Study on Status and Willingness towards Hepatitis B Vaccination among Migrant Workers in Chongqing, China: A Cross-Sectional Study

Willingness to pay for hepatitis B virus vaccine and associated factors among households in Bahir Dar City, northwest Ethiopia: using contingent valuation method

Background

The prevention of disease burden and death through vaccination is one of the most cost-effective methods. Even though the Hepatitis B Virus (HBV) has significant public health problems in Ethiopia, there is no compulsory HBV vaccination program for adults and the vaccine's market value was not yet estimated in the Ethiopia context. Therefore, this study aimed to assess the willingness to pay (WTP) for the HBV vaccine and its associated factors among households in Bahir Dar City, northwest Ethiopia.

Methods

A cross-sectional study was conducted among 620 households from March 1 to 30, 2020. A systematic random sampling technique was employed to select the required number of households. An interviewer-administered questionnaire was used to collect the necessary information. The contingent valuation method was conducted to measure WTP for the HBV vaccine. A Tobit regression model was employed to investigate significantly associated factors, and variables with a p-value of <0.05 were considered statistically significant.

Results

In this study, 62.17% of households were willing to pay for the HBV vaccine with an average cost of ETB174.24 (US$5.25). Male household heads (P = 0.014), favorable attitude (P = 0.017), and good knowledge (P < 0.001) toward the vaccine were positively associated with WTP, whereas age (P < 0.001), single marital status (P = 0.012) and divorced/widowed (P = 0.018) marital status were negatively associated with WTP.

Conclusions

Overall, most households were willing to pay for the HBV vaccine with an average demand of ETB174.24 (US$5.25). Therefore, a national-level HBV vaccine strategy should be designed considering the households' willingness to pay. In addition, working on attitudes and knowledge toward the vaccine could potentially increase the household's willingness to pay for the HBV vaccine.

Effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women: A clinical controlled study

Background

Menopausal women may experience menopausal syndrome and long-term effects caused by low estrogen levels, such as senile dementia and osteoporosis in the elderly. Most menopausal women may have misconceptions about menopause and low use of pharmacological interventions. These misconceptions may damage the quality of life and miss the critical period for preventing senile diseases. Thus, enhancing the awareness of menopausal women regarding psychosocial and physical changes through health education programs was a way to improve positive attitudes toward menopause and make further treatment options.

Objectives

This study aimed to evaluate the effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women.

Methods

The study was conducted in several hospitals in Chongqing, China. The two groups were from different hospitals with similar medical levels in order to reduce information contamination. It was designed as a clinical controlled trial in which the intervention group (n = 100) and control group (n = 87) were matched for age, age at menarche, menopausal symptoms and drug use status at enrollment. Women in the intervention group received multidisciplinary health education based on lifestyle medicine for 2 months while those in the control group received routine outpatient health guidance. Menopausal syndrome, physical activity and dietary status of participants were assessed before and after the intervention. Paired t-tests and Independent-sample t-tests were adopted for comparison within and between groups, respectively, in the normal variables. Wilcoxon signed-rank tests and Mann-Whitney U tests were adopted for comparison within and between group, respectively, in the abnormal variables. Categorical variables were tested using Pearson's χ2. P-value &lt; 0.05 was statistically significant in statistical tests.

Results

Post intervention testing indicated that menopausal syndrome of participants was significantly improved in the intervention group compared to the control group (P &lt; 0.001). Between-group comparison showed a significant improvement of weekly energy expenditure of total physical activity (P = 0.001) and participation in exercise (P &lt; 0.001) in the intervention group compared to the control group after the intervention. The dietary status of participants was significantly improved in the intervention group compared to the control group (P &lt; 0.001). In the intervention group, the menopausal syndrome of participants improved more in the hormone drug group than in the non-hormone group (P = 0.007), as did the control group (P = 0.02). In the hormone drug group, the physical activity (P = 0.003) and dietary status (P = 0.001) mproved more in the intervention group than in the control group.

Conclusions

The multidisciplinary health education based on lifestyle medicine was effective in improving the menopausal syndrome and healthy lifestyle behaviors of menopausal women. Studies with extended observation period and larger sample size are in need to evaluate the long-term scale-up effects of the multidisciplinary health education.

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

Aim

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

Subject and methods

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

Results

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

Conclusion

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

The association between the density of vaccination workers and immunization coverage in Zhejiang province, East China

Background: We aimed to evaluate whether the density of vaccination workers was associated with the immunization coverage in Zhejiang province.Methods: The immunization coverage of measles-containing vaccine (MCV), the third dose of diphtheria, tetanus, and pertussis combined vaccine (DTP3), and the third dose of poliomyelitis vaccine (PV3) was selected as the dependent variables. Immunization coverage data of children aged 13-23 months were taken from the Zhejiang immunization information system (ZJIIS). The aggregate density of vaccination workers was an independent variable in one set of regressions, while the full-time and part-time vaccination workers were adopted separately in other sets.Results: The density of total vaccination workers was positively and significantly associated with the immunization coverage (MCV: AOR = 3.36; DTP3: AOR = 2.68; PV3: AOR = 2.37). However, when the effects of full-time vaccination workers and part-time vaccination workers were assessed separately, we only found that the density of full-time vaccination workers was positively and significantly associated with the immunization coverage (MCV: AOR = 5.59; DTP3: AOR = 4.13; PV3: AOR = 3.28). The proportion of migrant children < 7 years and Land area were found as negative and significant factors for immunization coverage.Conclusions: A higher density of vaccination workers could improve the availability of vaccination services and immunization coverage. We recommended that government or other non-government organization should, apart from vaccine-related assistance, focus their efforts on human resources for vaccination.

