Hepatitis B vaccination status and needle stick injuries among medical students in a Nigerian university

Blood borne infections and Hepatitis B virus immunization levels among medical students in India

BACKGROUND

Medical students are actively involved in direct patient care during their training and subsequent medical practice, making them susceptible to acquiring blood-borne pathogens, including HBV. This study aimed to assess the occurrence of blood-borne infections and the Hepatitis B immunization status among medical students. Furthermore, it sought to identify gaps in risk assessment for blood-borne pathogens among medical students at a Medical College in New Delhi.

METHODS

The study included 108 medical students who participated in a blood donation camp. Blood samples collected from these individuals underwent testing for blood-borne pathogens in accordance with standard screening protocols at the blood bank. The quantitative estimation was performed for anti-HBs IgG using ELISA.

RESULTS

All 108 participants were pursuing their undergraduate or postgraduate medical degrees. All students tested negative for HBsAg and HIV markers and showed no reactivity to Syphilis and Malaria. However, one student tested positive for HCV. Two postgraduate students had a history of needlestick injuries. Eighty-one (75%) students had received Hepatitis B vaccination. Among the vaccinated students, 34 (41.97%) were immunized before the age of five years, 22 (27.16%) after the age of five years, while 25 (30.86%) couldn't recall the exact age of their Hepatitis B vaccination. Protective anti-HBs titer of anti-Hepatitis B antibodies (>10 mIU/ml) were detected in 48.15% (52/108) of students.

CONCLUSIONS

Over 50% of medical students did not possess sufficient immunity against HBV infection, putting them at a heightened risk of acquiring HBV during their active participation in patient care in the near future. It is imperative to establish a policy for routine anti-HBs titer assessment and ensure easy access to Hepatitis B immunization for medical students, thereby enhancing their protection against this infectious agent.

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.

Hepatitis B vaccination coverage and associated factors among medical students: a cross-sectional study in Bosaso, Somalia, 2021

BACKGROUND

Hepatitis B virus (HBV) is a leading cause of liver cancer and remains a global public health concern. The risk of acquiring HBV is higher in HCWs than in non-HCWs. Medical students are considered a high-risk group because similar to HCWs, they tend to be exposed to body fluids and blood during training in clinical settings. New infections can be effectively prevented and eliminated with an increased coverage of HBV vaccination. The purpose of this study was to evaluate HBV immunization coverage and associated factors among medical students attending universities in Bosaso, Somalia.

METHODOLOGY

An institutional-based cross-sectional study was conducted. A stratified sampling method was employed to draw a sample from four universities in Bosaso. From each university, participants were selected using a simple random sampling technique. Self-administered questionnaires were distributed among 247 medical students. The data were analysed with SPSS version 21, and the findings are presented in tables and proportions. The chi-square test was used to measure statistical associations.

RESULTS

Although 73.7% of the respondents had an above-average knowledge level of HBV and 95.9% knew that HBV can be prevented by vaccination, only 2.8% were fully immunized, while 5.3% were partially immunized. The students reported six main reasons for not being vaccinated: unavailability of the vaccine (32.8%), high vaccine cost (26.7%), fear of vaccine side effects (12.6%), lack of trust in vaccine quality (8.5%), lack of awareness about where to get vaccinated (5.7%), and lack of time (2.8%). Occupation and the availability of HBV vaccination in the workplace were associated with HBV vaccine uptake (p values of 0.005 and 0.047, respectively).

CONCLUSION

HBV immunization coverage among medical students was extremely low (2.8%), indicating the urgent need for increased vaccination coverage in this population. This should start with evidence-based advocacy for the development of a clear national HBV elimination policy, followed by implementing effective, large-scale immunization strategies and interventions. Future studies should expand the sample size to include multiple cities for increased representativeness and conduct HBV titre tests among participants.

Low uptake of hepatitis B vaccination among healthcare workers in primary health facilities in Mwanza region, North-Western Tanzania

Background

Despite the availability of hepatitis B vaccines (HBV) in Tanzania, their uptake among healthcare workers (HCWs) in high-level facilities, such as tertiary hospitals where the vaccines are available, is low. However, their uptake among HCWs in primary health facilities remains understudied. The lack of this information limits the scaling up of HBV vaccination programs.

