wolkite University among 417 study participants from November to December 2020. The study participants were recruited by using a simple random sampling technique. Data were collected using a self-administered structured questionnaire and analyzed using SPSS version 21. A binary logistic regression model was used to determine the factors associated with full-dose vaccination status. Statistical significance was set at P-value <0.05.

Results

Out of the 417 study participants, 5.8% (95%CI: 3.8–7.9) received a full-dose of the HBV vaccine in this study. Unavailability and high cost of the vaccine were frequently mentioned reasons for not being vaccinated against HBV. About 73.6%, 36.2%, and 47% of participants had good knowledge, positive attitudes, and good practices towards HBV, respectively. Being male gender (AOR: 8.8; 95%CI: 2.9–27), rural residence (AOR: 3.6; 95%CI:1.2–10.6), positive attitude (AOR: 0.44; 95%CI: 0.1–1.1), good practice (AOR: 0.17; 95%CI: 0.05–0.5), medicine department (AOR: 5.9; 95%CI: 1.2–29), being second-year student (AOR: 11.7; 95%CI: 2.7–50.9), third-year student (AOR: 19; 95%CI: 4.25–45), and fourth-year student (AOR: 27; 95%CI: 5.8–56) were significantly associated factors with full-dose vaccination status.

Conclusion

Our study revealed that only small proportions (5.8%) of study participants received full-dose HBV vaccination. Vaccinations of students before starting clinical attachments, provisions of training for students on infection prevention mechanism and universal precautions particularly on HBV, increasing the uptake of the HBV vaccine, creating awareness on attitude and practice of students towards HBV to enhance uptake of the vaccine are recommended.

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 Vaccination Status and Associated Factors Among Healthcare Professionals Working in Health Centers at Akaki Kality Subcity of Addis Ababa, Ethiopia: A Cross-Sectional Study

Background

People at high risk for hepatitis B virus include healthcare workers in contact with blood and human secretions. Hepatitis B virus is unique compared to other sexually transmitted infections because a highly efficacious vaccine exists. However, there have been few studies conducted around the vaccination status of hospital healthcare workers in Ethiopia. Little is known about vaccination penetration among healthcare professionals working in health centers in Ethiopia.

Objective

To assess hepatitis B vaccination status and associated factors among healthcare professionals working in health centers of Akaki Kality, Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted. Using simple random sampling, 528 healthcare workers were selected. Data were collected using a pre-tested, structured self-administered questionnaire. Data were entered into Epi-data and analyzed using SPSS version 20. Multivariable binary logistic regression analysis was used to identify the significant associations. Adjusted odds ratios were computed to measure the strength of association, with statistical significance considered at p< 0.05.

Results

Among 505 respondents, only 244 (48%) had ever received a hepatitis B vaccine. Monthly income, religion, age, working unit and educational level were found to be statistically associated with vaccinated status.

Conclusion

This study showed that the percentage of healthcare professionals who had received a hepatitis B vaccination was very low. This is a serious public health concern and a challenge for a country with high prevalence of hepatitis B infection. There is a need to promote hepatitis B screening and vaccination among healthcare professionals. The government must play its part by increasing healthcare budgets and prioritize hepatitis B prevention by establishing a national awareness campaign, and making screening and vaccination services available at all public health centers.

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.

Adequate Knowledge and Low Vaccination Rates of Hepatitis B Virus Infection Among Students, Medical, and Paramedical Persons in a Tertiary Care Teaching Hospital

Introduction 

Hepatitis B virus (HBV) is probably the only vaccine-preventable virus transmitted from one person to the other by blood transfusion, sex, and contact with blood and blood products. HBV is highly transmissible, where the infection has been noted to transmit among the household contacts. HBV is also transmitted from the mother to the child through the transplacental barrier. Clinical infection with HBV may be chronic and could remain for a lifetime. Most exposures with HBV are automatically resolved, but a few infected people may become carriers and may transmit infections. Although HBV can be treated, complete elimination of the virus and the morbidity and mortality associated with chronic infection should be considered as a cause of serious concern. Because healthcare workers are predisposed to HBV infection, adequate knowledge about the virus and the vaccine to prevent the infection is necessary. This study is carried out to assess the knowledge of HBV infection and the status of vaccination among medical, paramedical students, laboratory technicians, and doctors.

Methods

The study included 256 participants attending a tertiary care teaching hospital in Telangana, South India. The participants belonged to three groups, the MBBS students (first, second-, and third-year students), the doctors (the postgraduates, medical teachers, and the clinicians), and the paramedical personnel. All the participants in the study were included after oral consent, and the study was approved by the Institutional Ethics Committee. A questionnaire containing 13 points was used for the study. Seven questions were asked to know the respondent’s knowledge of HBV infection, and the other six were used to know the participant's knowledge and status of HBV vaccination. The study participants filled in the responses with their current understanding of the HBV infection and the vaccine. All the responses were analyzed using Microsoft Office Excel and drawing means and percentages.

Results

Among the 94 medical students, 79 (84%) knew about HBV infection. There was a significant improvement in the knowledge of HBV infection among MBBS students, with first-year MBBS (68%) to the final-year MBBS (100%). The knowledge of HBV among the doctors (postgraduates, medical teachers, and clinicians) was 100%. Among the paramedical participants that included the laboratory technicians and the nursing students, all (100%) knew about HBV infection. Very few MBBS students (12%), 28% of paramedical persons, and 45% of doctors were tested for HBV infection. The knowledge of HBV vaccination was best among the doctors (100%) followed by the paramedical personnel (89%) and the MBBS students (72%). The teaching faculty including the postgraduate students (83%) were vaccinated followed by the paramedical persons (66%), and only 24% of MBBS students were vaccinated.

Conclusions

The study participants had a reasonably good knowledge of HBV infection, and low vaccination rates were observed among various participants. There is an urgent need to understand the significance of HBV infection, especially among healthcare workers. Being easily transmissible and because of the availability of an effective vaccine, healthcare workers should be adequately vaccinated to prevent the spread of infection.