Assessment of knowledge, attitude, and practices toward prevention of hepatitis B infection among medical students in a high-risk setting of a newly established medical institution

Low Hepatitis B vaccination rates among medical students in South Asia: A systematic review and meta-analysis

BACKGROUND AND AIMS

Current and future healthcare professionals, such as medical students, are at risk of contracting Hepatitis B virus infection. Vaccination against Hepatitis B is an effective means of prevention. However, studies have reported variable vaccination rates among medical students from different regions of South Asia. Understanding vaccination rates and barriers can guide effective interventions to protect future doctors. Therefore, we aimed to find out the vaccination rate among medical students in South Asia.

METHODS

A comprehensive literature search was conducted across multiple databases (PubMed, PubMed Central, Scopus, Embase, CINAHL, Google Scholar, MEDLINE, and other sources) beginning from inception to July 15, 2024. Observational studies reporting vaccination rates among Bachelor of Medicine and Bachelor of Surgery (M.B.B.S.) students in South Asia were included. Two reviewers independently screened and performed the quality assessment. Pooled vaccination rates were calculated and visualized using a random-effects model in R Studio (Version 2023.12.0). Subgroup analysis was performed based on country and year of publication of the studies.

RESULTS

Fifty studies from the South Asian region, including 12,231 participants, were included in the quantitative analysis. The overall pooled Hepatitis B vaccination rate using the random-effects model was 56% (CI: 49-63%), with significant heterogeneity among the included studies (I2 = 98%; P = 0). Subgroup analysis based on country revealed a significant regional variation in vaccination rate (59% in Pakistan, 57% in India, 55% in Nepal, and 41% in Bangladesh; P < 0.01). Lack of awareness, perceived low risk or necessity, concerns about side effects, logistical challenges, and lack of motivation have been reported as barriers to vaccination.

CONCLUSION

The overall vaccination rate was relatively low in South Asia, with significant regional variation. Based on the reported barriers, we recommend that relevant authorities focus on vaccination awareness, motivation, cost-effectiveness, logistics management, policy formulation, and monitoring.

Knowledge, attitude, and practice towards Hepatitis B and vaccination status of pre-clinical medical students at Sylhet Women's Medical College, Bangladesh

BACKGROUND

Hepatitis B is a global health problem with high morbidity and mortality. The risk of transmission is more common among health care personnels and medical students during their professional health trainings. Vaccination is the most effective means of prevention. The main objective of this study was to determine the level of knowledge, attitude, and practice regarding Hepatitis B and vaccination among pre-clinical students in a medical college.

MATERIALS AND METHODS

A web-based, single-center, descriptive cross-sectional study was conducted among pre-clinical medical students in Bangladesh from April 28, 2024, to May 4, 2024. The whole sampling technique method was used taking the entire population for our study. Data were collected using a self-administered questionnaire and analyzed using JMP Pro V17 Statistical Software.

RESULTS

Sixty-one (34%) students were vaccinated against Hepatitis B, of whom 18% received all three doses with a booster dose. The most common reason for non-vaccination was lack of awareness of one's vaccination status (43%). The median knowledge, attitude, and practice (KAP) scores were 54 (50-60), 19 (17-21) and 20 (19-23) respectively, and they were moderately positively correlated. Forty-six (25.98%) students had a good overall KAP score (≥ 102).

CONCLUSION

Only one-third of the students had been vaccinated, and the commonest reason for non-vaccination was lack of awareness of one's vaccination status. Nearly one-fourth of the participants had good knowledge, attitude, and practice related to Hepatitis B. Therefore, education regarding Hepatitis B infection, risk factors, and importance of vaccination is a must among pre-clinical medical students in Bangladesh.

Awareness and Knowledge of Hepatitis B Vaccination Among Newly Enrolled First-Year Medical Undergraduates in South India: A Cross-Sectional Survey

BACKGROUND

Hepatitis B poses a significant public health risk, particularly for healthcare professionals who face heightened exposure in clinical settings. This study assesses the awareness and knowledge of hepatitis B vaccination among first-year medical undergraduates in their preclinical stage before transitioning to clinical phases.