Methodology

A cross-sectional analytical study was conducted between June and July 2022 among HCWs in the Misungwi and Ilemela districts, which were purposefully selected. The sample size was calculated using the Taro Yamane formula, and data were collected using a self-administered questionnaire and analyzed using IBM SPSS^® version 25.

Results

A total of 402 HCWs were recruited, their mean age was 34.9 ± 7.77 years, and only 18% (76/402) reported being fully vaccinated. HCWs in Ilemela showed higher uptake (χ² = 23.64, df = 1, p = 0.00) of the vaccine than HCWs in Misungwi. Being male (aOR = 2.38, 95% CI 1.28-4.45, p = 0.006), working in an urban setting (aOR = 5.75, 95% CI 2.91-11.35, p = 0.00), and having an employment duration of more than 2 years (aOR = 3.58, 95%CI 1.19-10.74, p = 0.023) were significantly associated with higher odds of vaccination. Moreover, high perceived susceptibility to HBV infection (aOR = 2.20, 95% CI1.02-4.75, p = 0.044) and history of needle prick injuries (aOR = 6.87, 95%CI 3.55-13.26, p = 0.00) were significantly associated with higher odds of HBV vaccination.

Conclusion

Low uptake of HBV vaccine among HCWs in primary health facilities was observed with a noteworthy difference between rural and urban settings. Therefore, advocacy campaigns and resource mobilization toward the promotion of HBV vaccination in primary health facilities are pivotal.

Effect of educational intervention based on health belief model on nurses' compliance with standard precautions in preventing needle stick injuries

BACKGROUND

The increasing prevalence of needle stick injuries among nurses and the arising risks double the need to pay attention to improve their knowledge and change their behavior using effective educational models. The present study aimed to investigate the effect of educational intervention based on the health belief model on nurses' compliance with standard precautions in preventing needle stick injuries.

METHODS

This quasi-experimental study was conducted on 110 nurses working in medical training centers in Shiraz and Fasa in 2019. Subjects were selected using a simple sampling method and were randomly divided into two interventions (n = 55) and control (n = 55). The intervention included 7 sessions of 50-55 min. Before and 3 months after the intervention, the health belief model questionnaire was completed by both groups. The data were analyzed using SPSS software version 22 through chi-square, independent, and paired t-tests (P < 0.05).

RESULTS

Based on independent and paired t-tests, there was no significant difference between the control and intervention groups regarding the mean score of health belief model constructs before the intervention. However, there was a significant difference regarding the mentioned scores 3 months after the educational intervention. Based on the paired t-test, the mean score of awareness, perceived sensitivity, perceived severity, perceived benefits, self-efficacy, cues to action, and behavioral performance in the intervention group significantly increased after the educational intervention (P < 0.05). Also, there was a significant decrease in perceived barriers (P < 0.05).

CONCLUSION

It is recommended to apply the proposed model as an effective and cost-effective method along with other methods in training programs for nurses and other health workers exposed to invasive procedures, contaminated blood, and secretions.

Viral Hepatitis B and C: Knowledge Gaps and Patterns of Preventive Practices Among Medical Doctors in Rivers State, Nigeria

Introduction

Hepatitis B and C viruses can result in both acute and chronic hepatitis, ranging in severity from a mild acute disease to a serious, lifelong manifestation including liver cirrhosis and hepatocellular carcinoma. This study aims to determine the knowledge and attitudes of medical doctors in Rivers State, Nigeria, to hepatitis B and C as well as their practice for prevention and treatment of the same. We also assessed their practice of universal precaution, provision, and use of personal protective tools.

Methods

One hundred and fifty doctors in both the private and public sectors were interviewed using self-administered questionnaires on viral hepatitis B and C. The questionnaire explored their knowledge and status of vaccination, viral hepatitis treatment, and their practice of universal safety precautions. Their responses were analyzed using SPSS version 21. Data was expressed in means and percentages.

