Hepatitis B in Moroccan health care workers

AIM

To evaluate knowledge and perception of hepatitis B, including prevention, among Moroccan health care workers (HCWs) and to estimate seroprevalence of hepatitis B and vaccine coverage (VC).

METHODS

Four hundred and twenty HCWs were randomly selected and stratified by site: 120 in Rabat, 140 in Taza and 160 in Témara-Skhirat. The study included an anonymous questionnaire about knowledge of hepatitis B and its prevention and a serological survey. Oral statements and vaccine registers were used to analyse the VC of the HCWs. Serological testing and VC were analysed according to the occupational exposure.

RESULTS

Participation rates in the questionnaire and serological tests were 68% (285/420) and 66% (276/420), respectively. Fifteen (5%) HCWs had a history of hepatitis B. All HCWs considered that hepatitis B virus (HBV) infection may be acquired through blood exposure. Vaccination was acknowledged as a necessary means against HBV transmission by 276 (98%) HCWs. Forty-two per cent HCWs had no HBV serological markers. The prevalence of hepatitis B surface antigen was 1%. The mean prevalence of hepatitis B core antibody (anti-HBc) was 28% and was significantly higher (P < 0.05) among nursing auxiliaries (57%), nurses (30%), medical physicians (31%) and midwives (25%) than among laboratory technicians (13%). According to the vaccination registers (available in two sites), VC (> or =3 doses) was 55%. VC was 75% among midwives, 61% among nurses, 53% among nursing auxiliaries and 38% among medical staff. Of the fully vaccinated HCWs without anti-HBc, 51% had serological evidence of protection.

CONCLUSION

HBV vaccines should be more readily available for Moroccan HCWs by reinforcing current vaccination programmes.

Comportement et conditions de travail exposant au sang : analyse des pratiques dans trois établissements de soins du Maroc

OBJECTIVE

As in other countries, Moroccan health-care workers are exposed to occupational blood exposure (OBE) hazards. The purpose of this study was to estimate the occupational safety and hygiene conditions determining the OBE risk for health-care workers. WORKERS AND METHODS: In March 2000, a multicentric study was carried out in Morocco on 420 health-care workers, with an anonymous questionnaire. The study included health-care workers in the Taza and Temara hospitals and health centers, as well as in a Rabat public medical analysis laboratory.

RESULTS

The participation rate was 67.8% (285/420). The population was mainly female (61%) with a mean age of 41.4 years (+/-7 years). Health-care workers answered that: occupational hygiene and safety were inadequate (55.1%); wearing single-use gloves was rare (34.5%); resheathing used needles was frequent (74.5%); safe containers were often missing (67%). In 1999, the annual average incidence of OBE was 1.5 (+/-4.3) per capita. If we consider the whole career of health-care workers, the incidence reached about 14.3+/-28.1 per capita. The absence of post-exposure chemoprophylaxis was the rule.

CONCLUSION

The study shows that there is a need to improve occupational hygiene and safety conditions for Moroccan health-care workers in order to reduce OBE hazards.