METHODS

This cross-sectional survey was conducted among newly enrolled first-year medical undergraduate students at a medical college before the commencement of a planned vaccination drive, allowing the institution to assess baseline knowledge and logistical needs for the drive. A self-administered questionnaire was used to evaluate students' awareness and understanding of hepatitis B transmission, vaccination, and the occupational risks associated with healthcare work. The data gathered from this survey provided critical insights for optimizing the logistics and educational components of the upcoming vaccination program for the incoming cohort.

RESULTS

Among the 126 respondents, there was a slightly higher representation of male participants (53.17%, n=67), while 46.83% (n=59) were females. Awareness of hepatitis B as a highly contagious liver infection was high, with 88.9% of students agreeing or strongly agreeing. The knowledge that hepatitis B is a public health concern and can lead to severe conditions such as liver cancer was similarly prevalent (97.6% and 90.4%, respectively). Most respondents (80.2%) were aware of the heightened risk for healthcare professionals and viewed vaccination as an effective preventive measure (96.1%). Awareness of transmission routes, including contact with infected blood (96%) and unprotected sexual contact (97.6%), was also strong. However, fewer students were informed about the recommended vaccination schedule (63.4%) or the necessity of booster doses for high-risk individuals (70.6%). Additionally, 93.7% believed healthcare workers should be vaccinated, while 88.9% recognized the need for immunity status checks in healthcare settings. Only 16.66% (n=21) reported receiving the hepatitis B vaccine, with 14.28% having completed the full three-dose series, while 2.38% received only one or two doses. A significant portion (62.69%) reported not being vaccinated, and 20.63% were unsure of their vaccination status. Key reasons for incomplete vaccination included lack of awareness about the full series (58.73%), fear of side effects (6.34%), and perceived lack of necessity (7.93%). Access challenges were also noted by 2.38% of students. Only 1.58% of respondents had checked their immunity status through anti-hepatitis B surface antibody (HBsAb) testing.

CONCLUSION

Newly enrolled medical undergraduates show substantial foundational knowledge of hepatitis B and its prevention. However, targeted educational and peer-led initiatives are recommended to bridge the remaining gaps, ensuring future healthcare professionals have comprehensive knowledge for effective hepatitis B prevention. The findings also underscore the need for improved vaccination awareness and accessibility to achieve comprehensive immunization among medical undergraduates.

Assessment of hepatitis-related knowledge, attitudes, and practices on quality of life with the moderating role of internalized stigma among hepatitis B-positive patients in Pakistan

Aim

This study aimed to assess the Pakistani hepatitis B patients' knowledge, attitudes, and practices towards hepatitis management and the impact of self-management on the quality of life of hepatitis B patients as well as the moderating role of stigmatization.

Methods

A cross-sectional study design was used, and the data was collected from a total of 432 hepatitis B positive patients through a self-designed questionnaire. The studied subjects consisted of men (n = 205, 47%), women (n = 165, 38%), and transgender (n = 62, 14%). The obtained data were statistically analyzed using SPSS software version 26.0 for Windows.

Results

The mean age of the study participants was 48. Knowledge has a significant positive relationship with hepatitis self-management and quality of life, whereas knowledge has a negative relationship with stigmatization. Furthermore, multivariate analysis revealed that men were more knowledgeable about the disease than women and transgender people (6.14 ± 2.08 vs. 3.23 ± 1.61 vs. 1.03 ± 0.73, F = 8.2**, p = .000). On the scale of attitude and practice, significant gender differences were found. Women had more experience with hepatitis self-management than men or transgender (4.21 ± 13.0 vs. 2.17 ± 6.02 vs. 0.37 ± 0.31, F = 6.21**, p = .000). The regression analysis showed that self-management has a positive association with quality of life (B = 0.36, p = .001). The moderation analysis revealed that stigmatization negatively moderates the relationship between self-management and quality of life (B = -0.53, p = .001).

Conclusion

Generally, patients had good knowledge about the disease and its self-management. However, a societal and community-level awareness campaign should be organized on the quality of life and stigmatization of people with chronic illness regarding their human rights, dignity, and physical, mental, and social well-being.

Hepatitis B immunization strategies and its associated factors: A narrative review

Background

Hepatitis B is a major public health concern as one third of the world's population is infected with hepatitis B virus (HBV). The risk of HBV infection remains primarily through percutaneous or mucosal contact with infected blood or body fluids.