Results

Out of all participants, 96% were aware that viral hepatitis B is preventable, while 46% erroneously believed that there is vaccination against the hepatitis C virus. Only 50% of the respondents were aware of the availability of a cure for hepatitis C infection, and 16% of the participants knew about drugs used for its treatment. While 76% of the doctors had been vaccinated against hepatitis B virus, only 4% had received treatment after testing positive for hepatitis B. Furthermore, nearly all respondents admit practicing universal precaution, especially during venipuncture; however, protective measures such as disposable gloves were not readily available to 20% of our respondents. There was a statistically significant association between sex and duration of practice with knowledge of hepatitis B and C, as well as between practice type and vaccination status.

Conclusion

This study shows that knowledge of the treatment of viral hepatitis amongst healthcare practitioners such as doctors is poor, and although universal safety precautions are practiced, personal protective equipment is not readily available for use in our healthcare setting, placing healthcare workers at risk of infections. There is also a need to encourage vaccination amongst healthcare practitioners to protect them against contagious diseases like hepatitis B and C infections.

Exposure to Occupational Hazards among Health Care Workers in Low- and Middle-Income Countries: A Scoping Review

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.

Hepatitis B virus infection and associated risk factors among medical students in eastern Ethiopia

BACKGROUND

Hepatitis B virus (HBV) is a highly contagious pathogen that has become a severe public health problem and a major cause of morbidity and mortality, particularly in developing countries. Medical students are at high occupational risk during their training. However, no facility-based studies were found among medical students in eastern Ethiopia. Thus, this study aimed to investigate the seroprevalence of Hepatitis B Virus and associated factors among medical students in eastern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among 407 randomly selected medical students from March to June 2018. A pretested and structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. A 5ml blood was collected, and the serum was analyzed for Hepatitis B surface antigen (HBsAg) using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Outcome and explanatory variables were described using descriptive summary measures. Binary and multivariable logistic regression was conducted at 95% CI and an association at P-value < 0.05 was declared statistically significant.

RESULTS

The seroprevalence of hepatitis B virus surface antigen was 11.5% (95%CI = 8.6, 14.7). Poor knowledge of universal precaution guideline (AOR = 2.58; 95% CI = [1.35-4.93]), history of needle stick injury (AOR = 2.11; 95% CI = [1.07-4.18]) and never been vaccinated for HBV (AOR = 2.34; 95% CI = [1.17-4.69]) were found statistically significantly associated with HBsAg positivity after multivariate analysis.

CONCLUSION

Hepatitis B virus infection rate is high among health care trainees in eastern Ethiopia. Improvement at health care practice centers safety through training on universal precaution guidelines, and scaling up HBV vaccination is mandatory.

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.

Vaccine uptake and immune responses to HBV infection amongst vaccinated and non-vaccinated healthcare workers, household and sexual contacts to chronically infected HBV individuals in the South West Region of Cameroon

Background

HBV infection affects about 257 million people globally and Sub-Saharan Africa has the highest burden. The disease still constitutes a major public health problem despite the advent of preventive measures like the HBV vaccine. This study was aimed at identifying factors that influence vaccine uptake and the efficacy of administered vaccines among people at high risk of HBV infection.

Methods

This was a cross-sectional study conducted between January 2016 and December 2017. A pretested semi-structured questionnaire was used to capture information on sociodemographic and vaccination status from healthcare workers, household and sexual contacts to HBV infected people. HBV serological panel as well as quantitative anti-HBs ELISA test was done for all participants. Additional information was obtained from the institutions that administered the vaccines.

Results

A total of 265 participants with a mean age of 32.1±8.7 were enrolled. Eighty (30.2%) of them had received at least 1 dose of the HBV vaccine while 185 (69.8%) were unvaccinated. Healthcare workers were the most vaccinated (37%). Ignorance, negligence, fear of injection and the cost of the vaccine all contributed to poor vaccine uptake in the study population. Natural immunity was seen in 9 (3.4%) of the participants. Only 64.9% of the vaccinated participants attained the desirable level of anti-HBs (≥10mIU/ml) 1–2 months after ≥ 3 doses of the vaccine. Age, gender, obesity, alcohol and smoking were not significantly associated with poor immune responses. No standardized protocol was followed by the institutions administering the vaccine.

Conclusion

This study revealed very poor vaccine uptake and poor immune responses to the HBV vaccine in the study population and this should urge the health sector in Cameroon to intensify their sensitization on HBV vaccine, standardize the protocol for storing and administering the vaccine, subsidize the cost of the vaccine especially amongst healthcare workers and encourage anti-HBs post vaccination testing.

