Study of hepatitis B among different categories of health care workers.

OBJECTIVE

To estimate the frequency of hepatitis B virus (HBV) infection among different categories of health care workers (HCWs) so as to identify groups and areas requiring special attention for the prevention of occupational transmission of bloodborne infections.

DESIGN

A cross-sectional study.

PLACE AND DURATION OF STUDY

The study was conducted in Bir Hospital, the central referral hospital of Nepal from December 2001 to February 2002.

PATIENTS AND METHODS

A total of 145 HCWs were selected by random allocation and blood samples were tested for HBV surface antigen (HBsAg), surface antibody (anti-HBs) and core antibody (anti-HBc). Multivariate analysis was done, including calculation of odd ratios for HBV infection by each variable of interest, like age, sex, HCW category, history of blood transfusion and vaccination status.

RESULTS

Anti-HBc was positive in 14.5% and HBsAg in 1.4% of HCWs. 20.9% of non-professional staff, 19.2% of nurses, 5.6% of laboratory workers and 3.1% of doctors had evidence of past or present HBV infection. 48.9% of HCWs, with only 16.7% of laboratory workers and 27.9% of non-professional staff, had received a full course of HBV vaccination. The significant risk factors associated with past or present HBV infection were lack of hepatitis B vaccination (p<0.05) and two HCW categories, nurses (p<0.05) and non-professional staff, who clean the used instruments (p<0.05).

CONCLUSION

Apart from lack of hepatitis B vaccination, nurses and non-professional staff on their own were found to be significantly more susceptible to HBV infection than others. This highlights the need to implement the internationally recommended measures to protect HCWs from bloodborne infections.