Aim

To update the society on hepatitis B immunization strategies and its associated factors.

Materials and Methods

The review paper utilized different search engines such as Pubmed Central, Scopus, Web of Science, Google Scholar, and so on to conduct this review paper.

Results

Improving immunity through general vaccination recommendations has reduced the number of chronic hepatitis B cases among children and adolescents, but an influx of infections from endemic countries has increased the number of chronically infected adults. This is due to immigration from endemic countries to Hepatitis less burden areas like developed countries. Introduction of infant immunization programs in some countries has reportedly reduced the prevalence of HBV infection and reduced the incidence of liver cancer in children and young adults.

Conclusion

While hepatitis B vaccination coverage is low, a significant number of people are not adhering to full hepatitis B vaccination posing a potential hazard to health.

Hepatitis B vaccination status and knowledge, attitude, and practice towards Hepatitis B virus among medical sciences students: A cross-sectional study

BACKGROUND AND AIMS

Healthcare staff are at high risk of occupational exposure to Hepatitis B and other blood-borne diseases. Lack of education about the knowledge of Hepatitis B virus contributes to an increase in cases. This study aims to determine the knowledge of the Hepatitis B virus among the medical professionals in Duhok province, Kurdistan Region of Iraq, and to determine their knowledge of the importance of vaccination.

MATERIALS AND METHODS

This cross-sectional study was conducted in Duhok province, Kurdistan Region of Iraq, among medical science students from November 2022 to February 2023 and a total of 511 students participated in the study. A Self-administered questionnaire comprising 22 items categorized into five sections was distributed to the students either electronically or by paper and pen method. The survey utilized a Five-point Likert scale when assessing respondents' opinions on knowledge, attitude, and practice (KAP). Microsoft Excel and GraphPad Prism 9 were used for statistical analysis.

RESULTS

A total of 511 responses were collected from medical, dental, pharmacy, and laboratory students. The average age of the participants was 20.74 ±1.43 years. Among the respondents, only 96 (18.8%) were fully vaccinated against the Hepatitis B virus (received 3 or more doses of the vaccine), while 294 (57.5%) were not vaccinated. Lack of vaccination programs was the major reason for not receiving a vaccination (n = 182, 62%). About 286 (55.96%) of the participants had good knowledge, attitude, and practice on Hepatitis B, manifesting median scores of 26, 18, and 20, respectively.

CONCLUSION

In our study, half of the students were found to be unvaccinated, mainly due to the absence of vaccination programs. Vaccinated students exhibited better knowledge, attitude, and practice toward the infection than non-vaccinated students. Therefore, we recommend the implementation of a vaccination program as well as training on infection prevention guidelines to increase awareness and encourage vaccination.

Prevalence of exposure to needle stick and sharp-related injury and status of hepatitis B vaccination among healthcare workers: A cross-sectional study

Background and Aims

Hepatitis B is a leading cause of chronic liver disease and subsequent liver transplantation. This is a vaccine-preventable illness. Health workers continue to be at risk for blood-borne pathogens due to occupational exposures. The overall goals of our study were to determine the prevalence of exposure to needle sticks and sharp-related injuries (NSSI) and hepatitis B vaccination status among healthcare workers (HCWs) of Nepalgunj Medical College Teaching Hospital (NGMCTH), Kohalpur, Banke, Nepal.

Methods

A descriptive cross-sectional study was conducted among HCWs at the NGMCTH following ethics approval by the NGMCTH Ethics Review Committee. A pretested structured questionnaire was used to compile the data. Data was collected from September 15, 2021 to September 14, 2022. Collected data entered in Microsoft Excel and analyzed using statistical package for social sciences version 22. Analyzed data were presented using simple descriptive statistics with appropriate figures and tables.

Results

A total of 304 among 506 HCWs (60.1%) participated in the survey were exposed to Needle sticks. Nine of whom (3.7%) were injured substantially (more than 10 times). Among nursing students, 21.3% had experience with NSSI. 71.7% of HCWs had received at least one dose of the hepatitis B vaccine, of whom 61.9% (44.5% of total HCWs) had received three doses.

