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Shah SM, Rodin H, Pogemiller H, Magbagbeola O, Ssebambulidde K, Zewde A, Goers M, Katz B, Obaitan I, Abdo EF, Hassany SM, Elbadry M, Moussa AM, Mtengezo J, Dedzoe M, Henkle B, Bah MB, Sabongi M, Kayandabila J, Fell R, Ijeoma I, Ochola L, Yousif M, Debes JD. Hepatitis B Awareness and Vaccination Patterns among Healthcare Workers in Africa. Am J Trop Med Hyg 2020; 103:2460-2468. [PMID: 33025875 DOI: 10.4269/ajtmh.20-0521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a P-value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, P < 0.001; 74% versus 58%, P < 0.001; and 62% versus 45%, P = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, P < 0.0001 and 52% versus 60%, P = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, P = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.
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Affiliation(s)
- Shemal M Shah
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Holly Rodin
- Analytic Center of Excellence, Hennepin Healthcare, Minneapolis, Minnesota
| | - Hope Pogemiller
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | | | - Kenneth Ssebambulidde
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Anteneh Zewde
- Department of Medicine, Adama Hospital Medical College, Adama, Ethiopia.,Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Matthew Goers
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin Katz
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Itegbemie Obaitan
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Ehab Fawzy Abdo
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
| | - Sahar Mohamed Hassany
- Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
| | - Mohamed Elbadry
- Department of Tropical Medicine and Gastroenterology, Aswan University Hospital, Aswan, Egypt
| | | | | | - Mark Dedzoe
- Department of Medicine, IHDN Mission Hospital, Accra, Ghana
| | - Benjamin Henkle
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Martha Binta Bah
- Department of Pharmaceuticals Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Matthew Sabongi
- Department of Gastroenterology and Hepatology, Hennepin Healthcare, Minneapolis, Minnesota
| | - Johnstone Kayandabila
- Department of Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania
| | - Robert Fell
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Ifeorah Ijeoma
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Lucy Ochola
- Department of Tropical and Infectious Diseases, Institute of Primate Research, Nairobi, Kenya
| | - Mirghani Yousif
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan
| | - Jose D Debes
- Department of Gastroenterology and Hepatology, Hennepin Healthcare, Minneapolis, Minnesota.,Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania.,Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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Mtengezo J, Lee H, Ngoma J, Kim S, Aronowitz T, DeMarco R, Shi L. Knowledge and Attitudes toward HIV, Hepatitis B Virus, and Hepatitis C Virus Infection among Health-care Workers in Malawi. Asia Pac J Oncol Nurs 2016; 3:344-351. [PMID: 28083551 PMCID: PMC5214867 DOI: 10.4103/2347-5625.195921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The highest prevalence of HIV infection occurs in Sub-Saharan Africa and hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence are the second highest in Sub-Saharan Africa including Malawi. Health-care workers (HCWs) play an important role in the prevention of, response to, and management of these infectious diseases. There is, however, no published research about the level of knowledge and attitudes toward HIV, HBV, and HCV infection among Malawian HCWs. The purpose of this study was to explore and determine the knowledge of and attitudes toward HIV, HBV, and HCV among a targeted population of Malawian HCWs. Methods: A cross-sectional community-based participatory research with 194 HCWs was completed employing health survey method. The project was a collaborative effort between nursing faculties in the USA and Malawian. A one-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in knowledge and attitude among three subgroups of HCWs. Results: Of 194 of Malawian HCWs surveyed, 41% were support staff, 37% were nursing students, and 22% were health-care professionals. Both health-care professionals and support staff had high knowledge scores related to HIV/AIDS, and their attitudes were mainly positive. However, a series of one-way ANOVAs revealed significant differences in knowledge and attitude toward HIV/AIDs, HBV, and HCV among HCWs (P < 0.01). The majority had less knowledge about HBV and HCV and more negative attitudes toward hepatitis. Conclusions: This study highlights the ongoing need for reducing negative attitudes toward HIV, HBV, and HCV; and providing health education among HCWs, especially focusing on HBV and HCV prevention. The findings of the research project can be used to develop interventions addressing low HBV- and HCV-related knowledge and attitudes.