Hepatitis B and C: Seroprevalence, knowledge, practice and associated factors among medicine and health science students in Northeast Ethiopia

BACKGROUND

Health care professionals, especially medical students, are at greater risk of contracting hepatitis B and C virus infections due to their occupational exposure to percutaneous injuries and other body fluids. The aim of this study was to determine the seroprevalence of hepatitis B and C virus infections among medicine and health science students in Northeast Ethiopia and to assess their knowledge and practice towards the occupational risk of viral hepatitis.

METHODS

A cross-sectional study was conducted among a total of 408 medicine and health science students during the period from March to September 2017. A pre-coded self-administered questionnaire was used to collect data on students' socio- demographic characteristics, knowledge and practice of hepatitis B and C infections. Blood samples were collected and screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies. SPSS version 20 statistical software was used for data analysis.

RESULTS

The seroprevalence of HBV infection was 4.2% (95% CI 2.5 to 6.1%) and 0.7% (95% CI 0.0 to 1.7%) for HCV. Older age (AOR = 15.72, 95% CI 1.57-157.3) and exposure to needlestick injury (AOR = 3.43, 95% CI 1.10-10.73) were associated with a higher risk of HBV infection. Majority of the students (80.1%) had an adequate knowledge about hepatitis B and C infection, mode of transmission and preventive measures. Only 50.0% of students had safe practice towards occupational risk of viral hepatitis infection. Almost half (49.8%) of students experienced a needlestick injury; of which, 53.2% reported the incidence, and only 39.4% had screening test result for viral hepatitis.

CONCLUSION

A high seroprevalence but poor practice of hepatitis B and C virus infection was found in the study area despite their good knowledge towards occupational risk of viral hepatitis infection.

Perceptions and practice of health care workers regarding hepatitis B vaccination, Bouaké, Côte d'Ivoire, 2016

Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouaké, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P<0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P<0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs.

Risk perception of hepatitis B infection and uptake of hepatitis B vaccine among students of tertiary institution in Jos

Background:

Hepatitis B virus (HBV) Infection is endemic in Nigeria. Healthcare students are more vulnerable because of direct contact with patients’ body fluids and blood. Risk perception of HBV and HB vaccine uptake are also poor. The aim of this study was to assess the level of risk perception of hepatitis B infection, and uptake of the HBV vaccine, between medical and other students of the University of Jos.

Methods:

A comparative cross sectional study was conducted among 1,200 students of the departments of Medicine, Nursing sciences and Public Administration, University of Jos (400 from each arm) using a pretested self-administered questionnaire. A five point Likert scoring system was used to assess risk perception. Data was analyzed using SPSS version 20. A P -value of <0.05 was considered significant.

Results:

Awareness on HB vaccine prevention was high (88.4%) among University of Jos students. Awareness was similar among medical and nursing students (36.2% and 36.0% respectively) but lower among public administration student (27.8%), P < 0.001. The overall risk perception was 76.8%. This was also similar for medical and nursing students (40.7% and 40.1% respectively), but lower for public administration students (9.1%), P < 0.001. Risk perception is 5x higher among medical students compared to public administration students (OR = 5.22, 95% CI = 2.19 – 12.93; P < 0.001). The uptake of full dose HB vaccine was 60.2%, 20.6% and 15.1% for medical, nursing and public administration students respectively. Medical students are 4x more likely to go for HB vaccination compared with public administration students (OR=3.62; 95% CI=2.39 – 5.48; P < 0.001).

Conclusions:

Awareness and risk perception on HBV infection are high among University of Jos students, but uptake of HB vaccine is low. Findings are worst for non-health students.

Health-care workers' occupational exposures to body fluids in 21 countries in Africa: systematic review and meta-analysis

OBJECTIVE

To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa.

METHODS

Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis.

FINDINGS

Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week.

CONCLUSION

The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.

Knowledge, attitudes and practices toward prevention of hepatitis B virus infection among medical students at Northern Border University, Arar, Kingdom of Saudi Arabia

Background and aim

Health care workers’ risk of occupational exposure to HBV is a chief concern, particularly with young students in the health profession.