Conclusions

This study demonstrated that more than two-quarters of HCWs were exposed to NSSI. Despite being at risk, vaccination status was still low, and less than half only received three complete doses. Precaution should be taken when working with instrumentation and procedures. Hepatitis B immunization programs for HCWs should be delivered at no cost with 100% coverage and protection. Raising awareness about hepatitis B infection and immunization remains crucial to primary prevention.

Social challenges experienced by Hepatitis B patients: A mixed method study

Background

Hepatitis B has a wide range of effects on patients' lives due to its chronic nature. Living with Hepatitis B has been associated with various social challenges such as stigma, disclosure, and discrimination.

Aim

To assess the social challenges experienced by Hepatitis B-positive patients seeking treatment at a super specialty liver hospital of the country.

Methods and Results

A mixed-method research design was used to explore various social challenges experienced by Hepatitis B-positive patients. Descriptive research design was used in the first phase and thematic analysis was done in the second phase of the study. Data were collected using a modified Hepatitis B stigma assessment tool and semi-structured interview guide. Total 180 Hepatitis B-positive patients were recruited for the first phase. Face to face interviews were recorded for the 9 patients facing high stigma in the second phase of the study. Mean age of the patients was 45 ± 13.1 years and 80% of the patients were male. Mean overall stigma score was found to be 74.34 ± 10.13. Of all, 5.1% patients experienced high stigma, 2.1% moderate stigma, and 92% patients experienced low stigma. Thematic analysis method uncovered various attributing factors to social challenges broadly classified into reaction on getting diagnosed with Hepatitis B, psychological issues, stigmatization in families, stigmatization at workplace, and stigmatization in healthcare settings.

Conclusion

Patients with Hepatitis B experience social challenges in aspect of lack of awareness, psychological issues, and stigmatization by healthcare providers, family members, and by the colleagues at their workplace. A better understanding and awareness regarding Hepatitis B is needed to eliminate stigma and discrimination among these patients. Hence, a holistic approach is must to treat patients with Hepatitis B.

A training for health care workers to integrate hepatitis B care and treatment into routine HIV care in a high HBV burden, poorly resourced region of Uganda: the '2for1' project

INTRODUCTION

The "2for1" project is a demonstration project to examine the feasibility and effectiveness of HBV care integrated into an HIV clinic and service. An initial phase in implementation of this project was the development of a specific training program. Our objective was to describe key features of this integrated training curriculum and evaluation of its impact in the initial cohort of health care workers (HCWs).

METHODS

A training curriculum was designed by experts through literature review and expert opinion. Key distinctive features of this training program (compared to standard HBV training provided in the Government program) were; (i) Comparison of commonalities between HIV and HBV (ii) Available clinic- and community-level infrastructure, and the need to strengthen HBV care through integration (iii) Planning and coordination of sustained service integration. The training was aided by a power-point guided presentation, question and answer session and discussion, facilitated by physicians and hepatologists with expertise in viral hepatitis. Assessment approach used a self-administered questionnaire among a cohort of HCWs from 2 health facilities to answer questions on demographic information, knowledge and attitudes related to HBV and its prevention, before and after the training. Knowledge scores were generated and compared using paired t- tests.

RESULTS

A training curriculum was developed and delivered to a cohort of 44 HCWs including medical and nursing staff from the two project sites. Of the 44 participants, 20 (45.5%) were male, average age (SD) was 34.3 (8.3) with an age range of 22-58 years. More than half (24, 54.5%) had been in service for fewer than 5 years. Mean correct knowledge scores increased across three knowledge domains (HBV epidemiology and transmission, natural history and treatment) post-intervention. However, knowledge related to diagnosis and prevention of HBV did not change.

CONCLUSION

A structured HBV education intervention conducted as part of an HIV/HBV care integration training for health care workers yielded improved knowledge on HBV and identified aspects that require further training. This approach may be replicated in other settings, as a public health strategy to heighten HBV elimination efforts.

Knowledge, attitude and practice of hepatitis B infection prevention among nursing students in the Upper West Region of Ghana: A cross-sectional study

Introduction

Hepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana.

Methods

We administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention.

Results

The students had moderate median scores for knowledge (12.00; IQR = 10–13) and attitude (6.00; IQR = 5.00–7.00) but a poor median score (5.00; IQR = 4.00–6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention.

Conclusion

The KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students.