Changing Epidemiology of Hepatitis B Virus and Hepatitis C Virus Coinfection in a Human Immunodeficiency Virus-Positive Population in China: Results From the Third and Fourth Nationwide Molecular Epidemiologic Surveys

BACKGROUND

The transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV)/hepatitis C virus (HCV) is similar in modes/routes and related risk factors. Understanding the long-term changing epidemiology of HIV, HBV, and HCV coinfection is important for evaluation of existing disease control policy and healthcare planning. We describe HBV and HCV coinfection based on the latest 2 nationwide molecular epidemiologic surveys of HIV infection in mainland China in 2007 and 2015.

METHODS

Seroprevalence of HBV and HCV infections was determined in antiretroviral treatment (ART)-naive people living with HIV-1 (PLWH) from 2 nationwide surveys conducted in 2007 and 2015 from 31 provinces, municipalities, and autonomous regions in mainland China. Demographic characteristics, route of HIV transmission, and CD4+ cell count were captured in the national database. Logistic regression was used to study the association between coinfection status and possible relevant risk factors.

RESULTS

A total of 6611 (n = 1571 in 2007; n = 5040 in 2015) ART-naive PLWH met the eligibility criteria. The prevalence of HBV and HCV coinfection in PLWH decreased from 61.1% in 2007 to 18.0% in 2015. Significant coinfection proportion reduction was found for HCV (from 53.7% to 4.9%), and a moderate decrease for HBV (17.8% to 13.9%). There was an increase of HBV/HIV coinfections among 12 provinces, municipalities, and autonomous regions, associated with domestic migration (adjusted odds ratio, 6.34 [95% confidence interval, 1.82-22.09]).

CONCLUSIONS

A significant decrease of HBV and HCV coinfection in PLWH was observed. Due to limited health resources and high transmission efficiency, concerted efforts should be made to further control viral hepatitis epidemics in HIV-positive populations.

The association between protection motivation and hepatitis b vaccination intention among migrant workers in Tianjin, China: a cross-sectional study

BACKGROUND

Migrant workers are a susceptible population to the hepatitis b virus (HBV) and a vulnerable spot in China's immunization procedures. There is no free HBV immunization program for migrant workers in China, so understanding migrant workers' motivation to receive the HBV vaccine is the first step in designing effective immunization policies.

METHODS

A fully specified protection motivation theory (PMT) model of HBV vaccination intention among migrant workers was specified. Data were collected through a cross-sectional survey of 406 migrant workers in three migrant-dense industries in Tianjin, China. Principal component factor analysis was used to produce PMT factors and nested binary logistic regression modeling was applied to assess the associations between protection motivation and HBV vaccination intention of migrant workers.

RESULTS

The nested binary logistic regression model suggested that the severity factor and self-efficacy factor were positively related to HBV vaccination intention (OR = 2.15, 95% CI: 1.25-3.71; OR = 2.75, 95% CI: 1.62-4.66) while the response costs was negatively related to the HBV vaccination motivation (OR = 0.50, 95% CI: 0.29-0.83). The socio-demographic variables showed that younger, married and good self-rated health status participants were statistically associated with the intention of taking the HBV vaccine. Sex, education level and income group were not significantly associated with vaccination intention. The migrant-industry variables showed that migrant location had a strong effect on migrant workers' vaccination intention.

CONCLUSION

Socio-demographic, migrant-industry variables and PMT factors (severity, self-efficacy and response costs) were statistically associated with migrant workers' intention to vaccinate. Our results suggest that health policy makers should provide more information to migrants on HBV severity; inform migrant workers on where, when and how to get the HBV vaccine; tap into work organizations as a location for vaccinations; and identify migrant worker subgroups for targeted interventions.

Insufficient Knowledge and Vaccination Practice of Inflammatory Bowel Disease Patients in the People's Republic of China

BACKGROUND

Inflammatory bowel disease (IBD) patients are at risk for HBV and varicella, which makes vaccination an important role.

AIM

To assess knowledge and vaccination rate of Chinese IBD patients and find the influencing factors.

METHODS

An online anonymous questionnaire was distributed to IBD patients through www.wjx.cn in the People's Republic of China during October 2019 to February 2020. The Kappa value and multivariate analysis were used to analyze the data using SPSS 25.0.

RESULTS

Among 900 participants, 746 (82.9%) hadreceived immunosuppressive treatment. Only 25 (2.78%) patients thought that they had sufficient information on vaccination, and 311 (34.6%) patients remembered being reminded about vaccination by their doctors before. The self-reported vaccination rate for hepatitis B was 125/666 (18.8%), and for varicella 44/671 (6.6%). Information from doctors was positively associated with vaccination status of hepatitis B (odds ratio [OR]=4.61, 95% confidence interval [Cl: 2.73-7.76], p<0.001) and varicella (OR=4.93, 95%Cl :2.02-12.05, p<0.001). The patients whose duration of IBD diagnosis was more than 2 years (OR=0.37, 95% Cl: 0.16-0.87, p=0.022) and those older than 38 years (OR=0.37, 95% Cl: 0.14-1.00, p=0.0497) were negatively related with the status of varicella vaccination.

CONCLUSION

Vaccination-related knowledge level in IBD patients appeared to be low and the rate of vaccination of both hepatitis and varicella was way below the recommended level. Proper education of both IBD patients and gastroenterologists in the People's Republic of China is needed.