This study was carried out to assess the knowledge regarding symptoms, risk factors and prevention of hepatitis B virus infection among medical students.

Methods

A cross-sectional study was carried out from November 01, 2016 to May 30, 2017 on medical students at the Northern Border University (Arar, Kingdom of Saudi Arabia). Data were collected from 200 students from all academic years using pre-designed questionnaire which included questions designed to fulfill the study objectives.

Results

Regarding students’ knowledge about hepatitis B infection, 81% of them knew that carriers could transmit infection, 89.5% of them knew that it could not be spread by casual contact, 80% by contact with open wound, 96.5% by contaminated blood and body fluids, 92.5% by unsterilized syringe, needle and surgical instruments and 79.5% by unsafe sex. In total, 86.5% of students knew that a vaccine could prevent HBV infection, 95% knew it had been laboratory tested, 64% knew HBV had post exposure prophylaxis and only 55% knew that it could be cured. In all, 75.5% of students knew that HBV caused liver cancer. Regarding attitude, 23% of students said they had no concern of being infected with HBV, 86.5% agreed that HBV vaccine was safe and effective and 90% believed that following infection, control guidelines would protect them from being infected by HBV at work. Regarding practice, only 56.5% of students had screened for HBV infection 22% had had a needle prick injury but 68% would report that injury. Furthermore, 69.5% have received HBV vaccine but only 38% of them had received 3 doses.

Conclusion

The students’ knowledge of the hepatitis B virus was found to be good. We recommend improving knowledge, attitude and practice of the public as well as students, through health education campaigns and settings.

Hepatitis B virus seroprevalence among Malawian medical students: A cross-sectional study

BACKGROUND

Hepatitis B virus (HBV) predominantly spreads through contact with infected blood or other body fluids and causes liver disease. HBV vaccination for students at the College of Medicine, University of Malawi, is done without screening for the virus. It is important to assess the prevalence of HBV antigens among foundation-year students in order to consolidate evidence in support of HBV screening before vaccination. The aim of this study was to determine the seroprevalence of HBV antigens among 2013-2014 foundation-year students at the University of Malawi College of Medicine.

METHODS

A prospective cross-sectional descriptive study was conducted among 2013-2014 foundation year students at the Malawi College of Medicine. Out of the 234 foundation-year students, written consent was obtained from 89 students. Venous blood samples were collected and tested for HBV surface antigen using SD Bioline immunochromatographic rapid assays.

RESULTS

Out of the 62 (69.7%) male students, none tested HBV-positive, and out of 27 (30.3%) female students, none were seropositive. This suggested the absence of HBsAg among students or presence of HBsAg levels below detectable limits.

CONCLUSIONS

This study showed levels of HBsAg below detectable limits among healthy young adults in Malawi. HBV screening for medical students should further be assessed to ensure adequate protection before they are assigned clinical duties. These findings provide enough grounds to agitate for further surveys to support the establishment of a universal HBV immunisation programme in Malawi.

Assessment of knowledge, attitudes and practices toward prevention of hepatitis B virus infection among students of medicine and health sciences in Northwest Ethiopia

Background

Hepatitis B virus (HBV) infection in the health setting is a global public health problem. The risk of occupational exposure to HBV among health care workers is a major concern, especially among students in health professions. In Ethiopia, very little is known about the knowledge, attitude, and practices (KAP) of trainees in the health professions towards occupational risk of HBV. Thus, the aim of this study was to assess the level of KAP of medicine and health Sciences students in Northwest Ethiopia towards occupational risk of HBV infection.

Methods

A cross-sectional study was conducted from February 2015 to June 2015. A total of 246 students of health care professions were included into the study using a systematic random sampling technique. Data were collected using self-administered structured questionnaire and analysed by using SPSS version 20.

Results

Majority of the study participants, (>80 %) had an adequate knowledge on risk factors for HBV, its mode of transmissions, and preventions. Two hundred of 246 (83.3 %) participants had positive attitude towards following infection control guidelines, and 201 (81.7 %) respondents believe that all HCWs should take HBV vaccine. However, only 5 (2 %) students had completed the three doses schedule of HBV vaccination. Whereas, a significant number of students, 66 (26.8 %), had been exposed to blood/body fluid via needle stick injury at least once since they started their training in the health facility.