Healthcare students' vaccination status, knowledge, and protective behaviors regarding hepatitis B: a cross-sectional study in Turkey

AIM

We aimed to determine the vaccination status, knowledge, and protective behaviors of healthcare students related to hepatitis B and to examine the related factors.

METHOD

This cross-sectional study was conducted in seven universities from seven geographical regions of Turkey. The study group included 5451 healthcare students. Data were collected with a questionnaire including items on sociodemographic characteristics, vaccination status, knowledge and protective behaviors related to hepatitis B. Data were analyzed with Pearson's chi-square and logistic regression analyses.

RESULTS

86.0% of the students had hepatitis B vaccine while 7.6% did not. Vaccination was higher in nursing and midwifery students (aOR = 1.87, CI 95%: 1.26-2.77; aOR = 3.87, CI 95%: 2.14-7.02, respectively). Vaccination was 1.28 times higher in females (CI 95% 1.03-1.60). The ≥23 age group had 1.79 times higher vaccination rate than those in the ≤19 (CI 95%: 1.26-2.53). Vaccination was higher in students whose family's economic status is middle and high (aOR = 1.53, CI 95%: 1.07-2.19; aOR = 1.47, CI 95%: 1.03-2.19, respectively). Vaccination was higher in those living in towns and cities during childhood (aOR = 1.36, CI 95%: 1.06-1.74; aOR = 1.79, CI 95%: 1.34-2.38, respectively). Females had more knowledge of hepatitis B and protective behaviors. Both knowledge and protective behavior scores of vaccinated participants were significantly higher (p < .05).

CONCLUSION

We found that the vaccination rate in healthcare students was high, but lower than the country's targets. The students were sensitive about the protective behaviors from hepatitis B infection and had sufficient knowledge of HBV contamination.

Hepatitis B: Knowledge and awareness among preclinical year medical students

Background and Objective

Hepatitis B is an occupational health hazard to health-care workers. The complete knowledge of hepatitis B virus (HBV) transmission and prevention is indispensable for medical students. This study was conducted to assess the knowledge and awareness of hepatitis B among preclinical year medical students.

Materials and Methods

This is a descriptive cross-sectional study. A predesigned self-administered questionnaire concerning hepatitis B knowledge and awareness was distributed to all the preclinical year medical students. The data were collected, tabulated, and analyzed by Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 22. The results were expressed in numbers and percentages.

Results

Of 251 students, only 132 students voluntarily participated in the study. Majority of the students (84.8%) were aware of HBV infection. Many students knew that blood transfusion (81.1%) and use of contaminated needles and syringes (74.2%) are major modes of transmission. However, less than 30% of the students had knowledge about other modes of transmission. More than 50% of the students lacked in their knowledge about clinical features and complications of hepatitis B infection. Majority of students (72.7%) were aware of HBV vaccination. However, many students did not know their vaccination status, whereas only 23.5% of the students were fully immunized.

Conclusion

This study revealed lack of complete knowledge regarding hepatitis B among preclinical year medical students. They are at high risk of acquiring HBV infection during their clinical practice, later in life. Hence, implementation of well-structured education program in the first year itself is needed to create complete awareness among medical students about hepatitis B.

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.

Knowledge, Attitude, and Practice Regarding HIV, HBV, and HCV Among Medical Students of Syrian Private University, Damascus, Syria

BACKGROUND

Hepatitis B, Hepatitis C, and HIV/AIDS are infections that constitute major health concerns impacting national health systems worldwide. This is the first study to determine Syrian medical students' attitudes, awareness and knowledge of HIV/HBV/HCV, regarding general knowledge about, clinical features, transmission, and prevention.

METHODS

This cross-sectional study was conducted at Syrian Private University on World AIDs Day (1/12/2019), Damascus, during the Syrian war crisis. Data were collected through self-administered surveys which targeted social demographic information, general knowledge, attitude, towards HBV, HCV, HIV. Data were divided and analysed according to the source of information, study year, marital status, and GPA using one-way analysis of variance to assess the level of knowledge.

RESULTS

Of 317 respondents, the majority (59.8%) were males with age ranging from 18 to 30 years of age. . The majority of students 188(59.3%) showed an average level of knowledge, 73(23%) showed a good level of knowledge. This study revealed adequate knowledge. However there were misconceptions regarding transmission pathways. The majority 173(54.6%) had a positive attitude, and 144(45.4%) had a neutral attitude, while none had a negative attitude towards HIV/HBV/HCV infected individuals. Clinical year students (mean 73.0%, SD ± 10.0%) demonstrated higher levels of awareness compared to pre-clinical students (mean 39.7%, SD ± 13.0%).