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Affiliation(s)
- Jasintha Mtengezo
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA; College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Haeok Lee
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA; College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Jonathan Ngoma
- General Medicine, Kamuzu Central Hospital, Lilongwe, Malawi; General Medicine, College of Medicine, Blantyre, Malawi
| | - Susie Kim
- College of Nursing, Daeyang University, Lilongwe, Malawi
| | - Teri Aronowitz
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Rosanna DeMarco
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Ling Shi
- Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
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Lee H, Kim S, DeMarco R, Aronowitz T, Mtengezo J, Kang Y, Yang Y, Touch C, Fitzpatrick JJ. Recognizing global disparities in health and in health transitions in the 21st century: what can nurses do? Appl Nurs Res 2014; 28:60-5. [PMID: 25448054 DOI: 10.1016/j.apnr.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 09/22/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine changes in patterns of health and disease in global context between rich countries (USA, Korea, South Africa) and poor countries (Cambodia, Malawi) by using the framework of epidemiology theory developed by Orman (1971, 2005), and to raise awareness of global health disparities thereby prompting actions to reduce such disparities. FINDINGS 1) Life expectancy has increased across all selected countries except South Africa; 2) Korea and the USA have substantially lower mortality rates than other countries; 3) Infant and maternal mortality are still high in the poor countries; 4) The major cause of mortality in the poor countries is still communicable disease with evidence of the onset of non-communicable disease; and 5) The health transition theory provides a description and explanation of the differences in progress in economic development between countries but fails to explain differences in health status within and between countries. CONCLUSIONS Life expectancy and mortality are enormously different among the five selected countries. This excessive health disparity is primarily due to the higher risk of communicable diseases in low-income countries. Social determinants of health are mainly responsible for the health disparities observed within and between countries. CLINICAL RELEVANCE Future health care development and global research priorities will not be the same for all countries because the pattern of health transitions in the developing countries is not the same as the developed countries. Actions to reduce global health disparities need to recognize the conditions and social context in which persons live. An effective strategic approach to global health equality should develop a shared system of values, priorities, and delivery infrastructures with the populations who are targeted, aligning delivery within the local social contexts.
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Affiliation(s)
- Haeok Lee
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA.
| | - Susie Kim
- Daeyang Luck College of Nursing, Lilongwe, Malawi
| | - Rosanna DeMarco
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA
| | - Teri Aronowitz
- Nursing Department, University of Massachusetts Boston, Boston, MA, USA
| | | | - Younhee Kang
- College of Health Sciences, Ewha Womans University, South Korea
| | - Youngran Yang
- College of Nursing, Chonbuk National University, South Korea
| | - Chhan Touch
- Lowell Community Health Center/Metta Health Center, Lowell, MA, USA
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Relf MV, Mekwa J, Chasokela C, Nhlengethwa W, Letsie E, Mtengezo J, Ramantele K, Diesel T, Booth C, Deng L, Mallinson RK, Powell D, Webb A, Liddle A, Yu-Shears J, Hall C, Aranda-Naranjo B, Parham Hopson D. Essential nursing competencies related to HIV and AIDS: Executive summary. J Assoc Nurses AIDS Care 2011; 22:S9-16. [PMID: 21211698 DOI: 10.1016/j.jana.2010.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Indexed: 10/18/2022]
Abstract
With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of taskshifting, task-sharing, and scope of nursing practices.
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Affiliation(s)
- Michael V Relf
- Duke University School of Nursing, Durham, North Carolina, USA
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Relf MV, Mekwa J, Chasokela C, Nhlengethwa W, Letsie E, Mtengezo J, Ramantele K, Diesel T, Booth C, Deng L, Mallinson RK, Powell D, Webb A, Liddle A, Yu-Shears J, Hall C, Aranda-Naranjo B, Hopson DP. Essential nursing competencies related to HIV and AIDS. J Assoc Nurses AIDS Care 2011; 22:e5-40. [PMID: 21168066 PMCID: PMC7129533 DOI: 10.1016/j.jana.2010.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 07/27/2010] [Indexed: 11/13/2022]
Abstract
With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug–drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices. This is an online Supplement to the Journal of the Association of Nurses in AIDS Care. Visit www.nursesinaidscarejournal.org for easy navigation. A Supplement Preview was published in the January/February 2011 issue, Volume 22, Number 1. The Supplement Preview and Online Supplement are supported by grant number U92HA07230 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, funded by the President's Emergency Plan for AIDS Relief.
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Affiliation(s)
- Michael V Relf
- Duke University School of Nursing, Durham, North Carolina, USA
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