Conclusions

Our study found that trainees in health profession are at a very high risk of contracting HBV infection during their training owing to the low HBV vaccine uptake rate and high rate of accidental exposure to blood. Thus, we recommend that all students in the health profession should be vaccinated prior to their entry into professional practices.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-016-2216-y) contains supplementary material, which is available to authorized users.

Hepatitis B infection awareness, vaccine perceptions and uptake, and serological profile of a group of health care workers in Yaoundé, Cameroon

Background

Cameroon is one of the countries in Africa with the highest burden of Hepatitis B infection. Health care workers are known to be at risk of occupational exposure to blood and other infectious bodily fluids. The aim of this study was to assess the profile of serological markers of hepatitis B virus (HBV) infection, knowledge and perceptions regarding HBV infection among health care workers in a health area in Yaoundé.

Methods

A cross-sectional study was conducted in the Mvog-Ada Health Area of the Djoungolo Health District from March 1 to November 31, 2014. All consenting health care workers were included in the study. Serological markers of HBV (HBs Ag, Hbe Ag, anti-HBs Ab, anti-HBe Ab, anti-HBc Ab) were qualitatively tested using Biotech®(OneHBV-5 parameter rapid test website) in each participant and the anti-HBs antibodies were quantified by ELISA (Biorex) among those who were positive with the qualitative test. Chi square test or its equivalents were used to compare qualitative variables and a p-value less than or equal to 0.05 was considered significant.

Result

A total of 100 participants were retained for the study out of 163 in the health area giving a response rate of 61.34 %; the mean age was 30.5 (SD 6.8) years and 71 % of participants were women. Forty seven percent (47 %) of workers had good level of knowledge of HBV infection. The men were 3.20 times (95 % CI: 1.02–9.19, p = 0.04) more likely to have a good level of knowledge than women. Participants with a university study level were more (95 % CI: 3.17–25, p < 0.0001) likely to have a good level of knowledge than those with a high school study level. Ninety-six percent of participants thought that they were at a greater risk of becoming infected with HBV than the general population, 93 % felt that the vaccine should be compulsory and all (100 %) were willing to recommend it to others. However, only 19 % had received at least one dose of the vaccine. The proportion of HBs Ag was 11 %. The different serological profiles with regard to HBV infection were naive subjects (62 %), chronic carriers (11 %), vaccinated (19 %) and subjects naturally immunized (8 %). Three out of the 19 participants who received at least one dose of the vaccine, only 9 (47.4 %) of whom had titers ≥100 IU/l indicating a good response to vaccination. Among those who received three doses of the vaccine (n = 12, 63 %), 2 (16, 66 %) had poor response to vaccination (HBs Ab titers < 100 IU/l).

Conclusion

The prevalence of HBs Ag among health care workers in the Mvog-Ada Health Area is high (11 %). These workers are at high risk of HBV infection because of very low vaccine uptake and poor post-exposure practices. Their knowledge of HBV infection is non-optimal.

Health care workers in Pearl River Delta Area of China are not vaccinated adequately against hepatitis B: a retrospective cohort study

BACKGROUNDS

Health-care workers' (HCWs) exposure to bodily fluids puts them at risk of hepatitis B virus HBV infection. This study investigated HBV vaccination practices and outcomes in HCWs and assessed postvaccination seroprotection across HCWs in different departments.

METHODS

A survey of HCWs in a Chinese public general hospital was carried out with a retrospective cohort of 1420 hospital HCWs (458 males and 962 females). HBV vaccination status (10-μg/dose used) was investigated in the cohort from vaccination records from the period of 1988 to 2008. Blood samples were collected and tested for hepatitis B surface antigen (HBsAg) and HBV antibodies (anti-HBs).

RESULTS

The overall vaccination (complete course) and HBsAg carrier rates among HCWs were 40.42 % (574/1420) and 6.13 % (87/1420), respectively. Vaccination rates differed by department, with HCWs in internal medicine (39.5 %) and emergency (42.0 %) departments having particularly low rates. The natural infection rate was 7.53 % (107/1420) among HCWs. HCWs in the department of infectious diseases (vaccination rate, 57.8 %) had the highest rate of antibody produced by natural infection (88.2 %).