CONCLUSIONS

This study revealed that medical students have adequate knowledge regarding HIV/HBV/HCV. Medical students play a pivotal role in raising awareness and disseminating knowledge among the community, thus more effort should be concentrated on developing educational programs to limit the risks of such infections.

Comparing Australian health worker and student attitudes and concerns about providing care to people living with hepatitis B

ISSUE ADDRESSED

Hepatitis B (HBV) is a major public health issue with over 250 million people chronically infected worldwide. In Australia, prevalence is higher among migrant communities and these groups may be reticent to attend health care services due to concerns about experiencing stigma and discrimination. The way health workers perceive their clients, particularly those of migrant backgrounds, may influence the way they treat these clients and the quality of care provided. This study investigated and compared the attitudes and concerns health workers and health students have towards working with clients living with HBV.

METHODS

Health workers (n = 551) and students (n = 199) completed an online survey which investigated attitudes towards people living with HBV, comfort with providing care for these clients and concerns they have about working with them.

RESULTS

Health students expressed less comfort (U = 47 611, z = -2.73, P = .006) and reported more concerns about working with people with HBV than qualified health workers (U = 61611.50, z = 2.64, P = .008). Students' concerns were centred around their own ability to provide care rather than issues related to clients. There were no differences in overall attitudes towards people living with HBV between health workers and students.

CONCLUSION

To address concerns that health workers and students may have in working with people living with HBV, particularly those from migrant communities, and to ensure that health workers feel comfortable and confident, HBV workforce development should be included in undergraduate and postgraduate training programmes as well as in continuing professional education. SO WHAT?: This will assist the health workforce to develop competency in the treatment of people living with HBV, with the ultimate aim of providing best quality, non-judgemental care to all people living with HBV.

Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities

Background:

Hepatitis B is a blood-borne infectious liver disease caused by the Hepatitis B Virus (HBV) and it is best prevented by immunization. Due to occupational exposure, medical students have an increased risk of contracting HBV. Therefore, it is essential for all medical students to have good knowledge about HBV and to complete their HBV vaccinations.

Aims:

The aim of this study was to assess and compare HBV knowledge, awareness, and vaccination compliance among pre-clinical medical students in four universities.

Settings and Design:

A cross-sectional study was conducted in September 2018 at the College of Medicine of four governmental universities: King Saud Bin Abdulaziz University for Health Sciences, King Saud University, Princess Noura university, and Imam Mohammed bin Saud Islamic University, in Riyadh, Saudi Arabia.

Methods and Materials:

Two-hundred-sixty-three pre-clinical medical students completed a questionnaire with sections about demographics, HBV awareness, knowledge, and vaccination compliance.

Statistical analysis used:

The data was transferred to Excel and SPSS version 22 was used for statistical analysis. A significance level of P < 0.05 was considered statistically significant.

Results:

The overall knowledge about HBV and vaccination compliance were poor. KSU students had the highest vaccination compliance (n = 52, 54.2%) and KSAU-HS the lowest (n = 19, 23,8%). The most-cited reasons for noncompliance were “forgetting about the vaccine” and “busy schedule“.

Conclusion:

Overall, most of the participants had poor HBV knowledge and vaccine compliance. Therefore, we recommend the implementation of pre-clinical vaccine checking and the addition of an infectious disease awareness and prevention program.

Exploration of Knowledge, Attitude, and Practice Among Residents of Saudi Arabia Toward Hepatitis Viruses

Background and aim: Data available in the Kingdom of Saudi Arabia (KSA) about public knowledge, attitude, and practice (KAP) toward viral hepatitis infection are scarce. Such information is essential for designing effective intervention strategies for the prevention and control of viral hepatitis. This study aimed to assess the knowledge, attitude, and practice among residents of KSA toward hepatitis viruses. Methods: A cross-sectional descriptive study was conducted among 549 participants in Saudi Arabia. An electronic questionnaire (in Arabic) was used to measure the KAP of the participants. Data were analyzed using SPSS version 23 at significance level of .05. Results: Most of the 549 participants were Saudi citizens (96%; n = 527) and 26.6% (n = 146) of them were males and mostly from the western Saudi Arabia (72.9%; n = 400). Most participants did not hear about hepatitis viruses and showed low level of knowledge on viral hepatitis (42%). On the other hand, a positive attitude was apparent from participants' responses, and their practices were toward protecting their bodies from the infection. Conclusion: The level of knowledge about viral hepatitis was low (42%) among KSA residents, and the practice and attitude of the participants were toward avoiding the infection. Awareness campaigns are required to increase the public knowledge about viral hepatitis.