CONCLUSION

The vaccination rate was a disappointingly low among HCWs in Pearl River Delta Area of China. HCWs working in infectious diseases departments and technicians were at particularly likely to have been infected with HBV. A concerted effort is needed to bring vaccination rates up among Chinese HCWs in Pearl River Delta Area of southern China.

Knowledge of Hepatitis B Virus Infection, Immunization with Hepatitis B Vaccine, Risk Perception, and Challenges to Control Hepatitis among Hospital Workers in a Nigerian Tertiary Hospital

Background. Studies had reported high rate of hepatitis B infection among hospital workers with low participation in vaccination programmes, especially those whose work exposes them to the risk of HBV infection. The study assessed knowledge of hepatitis B virus infection, risk perception, vaccination history, and challenges to control hepatitis among health workers. Methods. A descriptive cross-sectional study. Consenting health care workers completed a self-administered questionnaire that assessed respondents' general knowledge of HBV, vaccination history and HBsAg status, risk perception, and challenges to control hepatitis. Data was analysed using descriptive and inferential statistics. Results. Three hundred and eighty-two health care workers participated in the study. There were 182 males and 200 females. The respondents comprised 94 (25%) medical doctors, 168 (44%) nurses, 68 (18%) medical laboratory technologists, and 52 (14%) pharmacists. Over 33% had poor knowledge with 35% not immunized against HBV. Predictors of good knowledge include age less than 35 years, male sex, being a medical doctor, previous HBsAg test, and complete HBV immunisation. Identified challenges to control hepatitis include lack of hospital policy (91.6%), poor orientation of newly employed health workers (75.9%), and low risk perception (74.6%). Conclusion. Hospital policy issues and low risk perception of HBV transmission have grave implications for the control of HBV infection.

Occupational exposure to blood, hepatitis B vaccine knowledge and uptake among medical students in Cameroon

BACKGROUND

Hepatitis B virus (HBV) is the most contagious blood borne pathogen. The risk of occupational exposure to HBV among health care workers is a major concern, especially medical trainees. In this study we describe the knowledge of risk factors for HBV infection, history of accidental exposure to blood, awareness of HBV vaccine and the vaccination status among medical students in Cameroon.

METHODS

In April 2012, a cross-sectional survey was carried out using a pretested self-administered questionnaire among 111 medical students.

RESULTS

Sixty-two students (55.9%) had had at least one accidental exposure to blood since the beginning of their medical training, with a median of 2 (IQR, 1-3) exposures. There was a good knowledge of the risk factors for HBV infection and awareness of HBV vaccine among participants. However, only 20 (18%) participants had completed the three doses of primary HBV vaccination. Furthermore, only 2 of the 20 (10%) adequately vaccinated participants had a post-vaccination test to confirm a good immune response and thus an effective protection against HBV infection. The main reason for not being vaccinated was lack of money to pay for the vaccine (45.6%). Forty seven (42.3%) participants had been sensitized by their training institutions about the importance of HBV vaccination. These were more likely to be vaccinated compared to those who had not been sensitized (p<0,001).

CONCLUSION

There is a high rate of accidental exposure to blood and a very low HBV vaccination uptake in medical students in Cameroon, leading to a high occupational risk of HBV infection. HBV vaccination should be strongly recommended for medical students and the vaccine made available free of charge at the beginning of their training.

[Hepatitis B: cross-sectional study of knowledge and immunization among students at University of Cocody, Ivory Coast]

BACKGROUND

To evaluate knowledge about hepatitis B and vaccination coverage among students at Cocody's University, Ivory Coast.

MATERIALS AND METHODS

A cross-sectional study was conducted during the academic year 2005-2006 (2557 students). Parameters were collected by interview using a survey chart. Factors influencing knowledge and vaccination against hepatitis B were analyzed by logistic regression.

RESULTS

The majority of students (n=1174, 69.4% [95% CI 68-71]) knew about hepatitis B. Only 17.5% and 26.1% of students respectively were aware of sexual and blood transmission. None of the students were aware of maternal-fetal transmission. Factors associated with knowledge of hepatitis B were enrollment in health sciences (Odds Ratio=24.19 [95% CI 8.65-76.63]) and having a scholarship (Odds Ratio=2.34 [95% CI 1.54-3.56]). Vaccination coverage against hepatitis B was low (Odds Ratio=3.7% [95% CI 3-4]). Factors associated with vaccination were: knowledge of hepatitis B (Odds Ratio=6.83 [95% CI 4.57-10.27]), enrollment in health sciences (Odds Ratio=3.59 [95% CI 2.60-4.96]), marriage (Odds Ratio=2.04 [95% CI 1.13-3.64]) and having a scholarship (Odds Ratio=1.60 [95% CI 1.09-2.35]).

CONCLUSION

Knowledge and vaccination coverage against hepatitis B among students at Cocody's University is low. Students should be given information about hepatitis B and access to free vaccination. Students enrolled in health sciences should be vaccinated before admission because of specific risks of contamination, for themselves and for their patients.

Hepatitis B and C: neglected diseases among health care workers in Cameroon

BACKGROUND

Healthcare workers (HCW) are at risk of acquiring blood-borne viral infections, particularly hepatitis B (HBV), hepatitis C (HCV), and HIV, especially in high endemic regions such as sub-Saharan Africa.

METHODS

Sera from 237 hospital workers in Southwest Cameroon were tested for anti-hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antigen (anti-HBs), anti-HCV and (on a voluntary basis) for anti-HIV. Information on pre-study testing for HBV, HCV and HIV and pre-study HBV vaccination status was collected from these individuals.

RESULTS

The pre-study testing rate among participating hospital staff for HBV was 23.6% (56/237), for HCV 16% (38/237), and for HIV 91.6% (217/237). The pre-study HBV vaccination rate was 12.3% (29/237). Analysis of anti-HBc revealed that 73.4% (174/237) of the hospital staff had been infected by HBV. Active HBV infection (HBsAg positivity) was detected in 15 participants. Anti-HCV was found in four of 237 participants, HIV antibodies were detected in four of 200 participants tested.

CONCLUSION

HBV and HCV are neglected diseases among HCW in sub-Saharan Africa. The vaccination rate against HBV was very low at 12.3%, and therefore anti-HBc testing should be mandatory to identify HCW requiring HBV vaccination. Testing for HBV and routine HBV vaccination for HBV-negative HCW should be strongly enforced in Cameroon.

Hepatitis-B vaccination status among dental surgeons in benin city, Nigeria

BACKGROUND

The development of success-oriented hepatitis-B vaccine uptake approach among dental surgeons is dependent on the availability of comprehensive baseline data.

OBJECTIVE

To determine the hepatitis-B vaccination status among dental surgeons in Benin City.

MATERIALS AND METHODS

This questionnaire-based cross-sectional study of dental surgeons in Benin City was conducted in May 2011. The questionnaire elicited information on demography, occupational risk rating of contracting hepatitis-B infection, hepatitis-B vaccination status, barriers to uptake of hepatitis vaccine, and suggestions on how to improve hepatitis-B vaccination rates among dental surgeons.

RESULTS

Participation rate in the study was 93.3%. More than half (51.4%) of the respondents were 20-30 years old and 52 (74.3%) were males. The occupational risk of contracting hepatitis-B infection among dental surgeons was rated as either high or very high by 51 (72.9%) of the respondents. Amongst the respondents, 14 (20.0%) had received three doses of the hepatitis-B vaccine, 34 (48.6%) either two doses or a single dose, and 22 (31.4%) were not vaccinated. The major barriers reported among the respondents who were not vaccinated were lack of opportunity and the fear of side effects of the vaccines. The suggested ways to increase the vaccination rate among the respondents in descending order include: Making the vaccine available at no cost (51.4%), educating dentists on the merits of vaccination (17.1%), and using the evidence of vaccination as a requirement for annual practicing license renewal (14.3%) and for the employment of dental surgeons (11.4%) and others (2.9%).

CONCLUSION

This study revealed low prevalence of complete hepatitis-B vaccination among the respondents. Improvement in uptake following the respondents' recommendations will serve as a template in developing success-oriented strategies among stakeholders.