Hepatitis B vaccination status and knowledge, attitude, and practice regarding Hepatitis B among preclinical medical students of a medical college in Nepal

BACKGROUND

Hepatitis B imposes a major public health problem with an increased risk of occupational exposure among unvaccinated health care workers. This study was conducted to determine the Hepatitis B vaccination status, along with the knowledge, attitude, and practice regarding Hepatitis B, among preclinical medical students of a medical college in Nepal.

MATERIALS AND METHODS

This descriptive study was conducted among preclinical students of a medical college in Kathmandu, Nepal from 6th July to 14th July 2020. The whole sampling technique was used. Data were collected using a pretested, self-administered questionnaire which was emailed to individuals and analyzed with the statistical package for social sciences version-22.

RESULTS

A total of 181 students participated in the study out of 198, giving a response rate of 91.4%. Among the study participants, only 67 (37%) were fully vaccinated against Hepatitis B while 71 (39.2%) were never vaccinated. For the majority (74.6%) of the non-vaccinated participants, the main reason for not getting vaccination was a lack of vaccination programs. Half the study participants (n = 92, 50.8%) had good knowledge, attitude and practice regarding hepatitis B. The median knowledge, attitude and practice scores towards Hepatitis B were 61.00 (57.00-66.00), 20(18.00-21.00) and 21(19.00-23.00) respectively.

CONCLUSIONS

The majority of preclinical medical students were not fully vaccinated against Hepatitis B and only half of them had acceptable knowledge, attitude and practice towards Hepatitis B, which makes them vulnerable to the infection. This might represent the situation of not only Nepal, but also all South Asian countries, and creates concern about whether students take the vaccination programs seriously. Since unavailability of vaccination program is the main cause of non-vaccination, we strongly recommend the provision of the Hepatitis B vaccination program to the preclinical medical students.

A Survey on Medical, Dental, and Pharmacy Students' Knowledge, Attitude, and Practice about Hepatitis B Infection in a Private Medical University of Malaysia

Objective:

The present study aimed to assess the knowledge, attitude, and practice (KAP) of 3^rd- and 4^th-year medical, dental, and pharmacy students about hepatitis B (HB) infection at a private medical university, Malaysia.

Methods:

A cross-sectional, questionnaire-based study was conducted among 482 medical, dental, and pharmacy students of 3^rd- and 4^th-year degree program of Asian Institute of Medicine, Science and Technology University to assess their KAP about HB infection using 34 prevalidated questions by convenient sampling method. A questionnaire was administered to the students, and their responses were measured at “yes” and “no” scale. Students' responses were entered in SPSS version 22, and quantitative analysis was performed using descriptive statistics and nonparametric tests at P < 0.05.

Findings:

The medical, dental, and pharmacy students had good knowledge and practice with positive attitude about HB infection. Mann–Whitney U-test determined a significant difference in knowledge (P < 0.001) and practice (P < 0.001) scores between medical and pharmacy, attitude (P < 0.001) scores between medical and dental, and attitude (P < 0.001) and practice (P < 0.001) scores between pharmacy and dental students. Students' age was correlated with their attitude, practice, and KAP scores and family income with their knowledge, attitude, practice, and KAP scores.

Conclusion:

Although students' knowledge and practice were good with positive attitude, all the students did not participate in health education program, screening, and vaccination of hepatitis B virus (HBV) infection which makes them more vulnerable to occupational HBV infection. Hence, it is recommended to organize a regular health education program for the students on screening and vaccination against HBV to prevent its infection.

Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study

BACKGROUND

Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya's Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC).

METHODS

This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data.

RESULTS

Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC.

CONCLUSIONS

Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students.